RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02233
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051130

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Military Police, medically separated for “chronic left hip pain” with a disability rating of 10%.    

CI CONTENTION:  No specific contention was made.  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 - 20051025	VARD - 20060424	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Hip Pain	5099-5003	10%	Trochanteric  Bursitis of Left Hip	5019	10%	20060216	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Left Hip Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s left hip condition began in September 2003 associated with basic training and then in April 2004, she injured the same hip in a vehicle rollover accident.  Despite such trauma, X-rays were normal and surgical intervention was not an option.  Conservative treatment measures failed to relieve her pain.  

The 22 September 2005 MEB NARSUM examination, 2 months prior to separation, noted complaints of constant dull pain about the left hip which was aggravated by prolonged standing.  
Her physical examination (PE) revealed tenderness about the left hip and noted “there were no limitations of movement.”  Painful motion was present.  A physical therapy encounter dated 8 November 2005, 3 weeks prior to separation, documented an antalgic gait, weakness about the left hip, and normal range of motion (ROM).  

At the 16 February 2006 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported aching and stiffness in the left hip with local tenderness causing an inability to lie on her left side.   Additionally, the CI endorsed being unable to bear weight on her police officer's utility belt.  “She is doing much better at the present time since released from the military in November 2005 with 4 months of relative inactivity compared to her active military career.”  Physical examination revealed left hip tenderness as well as painful and decreased motion of the left hip.  Hip flexion and abduction were decreased at 110 and 30 degrees respectively (normal 125 and 45).   

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip condition 10%, analogously coded as 5003 (degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA also rated the left hip condition 10%, coded 5019 (bursitis), based on the C&P examination, citing limitation of motion with flexion to 110 degrees and painful motion.  Although there was insufficient limitation of motion to support a minimum rating, the panel agreed the PEB’s 10% rating was supported and appropriate for the presence of painful motion as evidenced in both pre- and post-separation examinations.  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 §4.71a, 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 20170224, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180010725, 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. 
	
	A copy of this decision has been provided to the counsel you listed on your application, XXXXXXXXXXXXXXXXXX.

Sincerely,					      
Enclosure