RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00312
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20020905

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Helicopter Repairer, medically separated for “healed right iliac bone fracture” with a disability rating of 0%.

CI CONTENTION:  The CI contends his knees and shoulder were not considered by the MEB/PEB.  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 - 20020520	VARD - 20030404	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Healed Right Iliac Bone Fracture	5299-5294	0%	Status Post Fracture of the Pelvis, with Residual Scar	5299-5298	0%	20021202	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Healed Right Iliac Bone Fracture.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s pelvic fracture occurred in January 2002 while snowboarding.  The CI underwent surgery on 9 January 2002 for open reduction and internal fixation (ORIF) of the pelvic fracture.  Radiographs of the pelvis in February 2002 showed healing right iliac stress fracture status ORIF and pubic symphysis separation maintained with metallic plates and screws.  The hardware was intact and the sites were all anatomically reduced.    

The 28 March 2002 MEB NARSUM examination, 7 months prior to separation, noted complaints of pelvic fracture with anterior thigh numbness secondary to local nerve injury due to the accident and/or surgical repair.  Physical examination showed well healed surgical incisions.  There was decreased sensation in the distribution of the anterior femoral cutaneous nerve.  Hip range of motion (ROM) was 120 degrees flexion (normal 125), 70 degrees abduction (normal 45), and external rotation 70 degrees (normal 80) bilaterally.  Strength was 5/5, except for mild hip flexor weakness graded 4/5 due to muscle weakness and mild pain.  

At the 2 December 2002 VA Compensation and Pension (C&P) evaluation, 3 months after separation, the CI reported occasional pain in the anterior pelvis (symphysis pubis) and some pain in the anterior right thigh after prolonged sitting.  The VA examiner noted that it appeared to be non-disabling as the CI seemed to have full function and was very active, with no difficulty walking.  Physical examination showed a normal gait.  There was normal ROM of both hips without pain.  Muscle strength and bulk was normal.  There was “slight” tenderness to palpation of the soft tissues of the right hip and the anterior pelvis (pubis).

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the pelvic fracture 0%, coded 5294 (sacroiliac injury and weakness), citing a normal physical examination except for an area of decreased sensation of the right thigh.  The VA also rated the pelvic fracture 0% coded 5298 (coccyx, removal of), based on the VA C&P examination 3 months after separation, citing “full range of motion of both hips and normal function of the lower extremities.”

The panel must make its rating recommendation based on the VASRD rules in effect on the date of separation.  There were “slight subjective symptoms” for a 0% rating under 5294 as adjudicated by the PEB.  There was no evidence of characteristic pain on motion for the next higher 5294 rating of 10%.  There was no limitation of right hip motion which supported a rating under the diagnostic codes for limitation of thigh flexion or extension, thigh impairment (5251, 5252, 5253) and there was no evidence of painful hip motion supporting a 10% rating (based on §4.59, §4.40 and §4.45).  There was therefore no route to a rating higher than the 0% adjudicated by the PEB under any applicable VASRD §4.71a code.  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 healed right iliac bone fracture condition.  

BOARD FINDINGS:  In the matter of the “healed right iliac bone fracture” 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 20160520, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

	

AR20170015265, 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,					      
						      					
Enclosure