RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01777
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20040730

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Telephone Systems Craftsman, medically separated for “chronic hip pain, bilateral” with a disability rating of 20%.  

CI CONTENTION:  “The Veterans Femur is not affected by here Bi lateral hip pain. At the time of her MEB the veteran was diagnose with a chronic unknown hip disability. Chronic does not mean slight The Veterans VA disability claim filed in Dec 2004. and awarded in Jul 2005. Rate the veteran with a overall rating of 30%. To date, Veteran still struggles with the injuries sustained on Active Duty. This Service connected injury is chronic and permanently aggravated from active service.” 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 - 20040607	VARD - 20050629	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Hip Pain, Bilateral	5255-5299	10%	Tendonitis Left Hip	5024	10%	20050107	
		10%	Tendonitis Right Hip	5024	10%	20050107	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Chronic Bilateral Hip Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral hip pain condition began in 2001 during technical school.  Conservative therapy including chiropractic, physical therapy and trochanteric injection was not effective in relieving the bilateral hip pain.  The 16 April 2004 MEB NARSUM examination, 3 months prior to separation, noted complaints of recurrent bilateral hip pain limiting her ability to run, march or stand for long periods of time.  Physical examination showed decreased range of motion (ROM) of both hips due to pain on internal and external rotation, but not abduction or adduction.  “She was able to stand and walk with minimal difficulty, but squatting caused some pain.”  Bilateral hip X-rays were normal.  

At the 7 January 2005 VA Compensation and Pension (C&P) evaluation, 5 months after separation, the CI reported bilateral hip pain with inability to tolerate prolonged standing, sitting, climbing stairs, or jumping.  She could only do minimal activities that required weightbearing to her lower extremities.  Physical examination showed a normal gait and posture.  The hips were normal in appearance and not tender.  Bilateral hip ROM full flexion, extension, and abduction; with slight decrease in adduction and rotations, and painful motion bilaterally in all planes of motion.  

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 analogous to 5255 (femur impairment).  The VA rated each hip condition 10%, coded 5024, (tenosynovitis), based on the C&P examination 5 months after separation, citing pain on motion.  There was no compensable limitation of hip motion under codes 5250 thru 5253 for either the right or left hip.  However, the NARSUM and VA ROMs both documented painful motion.  The panel adjudged that there was sufficient evidence of painful motion causing functional loss (based on §4.59, §4.40 and §4.45), supporting a 10% rating for each hip.  There was no evidence of femur fracture or malunion for any higher rating under code 5255, and there was no avenue to any higher rating than 10% for either hip under any alternative coding.  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 bilateral hip condition.  

BOARD FINDINGS:  In the matter of the chronic bilateral 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.  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 20160929, w/atchs
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

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-01777.

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.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have 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.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXXXXXXXX
Director 
Air Force Review Boards Agency 

Attachment:
Record of Proceedings