RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	  CASE:  PD-2015-02533
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20081028

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Human Resource Specialist, medically separated for “chronic right hip pain” with a  disability rating of 10%.  

CI CONTENTION:  The CI attached 20 pages to her application which was reviewed by the panel and considered in its recommendation.  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 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 FPEB - 20080923	VARD – 20081029	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain	5299-5255	10%	Fracture, Right Pubic Ramus		10%	Pre-Discharge	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Right Hip Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right hip condition began in March 2007 with right groin pain without specific trauma or injury reported.  Radiographic (X-ray) in April 2007 was consistent with a stress fracture of the right inferior pubic ramus.  X-ray in January 2008 showed bony changes (sclerosis) in the same area, with bone scan in February 2008 showing healing right inferior pubic ramus fracture.  

At the July 2008 MEB examination (recorded on DD Forms 2807 and 2808), 3 months prior to separation, the CI reported a fracture of her pelvic bone in Basic Training with persistent pain when running and standing for long periods, or activity, and also related back pain (with scoliosis).  Physical examination showed tenderness to the right pubic ramus with no masses, guarding or rebound.  

The 1 July 2008 MEB NARSUM examination, 3 months prior to separation, noted complaints of persistent pain from a stress fracture of the right inferior pubic ramus.  Physical examination showed tenderness over the right pubis ramus, without other tenderness.  There was no tenderness of the hips and no pain with hip movements.  The CI had a normal gait and examination of the back showed no tenderness, spasm or abnormal contour.  Lower extremities had no neurovascular deficits.  

The 18 September 2008 Medical Board Clinic evaluation, 1 month prior to separation, showed right hip range of motion (ROM) was painful with flexion limited to 100 degrees (normal 125) and other axis of movement painful without significantly limited motion.  There was a normal gait and no motor or muscle dysfunction was noted.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the hip condition 10%, coded 5299-5255 (femur, impairment), citing no response to conservative measures and functional loss.  There were no VA records proximate to separation in evidence and the CI did not consent to release of VA records.  However, the CI supplied a copy of the VA medical records problem list and a VARD dated 12 July 2013 (greater than 4 years after separation) showing evidence of a 10% rating for the CI’s hip condition, citing a VA C&P pre-discharge examination.

Regarding rating the right hip pain condition, the panel considered VASRD §4.67; there were no residuals of faulty posture, painful lumbar spine motion, tenderness, sciatic neuritis or peripheral nerve injury, in the treatment record proximate to separation, and rating for the right hip was predominant.  The MEB and Medical Board Clinic examinations documented evidence of painful right hip motion which supported the 10% rating awarded by the Formal PEB.  There was no compensable limitation of right hip motion under codes 5250 thru 5253 to support any 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 right hip condition.  

BOARD FINDINGS:  In the matter of the chronic right hip pain condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There are 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 20151110, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20170013314, XXXXXXXXXXXXXXXXXXX. 

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	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,					      
						      					
Enclosure