RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  xxxxxxxxxxxxxxxxxxxxx  	CASE:  PD-2017-01352
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080117

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Infantryman, medically separated for “right hip trochanteric bursitis” with a disability rating of 0%.  

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 - 20071106	VARD - 20080421	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip Trochanteric Bursitis	5019	0%	Right Hip Trochanteric Bursitis	5019-5251	0%	20080208	
Cervical Pain	Not Unfitting	Cervical Spine Degenerative Disc Disease	5242	10%	20080208	
Ganglion Cyst	Not Unfitting	Ganglion Cyst of Right Wrist	7899-7819	NSC	20080208	
Seborrheic Dermatitis	Not Unfitting	No VA Placement	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Hip Trochanteric Bursitis.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s Right hip condition began in October 2005 during airborne school with no specific injury.  An MRI showed bilateral stress fractures in his femurs.  Subsequent MRI in February 2007 showed findings compatible with right greater trochanteric bursitis.
The 20 August 2007 physical therapy range of motion (ROM) examination for the MEB, 5 months prior to separation, documented flexion of 130 degrees (normal 125 degrees), painful extension to 20 degrees (normal 30) and abduction to 45 degrees (normal).  The 17 September 2007 MEB NARSUM examination, 4 months prior to separation, noted the CI was unable to run, jump or do any impact movements without causing hip pain.  The physical examination was deferred to the VA examination.

At the 8 February 2008 VA Compensation and Pension (C&P) examination, 1 month after separation, the CI denied having any symptoms at that time.  His last reported episode of pain was in April 2007.  Physical examination showed normal gait and posture, and intact neurovascular function.  The CI was able to squat and return to a standing position without complaints of pain or loss of balance.  He was able to stand on one leg and do repetitive shallow knee bends without loss of balance or pain.  The ROM evaluation, after repetitive use, showed flexion of 125 degrees, extension of 30 degrees, abduction of 25 degrees and abduction of 45 degrees.  Painful motion was absent and there was no evidence of instability, weakness, tenderness, guarding of movement or abnormal movement.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 0%, coded 5019 (bursitis), citing ROM limited by pain.  The VA also rated the right hip condition 0%, analogously coded 5019-5251 (bursitis - thigh, limitation of extension of), based on the C&P examination.

The panel considered the somewhat disparate examinations and agreed the VA C&P offered greater probative value since it was most proximate to separation and more comprehensive than the other examination.  There was no limitation of flexion, extension or abduction that supported a rating under the VASRD diagnostic codes for limitation of motion (5251, 5252 or 5253).  There was no fracture, nonunion, or malunion of the femur to support consideration under the 5255 code.  There was no evidence of painful motion to support a 10% rating.  Panel members concluded, a compensable rating was not justified for the right hip condition.  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.  

Contended PEB Conditions:  Cervical Pain, Ganglion Cyst and Seborrheic Dermatitis.  The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting.  None of the conditions were profiled, implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions, so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the right hip condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended cervical pain, ganglion cyst and dermatitis conditions, the panel recommends no change from the PEB determinations as not unfitting.  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.  

AR20190002383, XXXXXXXXXXXXXXXXX 

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Dear XXXXXXXXXXXXXXXXX:

	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.