RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00663
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20040511

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Air National Guard E8, Services, medically separated for “right hip degenerative joint disease” with a disability rating of 20%.  

CI CONTENTION:  No specific contention made.  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 – 20040308	VARD - 20050228	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip Degenerative Joint-Disease…	5255	20%	Chronic Right Hip Strain…	5255	20%	20040611	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right Hip Degenerative Joint Disease (DJD).  According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI noticed nagging right hip pain and right groin pain in the spring of 2002 without antecedent trauma.  Over time her pain progressed.  She was thought to have a probable cartilage (labrum) tear and underwent right surgical repair on 28 October 2002.  Although she improved after surgery, she reinjured her hip in May 2003.  Despite continued rehabilitation, she was not able to return to full duty.  The 9 February 2004 MEB NARSUM examination, 4 months prior to separation, noted her healing had plateaued and she could not meet all duty requirements.  Her gait and range of motion (ROM) were abnormal due to pain.  

At the 11 June 2004 VA Compensation and Pension (C&P) evaluation, 2 weeks after separation, the CI reported ongoing hip pain aggravated by prolonged walking, standing, and sitting.  She did not use an assistive device.  The gait was painful and favored the right leg but the CI was able to toe, heel, and tandem walk.  Break-away weakness (weakness due to pain) was present.  Hip ROM in degrees showed flexion of 106 (normal 125), extension of 26 (normal 20), abduction of 38 (normal 45), adduction of 32 (normal 45), and external rotation of 42 (normal 45).  All motion was painful.  There was no additional limitations to ROM or joint function due to pain, weakness, fatigue or lack of endurance following repetitive use noted.  At a conference for an appeal of the VA decision, the CI reported she was able to work as a dental assistant.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 20%, coded 5255 (impairment of femur).  The VA also rated the right hip condition 20%, coded 5255, based on the C&P examination 1 month after separation, citing malunion of the femur with moderated knee or hip disability.  The panel noted the limitation in motion was not compensable using the codes 5251 (limitation in extension), 5252 (limitation in flexion), or 5253 (other impairment of the thigh).  The code 5255, used by the PEB and VA, supports a rating of 20% for a moderate disability and 30% for a marked disability.  The panel observed that although the CI had a painful gait, she was able to toe, heel, and tandem walk.  In addition, she worked as a dental assistant.  The impairment in evidence is more consistent with a moderate than severe level and the 20% rating adjudicated by both the PEB and VA was supported.  The panel also noted that at the above-mentioned appeal, the VA upheld the 20% rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the right hip DJD condition.  

BOARD FINDINGS:  In the matter of the right hip DJD 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 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 20160913, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record  

SAF/MRB

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-00663.

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