RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2016-00976
BRANCH OF SERVICE:  Navy 	SEPARATION DATE:  20041201

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an  active duty E4, Hospital Corpsman, medically separated for “bilateral hip arthritis status post intertrochanteric osteotomy on the right as a derotational solution” with a disability rating of 20%.  

CI CONTENTION:  Review requested of bilateral hips, knees, back and femur.  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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20041005	VARD - 20050617	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Hip Arthritis… 	5255	  10%   
+10%
  20%	Left Hip Femoral Anteversion with Degenerative Joint Disease [DJD]	5252	20%	20041109	
			Right Hip Femoral Anteversion with DJD Post-Osteotomy and Hardware Removal with Scar	5252-5252	20%	20041109	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Bilateral Hip Arthritis.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s bilateral hip condition began in early 1999 while training for a physical readiness test.  In February 2003, she had a right hip intertrochanteric osteotomy, which resulted in some improvement.  However, she continued to have bilateral hip pain that increased with high-impact loading, and she could no longer run.  

The 23 September 2004 MEB NARSUM examination, 3 months prior to separation, noted CI complaints of continued bilateral hip pain.  Physical examination showed active right hip range of motion (ROM) measurements, in degrees of:  extension to 0 (normal 20), flexion to 90 (normal 125), abduction to 50 (normal 45), adduction to 5 (normal 25), external rotation to 45 (normal), and internal rotation to 10 (normal 40).  Left hip ROM showed extension to 0, flexion to 90, abduction to 50, adduction to 5, external rotation to 75, and internal rotation to 10.

At the 9 November 2004 VA Compensation and Pension (C&P) examination, less than 1 month before separation, the CI reported daily bilateral hip pain rated at 3-8/10, with the right hip worse than the left.  Physical examination revealed an antalgic gait.  Active right hip ROM, in degrees, was extension 35, flexion 90, abduction 35, and adduction 20; left hip ROM hip was extension 25, flexion 95, and abduction 40.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral hip condition 20% (10% for each hip), coded 5255 (thigh, limitation of flexion of).  The VA separately rated each hip 20%, coded 5252 (left hip) and “5252-5252” (right hip), based on the C&P examination, citing thigh flexion of 40 degrees for both hips.  Members agreed there was no limitation of flexion or extension that supported a rating under VASRD diagnostic codes 5251 or 5252; and no limitation of abduction, adduction, or rotation that supported a rating under code 5253.  Additionally, there was no hip flail joint that supported a rating under code 5254.  There was, however, evidence of slight hip disability to justify a 10% rating under code 5255 (femur, impairment of).  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 bilateral hip condition.  

BOARD FINDINGS:  In the matter of the bilateral hip arthritis and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.  

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS Ref: (a) DoDI 6040.44
In accordance with reference (a), I have reviewed the cases listed below and approve the recommendations of the PDBR that the following individual's records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy's Physical Evaluation Board: