RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02309
BRANCH OF SERVICE:  nAVY 	SEPARATION DATE:  20040808

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, LAMPS MK III System Organizational Apprentice Maintenance Technician, medically separated for “chronic left hip pain” with a disability rating of 10%.

CI CONTENTION:  “Review all conditions.”  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting or non-compensable.  Any conditions outside the Panel’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military Records.  Furthermore, the panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical conditions at the time of separation.  The panel has neither the role nor the authority to compensate for progression or complications of service connected conditions after separation.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The panel gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20040420	VARD - 20090218	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Hip Pain	5255	10%	Bursitis of the Left Hip	5019	10%	20081224	
Depressive Disorder	Not Unfitting	Major Depressive Disorder	9434	50%	20081224	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  60% 	

ANALYSIS SUMMARY:  

Chronic Left Hip Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left hip condition began in January 2002 after without specific injury.  Despite treatment, the condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for an MEB.  At the 19 May 2003 LIMDU examination, 15 months prior to separation, noted complaints of continued significant hip pain, to the point where he was having a difficult time walking.  Physical examination showed the patient to be without any gross malalignment deformities.  There was some swelling in the upper thigh area around the hip on the left side.  He had tenderness of the gluteal muscles and into the greater trochanter area of the hip.  He had good range of motion of his hip, with pain at the extremes of his range of motion (ROM) radiating into the groin area.  The 13 February 2004 MEB NARSUM examination, 6 months prior to separation, noted complaints significant hip pain requiring a cane to walk, and only very limited distances.  He was unable to run, climb stairs or ladders.  Physical examination showed the CI walked with an antalgic gait using a cane.  He had pain with flexion, extension, internal and external rotation of the left hip.  He had good motor control of his lower extremity with no demonstrated weakness or sensory loss.  His physical examination was otherwise within normal limits.  The 24 December 2008 VA Compensation and Pension (C&P) evaluation, performed over 4 years after separation, was too remote and offers little to no probative value.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip condition 10%, coded 5255 (femur, impairment of), as slight hip disability.  The VA also rated the left hip condition 10% coded 5019 (bursitis), based on the C&P examination 4 years after separation, citing limitation of forward motion.  The MEB physical noted good left hip ROM with pain at the extremes of his ROM.  At the NARSUM examination was normal with the exception of an abnormal gait and pain with the movement of his left hip.  There was no limitation of flexion or extension that supported a rating under the VASRD diagnostic codes for limitation of motion (5251 or 5252).  There was no limitation of abduction or adduction or rotation that supported a rating under the VASRD diagnostic codes for limitation of motion (5253).  There was no hip flail joint that supported a rating under the VASRD diagnostic code (5254).  There was evidence of painful motion of the left hip with functional loss to support a 10% rating (based on §4.59, §4.40 and §4.45).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the chronic left hip pain condition.  

Contended PEB Conditions:  Depressive Disorder.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The contended condition was not profiled or implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the chronic left hip pain condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended depressive disorder condition, the panel unanimously recommends no change from the PEB determination as not unfitting.  There are no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150602, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44

      In accordance with reference (a), I have reviewed the cases listed below and approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN

		
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