RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01903
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090108

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty  E2, Basic Trainee, medically separated for “right hip pain” with a disability rating of 10%.   

CI CONTENTION:  The CI made no specific contention.  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 - 20081209	VARD - 20090625	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip Pain	5099-5003	10%	Residuals of Right Hip Tear	5252	10%	20090318	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10% 	

ANALYSIS SUMMARY:  

Right Hip Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right hip surgery in August 2008 with labral tear debridement.  During the 15 October 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported unresolved right hip pain.  Physical examination showed right hip pain on flexion, extension, internal and external rotation.  Range of motion (ROM) values were not recorded.

The 3 November 2008 MEB NARSUM examination, 2 months prior to separation, noted complaints of chronic 4/10 right hip pain.  Her pain increased when rising from a seated position and with all impact activities.  Physical examination of the right hip showed no tenderness.  The MEB ROM study by physical therapy 2 weeks earlier showed flexion of 115 degrees (normal125) and abduction to 31 degrees (45 normal).  Painful motion was noted.  

At the 18 March 2009 VA Compensation and Pension (C&P) evaluation, 2 months after separation, the CI reported “burning, sharp and sticking” pain that occurred with physical activity.  She reported the ability to function with medication, but had stiffness and lack of endurance.  Physical examination showed a normal gait, but there was tenderness on the right hip without evidence of inflammation, subluxation or guarding of movement.  Right hip flexion was 110 degrees, extension was 20 degrees (normal) and abduction was 30 degrees, with painful motion and additional limitation after repetitive use due to pain, fatigue, weakness and lack of endurance.

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 painful motion.  The VA also rated the right hip condition 10%, coded 5252 (thigh limitation of flexion), citing painful motion.

Panel members agreed that a 10% disability rating was justified based on VASRD §4.59, §4.40 and § 4.45.  There was no justification for a higher rating under code 5003.  The panel also considered the possibility of using hip or thigh codes 5250 (ankylosis), 5251/5252/5253 (thigh, loss of motion) and 5254 (flail joint, hip), but there was no evidence of ankylosis and the limitation of motion noted in the examinations proximate to separation did not support a rating higher than 0% under any applicable code.  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, undated, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180005883, 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