RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX		CASE: PD-2015-02472 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20070904

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Basic Trainee, medically separated for “left inferior pubic rami stress fracture” 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 condition(s) at the time of separation. The panel has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions. 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 - 20070817		VARD - NA	
Condition	Code	Rating		Condition	Code	Rating	Exam	
Left Inferior Pubic Rami Stress Fracture	5099-5003	10%		No VA Exam in Evidence	
COMBINED RATING: 0%		COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Left Inferior Pubic Ramus Stress Fracture. According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the left pubic ramus stress fracture began in March 2007 during Basic Combat Training with no history of traumatic injury. Radiographic imaging (X-ray and bone scan) in May 2007 documented an inferior pubic ramus stress fracture with healing. Two primary care visits in May and June 2007 and three physical therapy (PT) visits in June and July 2007 documented full hip range of motion (ROM). Four of these visits documented painful motion. The 18 July 2007 MEB NARSUM, 6 weeks prior to separation, noted the use of daily narcotics for control of pain occurring “80% of the…day.” The physical examination, showed tenderness in the inguinal area and lateral hip (over the greater trochanter).  ROM measurements showed flexion to 110 degrees (normal 125), extension to 0

degrees (normal 20), external rotation  (‘out toeing’) greater than 15 degrees (normal 45), abduction to 25 degrees (normal 45), and adduction (‘cross legs’) to 40 degrees (normal 45) without difficulty. Strength and sensation was normal. She was ambulating with crutches. Painful motion was not addressed. There was no VA examination in evidence proximate to separation.

The panel directed attention to the rating recommendation based on the above evidence. The PEB rated 10% for the pubic ramus fracture condition, coded 5099-5003 (arthritis, degenerative), citing the US Army Physical Disability Agency pain policy. Application of VASRD §4.59 (painful motion), was supported by STR documentation (painful motion and mechanical limitations) for a 10% rating as adjudicated by the PEB. There was no STR evidence of ankylosis (5250), abduction limited to 10 degrees (5253), or flexion limited to 30 degrees (5252) to support a higher rating. None of the other hip/thigh joint codes (5254, 5255) were applicable to this case and would not have resulted in a higher rating. 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 left pubic ramus fracture condition.

BOARD FINDINGS:   In the matter of the left pubic ramus fracture condition and IAW VASRD
§4.71a, the panel unanimously recommends no change in the PEB adjudication. There were no other conditions within the panel’s scope of review for consideration. The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20151019, w/atchs Exhibit B. Service Treatment Record

AR20170013242, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,	

2	PD-2015-02472