RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX		CASE: PD-2017-00842 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20070126

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Shower, Laundry and Clothing Repair Specialist, medically separated for “chronic pain due to [right] pelvic stress fracture” with a disability rating of 10%.

CI CONTENTION: Hip/pelvis area pain continues to worsen and negatively impacts daily activities. 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 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.

SERVICE PEB - 20070103	VARD - 20070615	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain due to Right Pelvic Stress Fracture	5099-5003	10%	Residual of Right Hip Inferior Ramus Stress Fracture	5255	10%	20070412	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Chronic Pain due to Right Pelvic Stress Fracture. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right hip condition began during basic training. Bilateral hip X-rays showed pubic ramus stress fractures (superior and inferior). The CI was treated conservatively but continued to report right hip pain. Imaging showed a slowly healing right inferior pubic ramus stress fracture. The 13 November 2006 MEB physical therapy (PT) examination, 2 months prior to separation, documented right hip flexion to 80 degrees with knee extended and to 140 degrees with knee flexed (normal 125), extension was 20 degrees (normal 30), abduction was 50 degrees (normal 45) and external rotation was 60 degrees (normal) with painful motion. The 8 December 2006 MEB NARSUM examination, 2 months prior to separation, noted complaints of constant “hip” pain aggravated by weight bearing activity.

During the 12 April 2007 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported constant right hip pain with difficulty walking or standing. Physical examination showed an antalgic gait. Right hip flexion was 118 degrees, extension was 30 degrees, abduction was 38 degrees, and external rotation was 60 degrees. Painful motion was elicited and there was no ROM loss following repetitive motion.

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 (degenerative arthritis), citing the US Army Physical Disability Agency’s (USAPDA) pain policy. The VA also rated the right hip condition 10%, coded 5255 (femur, impairment), based on the C&P examination, citing functional loss due to pain. According to VASRD §4.67 (pelvic bones), pelvic fractures are based upon the specific residuals. In this case the CI’s residual impairment was due to pain with painful motion of the right hip supporting a 10% rating (based on §4.59, §4.40 and §4.45). The panel considered other VASRD hip and analogous codes, but all were less applicable and/or not advantageous to rating. There was therefore no higher than a 10% rating supported under any applicable VASRD code. The panel noted that the PEB’s reliance on the USAPDA pain policy was not detrimental to arriving at the highest rating and no change to the PEB’s coding choice is recommended. After due deliberation, considering all 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.

PD-2017-00842 

AR20190014222, XXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXX

	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.

2	PD-2017-00842