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From:
To:

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD DC 20374-5023
I

Director, Secretary of the Navy Council of Review Boards
PD-2017-02692

IN REPLY REFER TO

1850
CORB:003
27 Feb 20

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)
Ref:	(a) DoDI 6040.44
(bl PDBR ltr of 28 Oct 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its
recommendation to the Department of the Navy for appropriate   action.

2.	On 21 February 2020, the Assistant General Counsel of the Navy (Manpower & Reserve  Affairs)  took action  in  your case by    accepting  the recommendation of the PDBR.	Accordingly,  your  records  will  be corrected  to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEB) from 0% to 10% without re-characterization of your discharge.
3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement  to  additional  compensation.

4.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, has been forwarded to the Deputy Commandant, Manpower and Reserve  Affairs,  for appropriate  changes to  your personnel records and notification to you upon completion.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-02692 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20061115

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Rifleman, medically separated for “right hip pain” with a disability rating of 0%.

CI CONTENTION: “I contend that the 10 percent [VA rating] did not adequately reflect my level of disability. I continue to suffer pain, stiffness, weakness, instability and cannot sit or stand for prolonged periods of time. I believe my rating from the PEB was inaccurate and unfair because  it did not consider the course of my condition over the long term...” 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 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 RPEB - 20060920	VARD – 20061128	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip Pain, Presumed Iliopsoas Tenosynovitis	5024-5003	0%	Chronic Iliopsoas Tenosynovitis Right Hip	5252-5024	10%	20060831	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 60%	

ANALYSIS SUMMARY:

Right Hip Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s hip condition began in December 2004 when he was awakened by an IED explosion, twisted quickly, and jumped out of his rack. He was initially treated with anti- inflammatory medication, rest, ice, and elevation for an inguinal strain. X-rays of the right hip were normal and a three-phase bone scan with SPECT imaging on 13 April 2005 revealed no abnormality of the sacroiliac joints, pelvis, or hip. An MRI of the right hip dated 11 October 2005 was unremarkable. On 9 November 2005 the examiner’s impression was iliopsoas tendinitis. At an orthopedic clinic visit, the CI was felt not to be a surgical candidate.

The 25 July 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of right hip pain.  Physical examination showed he walked with a limp perhaps 20-30% of the time.

Range of motion (ROM) measurements (in degrees) of the right hip revealed flexion 80 (normal 125), abduction 35 (normal 45), adduction 10 (normal 25), and extension of 20 (normal 30), with limitation of motion due to discomfort. While standing up, in-toeing rotation of the leg was 45 degrees and out-toeing was 80 degrees.

At the 31 August 2006 VA Compensation and Pension (C&P) examination, 3 months before separation, the CI reported right hip pain, described as aching, squeezing, oppressing, cramping, and sharp. The level of pain was 8/10 and was exacerbated by physical activity. Physical examination revealed tenderness anteriorly in the right hip in the area of the flexor tendons or the anterior iliopsoas [muscle and/or tendon], but there was no edema, effusion, weakness, redness, heat, abnormal movement, guarding movement, or subluxation. Measured right hip ROM in degrees was flexion to 125, extension 30, adduction 25, abduction 45, external rotation 60 (normal 60), and internal rotation 40 (normal 40), with painful motion with abduction and internal rotation. Posture and gait were normal and he did not require an assistive device for ambulation.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right hip condition 0%, dual coded 5024-5003 (tenosynovitis- degenerative arthritis). The VA rated the condition 10%, dual coded 5252-5024 (bursitis-tenosynovitis), based on the C&P examination, citing pain all through flexion and extension, at the extreme end of abduction, and at 20 degrees during internal rotation. Panel members agreed that the VA examination, the most proximate examination to separation provided evidence of painful motion. Therefore, a 10% rating is justified and clearly supported IAW VASRD §4.59 (painful motion). There was no limitation of extension and flexion (codes 5251 and 5252) or thigh impairment (code 5253) nor was there any hip ankylosis (code 5250), hip flail joint (code 5254), or femur impairment (code 5255) to support a higher rating than 10%. 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 right hip condition, coded 5024-5003.

BOARD FINDINGS: In the matter of the right hip condition, the panel recommends a disability rating of 10%, coded 5024-5003 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	
Right Hip Pain, Presumed Iliopsoas Tenosynovitis	5024-5003	10%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20170314, w/atchs Exhibit B.  Service Treatment Record

Exhibit C.  Department of Veterans Affairs

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