RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01603
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20041114

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Ammunition Specialist, medically separated for “chronic right hip and thigh pain secondary to stress fractures” with a disability rating of 10%.  

CI CONTENTION:  “Review all conditions.”  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 - 20040802	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip and Thigh Pain… 	5099-5003	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Right Hip and Thigh Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right hip condition began in August 2002 when she resumed running following the delivery of a child.  After X-rays showed a right femur focal stress reaction, she was placed on limited duty and crutches, but her pain persisted.  A right hip MRI on 24 December 2002 was normal.  She was thought to have trochanteric bursitis at an orthopedic appointment on 22 January 2003, and an injection of the bursa gave complete pain relief.  

In primary care 1 month later, the CI had full but painful hip range of motion (ROM).  At a physical therapy appointment on 10 April 2003, the examiner noted that she used bilateral crutches, but walked with full weight-bearing and rose and sat without difficulty; lower extremity ROM and strength were normal.  In orthopedics on 19 September 2003, the provider documented that a previous bone scan (not in evidence) had shown bilateral femoral shaft stress fractures, however, X-rays that day were normal.    

During the 10 March 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 8 months prior to separation, the CI reported thigh and hip pain with activity.  The right hip was tender with painful, reduced ROM.  The 27 May 2004 MEB NARSUM examination, 6 months before separation, noted complaints of persistent pain aggravated by activity.  On physical examination, she was not in significant distress but the right hip was tender with painful ROM.  Extension and external rotation were full, but flexion was limited to 95 degrees (normal 125) and abduction to 40 degrees (normal 45).  No comment was made regarding the gait.  There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 10%, analogously coded 5099-5003 (arthritis, degenerative), citing the US Army Physical Disability Agency pain policy.  The VA assigned a non-compensable rating as the CI failed to report for the scheduled examination.  The panel noted that neither the coding option specific for the hip or the code used by the PEB, 5003, supported a rating higher than the 10% rating adjudicated by the PEB.  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 condition.  

BOARD FINDINGS:  In the matter of the chronic right hip and thigh condition 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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161024, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180005849, 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