RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-03024
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060415

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

CI CONTENTION:  “Currently 30% by Department of Affairs filed with one year of separation.” 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 - 20060224	VARD - 20060823	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain, Status Post Stabilization of Right Femoral Neck Stress Fracture	5099-5003	10%	Right Compression sided Femoral Neck Stress Fracture	5252	10%	20060920	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20% 	

ANALYSIS SUMMARY:  

Right Hip Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent open reduction internal fixation surgery in January 2005 for a right femoral neck stress fracture.  Despite physical therapy and medications, right hip pain persisted.  The 11 January 2006 MEB NARSUM examination, 3 months prior to separation, noted complaints of right hip pain that was worse in the morning and after standing all day.  Physical examination revealed tenderness at the surgical scar and some giveaway weakness secondary to pain, but no right leg warmth, swelling or redness.  Range of motion (ROM) measurements showed right hip flexion to 120 degrees (normal 125) and extension to 17 degrees (normal 20).  Right leg muscle testing showed giveaway secondary to pain, and pain when heel walking.  

At the 20 September 2006 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI reported right hip pain.  The examiner documented some giveaway weakness secondary to pain, but no swelling or warmth of the right leg.  Right hip flexion was to 120 degrees and extension to 17 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 10%, analogously coded 5099-5003 (degenerative arthritis), citing the condition was “slight-not requiring daily narcotics/constant.”  The VA also rated the hip condition 10%, but analogously coded 5252 (limitation of flexion of: thigh), based on the C&P examination, citing functional loss shown by weakness secondary to pain and persistent pain.  Panel members agreed there was no ROM limitation in evidence under the applicable codes (5251, 5252 and 5253) that would support a rating higher than 10%.  Also, there was no ankylosis (5250) or flail joint (5354) that would support a higher rating under the remaining VASRD §4.71a joint codes.  The panel considered whether the disability in evidence merited rating under code 5299-5255 (femur, impairment of), but members adjudged that the analogous application of this fracture code (complications of non-union or malunion) was not sufficiently justified by VASRD §4.20 (analogous ratings), given that this case satisfies compensable criteria under more applicable joint codes.  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 hip condition.  

BOARD FINDINGS:  In the matter of the right hip condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  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:

[AR NUMBER], 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.

A copy of this decision has been provided to the counsel you listed on your application, Disabled American Veterans (DAV), 110 9th Avenue South, Room 6166B, Nashville, TN 37203.

					      

Enclosure