RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00657
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060622

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E1, Trainee, medically separated for “residual right hip pain” with a disability rating of 10%.  

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 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 - 20060616	VARD - 20060926	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Residual Right Hip Pain	5009-5003	10%	Residuals, Status Post Right Hip Fracture	5255	10%	20060804	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Residual Right Hip Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right hip condition began in June 2005 after falling from an obstacle.  He was found to have an occult fracture in the area of the right acetabulum (socket of the hip joint) and was removed from training until the pain resolved.  In September 2005, he was returned to training, but after resumption of activity, his pain returned.  A repeat bone scan in February 2006 showed resolution of the fracture.  Plain film X-rays, MRI and CT scan of the hip showed no abnormality.  There was no surgical indication.  

The 20 April 2006 MEB NARSUM examination, 2 months prior to separation, noted complaints of right hip pain that prevented running, jumping and carrying gear.  Physical examination showed an abnormal gait with a limp.  Range of motion (ROM) testing showed hip flexion of 135 degrees (normal 125) and external rotation of 60 degrees (normal 45).  During the 2 May 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), the physical examination revealed right hip pain with weight bearing.

At the 4 August 2006 VA Compensation and Pension (C&P) evaluation, 1 month after separation, the CI reported constant right hip pain that increased with walking or standing.  Physical examination showed normal gait.  It appeared the examiner reversed the reported flexion and extension measurements.  Flexion (reported as extension) was 120 degrees (normal 125), extension (reported as flexion) was 30 degrees (normal 20), abduction was 45 degrees (normal), internal rotation was 40 degrees and external rotation was 60 degrees (normal 45), with painful motion reported.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 10%, coded 5099-5003 (analogous to degenerative arthritis), citing mild limitation of motion.  The VA also rated the right hip condition 10%, coded 5255 (femur impairment), based on the C&P examination, citing malunion of the femur with slight knee or hip disability.  The panel agreed there was insufficient limitation of ROM of the hip to provide a minimum rating using VASRD codes 5251 (thigh limitation of extension), 5252 (thigh limitation of flexion) or 5253 (thigh impairment).  In addition, there was no indication of a flail joint of the hip to support an 80% rating using code 5254, ankylosing of the hip to support a 60% rating using code 5250 or malunion of a femur fracture to support a 10% or higher rating using code 5255.  However, there was evidence of painful motion with functional loss supporting a 10% rating (based on §§4.59, 4.40 and 4.45).  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 right hip 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 20170221, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180007707 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