RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02578
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20080520

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Multichannel Transmission Operator/Maintainer, medically separated for “shrapnel wound, right thigh,” with a disability rating of 10%.  

CI CONTENTION:  Review all conditions.  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 – 20080229	VARD - 20090330	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Shrapnel Wound, Right Thigh	5316	10%	Right Hip	7802-5252	0%	20090120	
Anxiety Disorder	Not Unfitting	PTSD	9411	70%	20081117	
High Frequency Hearing Loss	Not Unfitting 	Left Ear Hearing Loss	6100	0%	20090203	
		Right Ear Hearing Loss	6100	NSC	20090203	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS:  70%	

ANALYSIS SUMMARY:  

Shrapnel Wound, Right Thigh.  According to the service treatment record and MEB narrative summary (NARSUM), the CI was hit with shrapnel just distal to the greater trochanter (hip) on his right thigh in June 2003 and underwent shrapnel removal in January 2004.  X-rays in July 2007 showed a normal right hip with a metallic density in the upper margin of the pelvis.  The 20 December 2007 MEB NARSUM examination, 5 months prior to separation, noted complaints of right hip discomfort with occasionally “going out” and thigh muscle twitching.  The CI had no confidence in weightbearing on the right hip without use of a cane.  Physical examination showed right hip extension to 0 degrees (normal 30) and flexion to 125 degrees (normal).  Hip flexor and extension strength was decreased and fatigable after five or six repetitions, as was knee flexion and extension.  Reflexes were normal.  There was a small entrance wound from the shrapnel injury on his right thigh, which was non-tender, and a well-healed surgical scar on the right groin.  

At the 20 January 2009 VA Compensation and Pension (C&P) examination, 8 months after separation, the CI reported right hip and leg pain.  Physical examination showed a limping and listing gait with decreased endurance, but no acute pain.  The CI used a straight cane in the left hand.  There was a right sub-inguinal scar (1.5 by 0.35 inches) and a dime-sized scar on the proximal thigh without keloid, hypertrophy, tenderness, evidence of pain, or muscle herniation.  Skin motion was normal and the scars did not restrict range of motion (ROM).  Right hip ROM testing showed, after repetition, flexion of 115 degrees and extension of 20 degrees, limited by pain and lack of endurance.  Strength was mildly decreased in all planes of motion.  Knee strength was normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right thigh condition 10%, coded 5316 (Group XVI), citing moderate muscle injury.  The VA rated the right hip condition 0%, dual coded 7802-5252 (scars, superficial causing thigh, limitation of flexion), based on the C&P examination, citing a noncompensable scar and arthralgia without identifiable underlying malady or condition.  

The panel deliberated on the CI’s level of muscle injury IAW VASRD §4.55 (principles of combined ratings for muscle injuries) and §4.56 (evaluation of muscle disabilities).  There was no history of broken bones, debridement, prolonged infection, sloughing of soft parts, intermuscular scarring, prolonged hospitalization, loss of deep fascia, loss of muscle substance or loss of normal firm resistance of muscles (compared with the sound side) to support the next higher moderately severe disability level.  The panel considered alternate rating for limitation of hip extension or painful hip ROM, but these would rate no higher than the 10% adjudicated by the PEB.  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 right thigh condition.  

Contended PEB Conditions:  Anxiety Disorder and High Frequency Hearing Loss.  The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting.  Although the hearing loss was profiled H2, it did not fail retentions standards.  The anxiety disorder was not profiled and did not fail retention standards. Neither condition was implicated in the commander’s statement.  There was no performance-based evidence from the record that either of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for either of the contended conditions, so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the right thigh condition and IAW VASRD §4.73, the panel recommends no change in the PEB adjudication.  In the matter of the contended anxiety disorder and high frequency hearing loss, the panel recommends no change from the PEB determinations as not unfitting.  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 20170311, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190006084, 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.