RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX	CASE:  PD-2017-03002
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081030

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Infantryman, medically separated for “right hip pain from a pubic ramus stress fracture” with a disability rating of 10%.   

CI CONTENTION:  “Still deal with pain on right leg, limited mobility, as well as weakened leg.”  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 - 20080804	VARD - 20090227	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip Pain…	5299-5255	10%	Slight Right Knee and Hip Disability; Status Post Right Pubic Ramus Fracture	5299-5255	10%	20090120	
Bilateral Knee Pain	Not Unfitting	Left Knee Pain	5299-5260	NSC		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Hip Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right hip pain began in November 2006 after a ruck march.  A bone scan on 17 July 2007 showed findings consistent with a right inferior pubic ramus stress fracture, and an MRI on 13 September 2007 revealed a nondisplaced right inferior pubic ramus stress fracture and quadratus femoris muscle strain. A physical therapy evaluation on 12 October 2007 showed full active range of motion (ROM) with mild discomfort on right hip external rotation and extension.  Gait was normal, but there was pain with squatting.  At an orthopedic visit on 22 April 2008, the CI complained of pain with sustained vigorous activity, but the provider documented a normal right hip examination except for pain with standing.  

During the 6 May 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported that his right hip gave way with weight bearing.  Physical examination showed pain limited motion with internal and external rotation, flexion and extension.  The 27 May 2008 MEB NARSUM examination, 5 months before separation, noted complaints of pain with walking or running, and the inability to do sit-ups or wear individual body armor.  The examiner recorded right hip flexion to 121 degrees (normal 125), extension to 5 degrees (normal 20) and abduction to 45 degrees (normal), with exquisite pain during motion.

At the 20 January 2009 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported right hip pain.  Physical examination showed a normal gait and ROM tests demonstrated flexion to 110 degrees, extension to 30 degrees, and abduction to 25 degrees, with painful motion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 10%, analogously coded as 5255 (impairment of femur), citing painful motion.  The VA also rated the right hip condition 10%, analogously coded as 5255, based on the C&P examination, citing malunion of the femur with slight knee or hip disability.  The panel determined that the evidence supported a 10% rating for painful motion as noted on the NARSUM and VA examinations, and alternatively, for limitation of extension to 5 degrees as noted on the NARSUM examination.  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 hip condition.  

Contended PEB Condition:  Right Knee Pain.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  Although the contended condition was implicated in the commander’s statement, it was not profiled and did not fail retention standards.  There was no performance-based evidence from the record that the condition 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 the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the right hip pain and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended right knee pain, 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 20170427, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20190008723, XXXXXXXXXXXXXXXXXX 

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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.