RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02270
BRANCH OF SERVICE:  ARMY	SEPARATION DATE:  20050920

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Intelligence Analyst, medically separated for “chronic left hip/groin pain” with a disability rating of 0%.

CI CONTENTION:  Her current left hip condition supports a higher rating.  Multiple other conditions were not evaluated.  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 - 20050825	VARD - 20060725	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Hip/Groin Pain 	5099-5003	0%	Status Post Femoral Neck Stress Fracture, Left Hip	5252-5019	0%	20060620	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:

Chronic Left Hip/Groin Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left hip condition began in March 2005 during basic training.  No injury or trauma was reported.  Radiologic imaging revealed a left femoral neck stress fracture.  The CI’s symptoms persisted despite conservative treatment.

Three physical therapy encounters, on 15 June, 28 June and 6 July 2005, revealed normal hip range of motion (ROM) with  painful motion.  At the 15 August 2005 MEB NARSUM examination, 1 month prior to separation, the CI reported left hip pain.  Physical examination noted localized tenderness about the left inguinal fold (groin) area.  All other examination findings were normal, including hip ROM.  

At the 20 June 2006 VA Compensation and Pension (C&P) examination, 9 months after separation, the CI reported intermittent left hip pain aggravated by prolonged standing and walking.  Physical examination revealed left hip tenderness.  ROM testing showed flexion of 120 degrees (normal 125), abduction of 40 degrees (normal 45) and adduction of 40 degrees (normal 45); painful motion was not addressed.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip condition 0%, analogously coded 5099-5003 (arthritis, degenerative), citing symptomatic without significant loss of hip joint motion.  The VA also rated the left hip condition 0%, analogously coded 5252-5019, (thigh, limitation flexion of-bursitis), based upon the C&P examination, citing a non-compensable examination.

Although there was no limitation of hip motion to support a 10% rating, the panel agreed a 10% rating was justified for the presence of painful motion (VASRD §4.59), as recorded on the physical therapy examinations proximate to separation.  There was no femur or knee impairment to support a rating under code 5255.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the left hip condition, coded 5022.

BOARD FINDINGS:  In the matter of the left hip condition, the panel recommends a disability rating of 10% coded 5022 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Left Hip/Groin Pain 	5022	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170409, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180008221, XXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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 also been provided to the Department of Veterans Affairs. 

Sincerely,					      
Enclosure