RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX  	CASE:  PD-2017-04316
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20091119

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

CI CONTENTION:  In addition to the right hip, 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 - 20090821	VARD - 20091217	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain	5099-5003	10%	Dysplasia, Right Hip 	5255	10%	20090319	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20% 	

ANALYSIS SUMMARY:  

Chronic Right Hip Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right hip condition began in July 2007 during basic combat training with no specific traumatic event.  X-rays were normal, but MRI in June 2008 revealed bilateral acetabular dysplasia (abnormality of the hip joint, likely present at birth or early childhood).  At the 19 March 2009 VA Compensation and Pension (C&P) examination, 8 months prior to separation the CI reported constant pain in the right hip.  She denied hip weakness, giving way or locking, and did not require any assistive device for ambulation.  Physical examination revealed some guarding of movement, but no evidence of edema, effusion, weakness, tenderness, or inflammation.  There was no subluxation.  Range of motion (ROM) testing, after repetition, showed 125 degrees of flexion (normal) and 45 degrees of abduction (normal).  The 2 June 2009 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, documented full ROM and pain on palpation.  During the 28 July 2009 MEB NARSUM examination, 4 months prior to separation, the CI complained of daily right hip pain exacerbated by prolonged weight-bearing or high impact activities.  Physical examination showed a normal gait.  ROM testing of the right hip showed 100 degrees of flexion and 30 degrees of abduction with pain.  Leg lengths were equal, and there was no edema, motor or sensory abnormalities, or muscle atrophy of the extremities.  

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 limitation of motion and pain. The VA also rated the right hip condition 10%, coded 5255 (femur, impairment), based on the C&P examination, citing malunion of the femur with slight hip disability.

There was no limitation of flexion, extension or abduction that supported a rating under the VASRD diagnostic codes for limitation of motion (5251, 5252, 5253). There was no fracture, nonunion or malunion of the femur to support a higher rating under the 5255 code.  However, there was evidence of painful limitation of motion to justify the PEB’s 10% 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 right 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:

PD-2017-04316

AR20190011348, XXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXX

	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.