RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02596
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090702

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Satellite Communications Systems Operator-Maintainer Trainee, medically separated for “bilateral femoral anteversion with chronic hip pain,” rated 10% and 10%, respectively, with a combined disability rating of 20%.

CI CONTENTION:  “I have more issues with hips.”  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 - 20090528	VARD – No VA Claim	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Femoral Anteversion with Chronic Hip Pan	5099-5003	20%		
COMBINED RATING:  20%	COMBINED VA RATING: N/A	

ANALYSIS SUMMARY:  

Bilateral Femoral Anteversion with Chronic Hip Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral hip pain condition began as a child and was treated with physical therapy.  By age 10 he was no longer symptomatic.  Pain began again intermittently in basic training but became constant in January 2009 after taking an Army Physical Fitness Test (APFT).  There was no surgical indication and the CI’s condition could not be adequately rehabilitated.  

The 7 May 2009 MEB NARSUM examination, 2 months prior to separation, noted complaints of right greater than left hip pain that was increased with any running, jumping or other impact activities.  Physical examination showed a normal stance and gait.  The right hip demonstrated flexion to 85 degrees (normal 125), extension 10 degrees (normal 20) and abduction to 25 degrees (normal 45).  The examiner noted that the decreased range of motion was secondary to pain only suggesting painful motion.  The left hip exhibited flexion to 95 degrees (normal 125), extension 10 degrees (normal 20) and abduction to 35 degrees (normal 45).  Again, the examiner noted that the decreased range of motion was secondary to pain only suggesting painful motion.  

There was no VA examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral hip pain condition 10% for each hip for a combined 20%, coded 5099-5003 (analogous to arthritis, degenerative), citing painful motion.  

The findings supplied from the X-rays completed 11 February 2009 of bilateral hips did not show evidence of arthritis to support a rating using code 5003 (arthritis, degenerative).  The panel agreed that there was insufficient limitation of range of motion to provide a minimum rating using VASRD codes 5251 (thigh, limitation of extension of), 5252 (thigh, limitation of flexion of) or 5253 (thigh, impairment of).  In addition, there was no indication of a flail joint of the hip to support an 80% rating using code 5254, ankylosing of the hip to support a 60% rating using code 5250 or malunion of a femur fracture to support a 10% or higher rating using code 5255.  The panel did find that there was sufficient evidence of painful motion (VASRD §4.59) to support a minimum 10% rating using code 5099-5003.  

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 bilateral femoral anteversion with chronic hip pain condition.  

BOARD FINDINGS:  In the matter of the bilateral femoral anteversion with chronic 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 re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20151220, w/attachments
Exhibit B.  Service Treatment Record

AR20170013342, 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