RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02540
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051216

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Wheeled Vehicle Mechanic, medically separated for “chronic pain of the right hip and anterior pelvis” with a disability rating of 0%.  

CI CONTENTION:  The current hip condition is causing limitations.  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 - 20051108	VARD – 20060922	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain of the Right Hip and Anterior Pelvis	5009-5003	0%	Right Trochanteric Bursitis with Right Meralgia Paresthetica	8726-5019	10%	20060914	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Right Hip and Anterior Pelvis Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right hip and anterior pelvis condition began in the spring 2001 following a long unit run, but without reported trauma or injury.  Treatment included nonsteroidal anti-inflammatory drugs and temporary profiling, and in 2002 she began to have sacroiliac joint (SIJ) and anterior pelvis pain during her pregnancy.  In July 2003, an X-ray showed a normal right hip, and bone scan studies in August 2003 showed mild to moderate post-traumatic change in the right pubic symphysis region, but no evidence of a stress fracture.  In March 2005, a follow-up MRI found no right hip abnormalities.  

During the 27 September 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, physical examination showed tenderness of the bilateral SIJs, right pelvic rim, pubis symphysis and the right greater trochanter.  There was minimal tenderness about the SIJ and right pelvis with pelvic rock and pelvic compression, and distal neurovascular evaluation was intact.  The MEB NARSUM examination the same day noted complaints of hip pain, rated at 2/10, and worsened by prolonged standing or walking, bending, squatting, repetitive climbing stairs, and impact activities.  The CI also reported bilateral SIJ and right anterior pelvis pain.  Physical findings were repeated from the MEB examination.  Range of motion (ROM) measurements were also recorded the same day by physical therapy (PT), and revealed right hip flexion to 69 degrees (normal 125), extension to 16 degrees (normal 30), and abduction to 34 degrees (normal 45).  

At the 14 September 2006 VA Compensation and Pension (C&P) examination, 9 months after separation, the CI reported that the SIJ pain had resolved, but she continued to have pain about the hip and thigh.  Physical examination revealed right greater trochanter tenderness, and ROM measurements showed right hip flexion to 120 degrees, extension to 30 degrees, and abduction to 45 degrees.  Painful motion was present, but ROM was not limited by repetition.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 0%, analogously coded 5003 (degenerative arthritis), citing constant and minimal pain IAW the US Army Physical Disability Agency pain policy.  The VA rated the right hip condition 10%, dual coded 8726-5019 (neuralgia-bursitis), based on the C&P examination, citing painful motion.  Members agreed there was no limitation of flexion or extension, or abduction (5251, 5252 or 5253), or fracture, nonunion, or malunion of the femur (5255) to support consideration under the respective diagnostic codes.  However, there was evidence of painful and limited motion as reported at the PT evaluation, to support a 10% rating IAW VASRD §§4.59 and 4.40.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right hip condition, coded 5099-5003.  

BOARD FINDINGS:  In the matter of the chronic pain of the right hip and anterior pelvis, the panel recommends a disability rating of 10%, coded 5099-5003 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 the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Pain of the Right Hip and Anterior Pelvis	5099-5003	10%	

The following documentary evidence was considered:  

Exhibit A.  DD Form 294, dated 20170311, w/atchs  
Exhibit B.  Service Treatment Record  
Exhibit C.  Department of Veterans Affairs Record  

AR20190006074, 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