RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE: PD-2017-00844 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20060715

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Field Radio Operator, medically separated for “sacroilitis right sided” with a disability rating of 10%.

CI CONTENTION: “Continue to have issues with my hip and lower back. Unable to seek continual treatment due to having to work.”  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.

RATING COMPARISON:

SERVICE PEB - 20060519	VARD - 20070125	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Sacroiliitis Right Sided	5236	10%	Scoliosis, Lumbar Spine	5299-5235	NSC	20061109	
Snapping Hip Syndrome, Right Hip	Cat II	Residuals, Right Hip Strain	5009-5019	0%	20061109	
Right Hip Pain	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	
	
ANALYSIS SUMMARY:

Sacroiliitis Right Sided. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s sacroiliac condition began in 2005 after falling. The CI was diagnosed with sacroiliac dysfunction. At the 6 December 2005 orthopedic visit, the CI reported right hip pain with popping when rolling over in bed. Physical examination revealed full right hip range of motion (ROM) without pain. However, there was pain at the sacral and gluteal area. An MRI was consistent with spina bifida occulta. The 4 April 2006 MEB NARSUM examination, 3 months prior to separation, noted complaints of unresolved right lower back and hip pain. Physical examination showed ROM of 80 degrees of flexion (normal 90) and 230 degrees of combined ROM. At the 1 May 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the examiner noted spine “difficulty with ROM, pain.”

At the 9 November 2006 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported intermittent episodes of  lower back and right hip pain.        Physical

examination revealed spine curvature to the right which was further emphasized with forward bending, but there was no radiation of pain, muscle spasm or tenderness. The ROM studies of the hips and spine were normal and without pain. X-ray examination revealed a minimal scoliotic curve of the lumbar spine.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the back condition 10%, coded 5236 (sacroiliac injury and weakness). The VA determined the back condition was not service-connected, citing a developmental defect. The VA rated the right hip condition 0%, citing no evidence of painful motion. IAW VASRD §4.66 “the lumbosacral and sacroiliac joints should be considered as one anatomical segment for rating purposes.” Panel members agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 60 degrees but not greater than 85 degrees), as reported on the NARSUM examination. An alternative 10% rating was justified for the presence of painful motion as noted on the MEB examination. There was no muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis. 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 back condition.

Contended PEB Conditions: Snapping Hip Syndrome, Right Hip and Right Hip Pain. The PEB adjudicated the contended conditions as a Category II conditions (contributed to the primary unfitting condition but were not separately ratable). The panel first agreed that in this case the various right hip conditions were part and parcel of a singular right hip condition distinct from the sacroiliitis. The panel next considered whether the right hip was a separately unfitting condition at separation and eligible for rating. The panel majority agreed the right hip condition was reasonably justified as separately unfitting and eligible for rating consideration.

The panel then considered its rating recommendation. The panel noted that neither the NARSUM, MEB, nor VA examinations demonstrated ratable right hip limitation of motion or painful motion. Panel members agreed that the evidence supported a 0% rating coded 5024 tenosynovitis. This rating would not result in any benefit to the CI; therefore, the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the right hip condition, so no additional disability rating is recommended.

BOARD FINDINGS: In the matter of the back condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication. In the matter of the contended right hip condition, the panel agrees it cannot recommend it for additional disability rating. 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.

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN   REPLY   REFER  TO:

1850
CORB: 003 20May20

From: Director, Secretary of the Navy Council of Review Boards

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW  (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 7 Nov 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation  Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.

Copy to: PDBR