RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:XXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-04550
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20071215

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E1, Basic Marine, medically separated for “left hip femoral neck stress fracture” with disability rating of 10%.

CI CONTENTION: “Reduced range of motion and pain.” 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 - 20071101	VARD - 20080512	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Hip Femoral Neck Stress Fracture	5299-5003	10%	Healed Fracture of The Left Femoral Neck, Status Post Open Reduction Internal Fixation	
5252	
10%	
20080407	
Stress Fracture Surgical
Treated	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Left Hip Femoral Neck Stress Fracture. According to the service treatment record and MEB narrative summary (NARSUM), the CI experienced left hip pain in the summer of 2007 after 6 weeks of training. He was diagnosed with a left hip stress fracture and underwent closed reduction and internal fixation with three cannulated screws. In October 2007, X-rays showed the screws in good position with a healing femoral neck fracture.

During the 27 September 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, physical findings revealed decreased hip range of motion (ROM) and tenderness. The 19 October 2007 MEB NARSUM examination, 2 months before separation, noted complaints of left hip pain. The CI was 4 weeks post-surgery and on crutches, but was being advanced to partial weight-bearing. The examiner noted a healed surgical incision and full left hip ROM with mild pain during resisted flexion.

At the 7 April 2008 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported intermittent left hip pain with prolonged standing and walking, but denied any weakness or numbness. Physical examination showed a normal gait, and measured ROM, in degrees, demonstrated flexion to 125 (normal), abduction to 45 (normal), and painful external rotation to 40 (normal 45).

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left hip condition 10%, analogously coded 5299-5003 (arthritis, degenerative), and listed “stress fracture surgical treated” as a Category II (contributes to the primary unfitting condition but were not separately ratable) condition. Panel members agreed that this an intertwined diagnosis, and that the overall hip impairment from the listed diagnosis was subsumed under the rating for the hip by both the PEB and the VA to avoid pyramiding (§4.14). The VA also rated the left hip condition 10%, but coded 5252 (thigh, limitation of flexion of), based on the C&P examination, citing painful and limited motion. The panel noted that while there was no compensable limitation of flexion, extension, or abduction (5251, 5252, or 5253), there was evidence of painful, limited motion to justify the 10% rating adjudicated by the PEB. There was no fracture, nonunion, or malunion of the femur to support a higher rating under code 5255. 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 left hip condition.

BOARD FINDINGS: In the matter of the left 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:

2	PD-2017-04550

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

IN REPLY REF ER TO,
1850
CORB: 003
10 Sep20

From: Director, Secretary of the Navy Council of Review Boards To:

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.