RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00485
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070730

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

CI CONTENTION:  The CI contended his back condition.  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 PEB - 20070613	VARD - 20071031	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain	5003	10%	Right Hip Strain	5299-5252	0%	20071022	
RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10% 	

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 August 2006 while bending over to pick up something.  He denied other any specific injury or trauma; however, at a subsequent examination, he noted a similar episode over 2 years earlier after a skateboard accident.  He was treated with medications and duty limitations without resolution of the pain.  An X-ray of the right hip on 28 August 2006 was negative (for pathology).  A bone scan on 22 September 2006 showed stress changes of the hips, ankles, and feet but was negative for the hips.  X-rays of the lumbar spine on 21 November 2006 were also negative.  The CI was evaluated by orthopedics on 30 January 2007 and reported pain free intervals.  Other than tenderness over the right hip, the examination was basically normal including gait.  

The CI was seen in primary care on 22 February 2007, 5 months prior to separation, and reported ongoing pain.  On examination, the gait, motor function, and range of motion (ROM) were normal.  The right hip was tender over the greater trochanter (hip bone).  This note was apparently used in lieu of a formal MEB NARSUM examination.  

At the 22 October 2007 VA Compensation and Pension (C&P) evaluation, 3 months after separation, the CI reported that he could walk 1-3 miles and stand 3-8 hours with only a short rest period.  On examination, he had a normal gait.  The ROM showed flexion of 125 degrees (normal), extension of 15 degrees (20 is normal), normal abduction at 45 degrees, and adduction limited to 30 degrees (normal is 45 degrees).  The ability to cross his legs and out toe over 15 degrees was preserved.  Painful motion was present in some planes.  The right hip was normal on X-rays.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 10%, coded 5003 (arthritis, degenerative).  The VA rated the right hip condition 0%, analogously coded 5252, (thigh, limitation of flexion), citing a non-compensable evaluation.  Both the X-rays and bone scan were negative for disease of the right hip.  Thus, a compensable rating under 5003 is not supported by the evidence.  Painful motion was present which would support a 10% rating in the presence of arthritis.  This is not supported by the evidence nor was it a diagnosis made by the PEB.  The panel also considered the codes 5251 (limitation of extension), 5252 (limitation of flexion), 5253 (limitation of abduction, leg crossing, or out-toeing), but no route to a compensable rating was supported by the evidence.  The evidence supported a 0% rating as adjudicated by the VA.  However, the panel does not recommend a combined rating lower than that adjudicated by the PEB.  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 right hip pain 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 20160808, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-00485.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  The Board recommended no re-characterization or modification of your separation.

I carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  I accept their recommendation that your application be denied.

Sincerely,

Attachment:
Record of Proceedings