RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02198
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050922

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Multiple Launch Rocket System Crewmember, medically separated for “osteoarthritis, left hip” with a disability rating of 0%.  

CI CONTENTION:  The CI requested review of his unfitting condition and additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20050816	VARD - 20060118	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Osteoarthritis, Left Hip	5003	0%	Osteoarthritis, Left Hip	5252-5003	10%	20050921	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Osteoarthritis, Left Hip.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left hip condition began in December 2003 after stepping in a pothole.  He was treated conservatively with nonsteroidal anti-inflammatories and Physical therapy.  He reported some improvement but continued to experience left hip pain.  

The 22 June 2005 MEB NARSUM examination, 3 months prior to separation, noted the inability to run, jump or do sit-ups.  Range of motion (ROM) testing showed flexion of 120 degrees (normal 125), extension of 20 degrees (normal) and abduction of 40 degrees (normal 45) as measured with a goniometer.  There was no muscle atrophy, spasm or edema of the extremities.  Sensation to light touch and pin prick was intact throughout the extremities.  

At the 21 September 2005 VA Compensation and Pension (C&P) evaluation, 1 day before separation, the CI reported constant pain, swelling, fatigue, stiffness and limited motion of the left hip.  Physical examination showed no ankylosis.  ROM of the left hip was limited, with flexion of 120 degrees, extension of 25 degrees, abduction of 40 degrees, external rotation of 60 degrees (normal 45) and internal rotation of 40 degrees (normal 45).  The hip was not additionally limited after repetitive use by pain, fatigue, weakness, lack of endurance or incoordination.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip condition 0%, coded 5003 (arthritis, degenerative).  The VA rated the left hip condition 10%, dual coded 5252-5003 (thigh, limitation of flexion and arthritis, degenerative), based on the C&P examination.  

There was no limitation of motion that supported a rating under the VASRD diagnostic codes for limitation of motion (5251, 5252 or 5253).  There was no hip flail joint that supported a rating under the VASRD diagnostic code (5254).  There was no impairment of the left femur to justify a rating under 5255 (femur, impairment of).  There was also no evidence of painful motion of the left hip with functional loss IAW §4.59, §4.40 and §4.45.  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 left hip condition.  

BOARD FINDINGS:  In the matter of the left 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, dated 20170401, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180008193, 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