RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02260
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050825

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E1, Basic Trainee, medically separated for “left groin and hip pain” with a disability rating of 0%.  

CI CONTENTION:  The condition continues to worsen and negatively affects daily activities.  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 - 20050805	VARD - 20060619	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Groin and Hip Pain	5022	0%	Residual Stress Fracture Left Pubic Ramus	5253	0%	20060530	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Left Groin and Hip Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left groin and hip condition began in April 2005 after a fall.  Radiographs demonstrated mild irregularity and sclerosis of the left inferior pubic ramus.  The CI was diagnosed with left inferior pubic ramus stress fracture.

The 18 July 2005 MEB NARSUM examination, one month prior to separation, noted complaints of 7/10 hip and groin pain with prolonged walking and standing, but the pain level was usually 0/10.  Physical examination showed normal gait and muscle strength with full range of motion (ROM), but there was localized tenderness to the left inferior pubic ramus.  Painful motion was not addressed.

At the 30 May 2006 VA Compensation and Pension (C&P) examination, 9 months after separation, the CI reported intermittent pain in the left anterior groin that was sometimes sharp and dull.  Her pain increased with full squatting, but there was no weakness or fatigue.  Physical examination revealed pain with deep palpation at the anterior inferior ramus in the region of the left groin.  The ROM evaluation showed left and right hip flexion of 125 degrees (normal) and adduction of 25 degrees (normal).  All other hip measurements were full.  Painful motion was noted with adduction and internal rotation of the left hip.  The CI was able to stand on her heels and heel walk without loss of balance.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left groin and hip condition 0%, analogously coded 5022 (periostitis), citing no significant loss of hip joint motion.  The VA also rated the left groin and hip condition 0%, coded 5253 (thigh, impairment), based on the C&P examination, citing full equal ROM of both hips.  

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.  The panel considered if there was sufficient evidence to support a 10% rating IAW VASRD §§4.59 and 4.40 for painful motion with functional loss.  Although there was pain with adduction and internal rotation during the C&P examination, the panel majority agreed the examination was fairly remote from separation and not a good indicator of the level of disability at separation.  A 6 June 2005 physical therapy entry related painful motion, but the CI was able to perform full squats without pain and there was no limitation of motion.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel majority concluded there was insufficient cause to recommend a change in the PEB adjudication for the left groin and hip condition.  

BOARD FINDINGS:  In the matter of the left groin and hip condition and IAW VASRD §4.71a, the panel majority recommends no change in the PEB adjudication.  The single voter for dissent recommends modification to 10% but did not elect to submit a minority opinion. 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 20170304, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190007779, 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