RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03248
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090302

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Fire Control Repairer, medically separated for “Group XIX muscle injury” with a disability rating of 10%.  

CI CONTENTION:  “The VA has given me 80% rating.” The CI also requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20090130	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Group XIX Muscle Injury	5319	10%	No VA Examination Proximate to Separation in Evidence	
Depressive Disorder	Not Unfitting		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:  

Group XIX Muscle Injury.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s muscle injury began in August 2007 after extensive heavy lifting over an extended period of time.  While lifting and moving, he reported low back pain and a sharp pulling pain in his right lower abdomen and groin area.  Later in the day he developed pain in the same area on the left.  The CI was initially diagnosed with a groin strain.  A comprehensive evaluation (ultrasound of the groin, CT of the abdomen and pelvis and MRI of the lumbar spine) was unrevealing.  The CI was treated with local injections in the groin area, epidural steroid injections of the back, pain medications and medications for nerve related pain without significant benefit.  

During the 1 July 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 8 months prior to separation, the CI reported recurrent extreme pain in the groin.  Physical examination showed tenderness in the groin bilaterally, greater on the right than the left.  

The 5 December 2008 MEB NARSUM examination, 3 months prior to separation, noted complaints of bilateral 4/10 groin pain aggravated by running, lifting, marching and jumping, with spontaneous flare-ups at times that lasted up to 30 minutes.  Physical examination showed a normal gait.  Pain and tenderness were noted at the level of the anterior superior iliac crest bilaterally, but not in the testicles or groin.  On deep palpation of the lower abdomen there was moderate discomfort without masses.  There was no inguinal hernia and the testicles were normal.  At a pain medicine examination on 22 December 2008, 2 months prior to separation, the CI reported constant aching, sharp and stinging pain.  Physical examination showed tenderness in the mid lumbar area and mild pain in the inguinal area bilaterally.  Neurological examination was normal.  There was no VA examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the muscle injury 10%, coded 5319 (Group XIX, includes abdominal muscles), citing moderate muscle injury.  A 10% rating was supported for “moderate” group XIX muscle injury proximate to separation.  All members agreed that the CI’s chronic abdominal pain could not be characterized as moderately severe for the next higher rating in the absence of additional objective findings such as muscle swelling, spasm or defects such as identified muscle tears or herniation.  The panel considered other VASRD and analogous codes, but all were less applicable and/or not advantageous for rating.  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 group XIX muscle injury.  

Contended PEB Conditions:  Dysthymic Disorder.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was not implicated in the commander’s statement or judged to fail retention standards.  However, the CI was given an S2 profile for dysthymia with anxiety, but the panel noted that a “2” profile designation requires only some limitations and is not necessarily disqualifying for continued military service.  The psychiatry MEB addendum indicated the CI’s symptoms were not independently impairing for military service.  There was no performance-based evidence from the record that the contended 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 group XIX muscle injury and IAW VASRD §4.73, the panel recommends no change in the PEB adjudication.  In the matter of the contended dysthymic disorder, the panel recommends no change from the PEB determination 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:

AR20180016664, 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.

					       

Enclosure