From: To:

IN REPLY REFER TO

12 Feb 20

Director, Secretary of the Navy Council of Review Boards 
PD-2017-02064

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

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

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy of 15 October 2019 for appropriate  action.

2.	On 31 January 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no 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.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-02064 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20090330

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

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 - 20090210	VARD – 20090921	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Hip Labral Tear	5099-5003	10%	Left Hip Condition	5299-5252	NSC	20090421	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 0%	

ANALYSIS SUMMARY:

Left Hip Labral Tear. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s left hip condition began in February 2008 during the rifle range portion of boot camp. A non-contrast MRI of the left hip was negative for labral pathology but a follow-up arthrogram showed a small posterior labral tear. During the 12 January 2009 MEB NARSUM examination, 2 months prior to separation, the CI complained of migratory pain around the hip, with was aggravated by any activity, but she denied mechanical symptoms. Physical examination showed tenderness about the iliac crest along with point tenderness over the left greater trochanter. Range of motion (ROM) testing revealed flexion to 110 degrees (normal 125), extension to 20 degrees (normal) and abduction to 60 degrees (normal), with significant pain on

motion, especially with internal rotation. There was a positive impingement test (damage to cartilage of the socket) and an equivocal McCarthy’s sign (evidence of a labral tear).

At the 21 September 2009 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported constant left hip, worsened with activity. She could not run or bend without increased pain, and also reported popping and grinding, but no locking or buckling. Physical examination showed a limp, but no use of an assistive device. The left hip was tender, and the ROM study revealed flexion of 60 degrees and extension of 5 degrees, with pain. During the 1 April 2010 VA C&P examination, 12 months after separation, the CI reported constant left hip pain, and used a cane as needed. There was no impact on daily activities or function in her occupation. Physical examination showed normal strength, but tenderness. Flexion was to 110 degrees, extension to 30 degrees, and abduction to 45 degrees.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left hip condition 10%, analogously coded 5099-5003 (degenerative arthritis). The VA did not service-connect the left hip condition, citing no permanent residual or chronic disability shown by the STR or by evidence following discharge. Members adjudged that the NARSUM examination held greater probative value because it was most proximal to separation. Although the left hip condition was non-compensable for limitation of motion under codes 5250, 5251, 5252 and 5253, the panel agreed that a 10% rating was warranted for satisfactory evidence of functional loss due to painful motion of a major joint IAW VASRD §4.40, §4.45, and §4.59. The panel considered other rating options, but there was not sufficient evidence to justify a rating greater than 10%. 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 left hip condition.

BOARD FINDINGS: In the matter of the left hip condition and IAW VASRD §4.71, 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 20170310, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record