RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04978
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070324

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Military Police, medically separated for “chronic right hip pain” with a disability rating of 0%.

CI CONTENTION:  “Right hip injury was not repaired.  Surgery was not successful.  There is still a lot of pain and swelling daily.  Possibility of full tear of labrum which will cause full hip replacement.”  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 - 20060612	VARD - 20070820	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain 	5099-5003	0%	Arthropathy; Status Post Labral Tear and Surgical Repair, Right Hip and Pelvis	5009	10%	20070417	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Chronic Right Hip Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s right hip condition began in September 2005 while performing flutter kicks.  An MRI arthrogram demonstrated a superior labral tear and she underwent arthroscopic debridement in July 2006.  

During the 8 August 2006 orthopedic examination, 7 months prior to separation, the CI reported no mechanical hip symptoms, but groin pain persisted and she used crutches for ambulation.  Physical examination revealed normal right hip strength.  Right hip range of motion (ROM) was painful; measurements were not provided.  At the 26 September 2006 orthopedic examination, 6 months prior to separation, the CI reported persistent right hip pain and she still required a cane to ambulation.  Physical examination revealed normal strength and pulses.  Passive right hip ROM elicited painful motion.  During the 11 October 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported chronic right hip pain.  Physical examination revealed no effusion or warmth.  Right hip ROM testing showed flexion of 110 degrees (normal 125), abduction of 16 degrees (normal 45) and extension of 5 degrees (normal 20); painful motion was not addressed.  The 16 November 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of right hip cramping aggravated by walking, lifting or twisting and she still used a cane to ambulate.  Physical examination showed a severe-antalgic gait.  Right hip flexion was 75 degrees, abduction 25 degrees, and extension was 30 degrees; ROM was limited by pain.

At the 17 April 2007 VA Compensation and Pension (C&P) general examination, 1 month after separation, the CI reported right hip pain aggravated by walking, lifting or twisting.  Physical examination revealed the CI ambulated with a limp and utilized a cane.  There was right hip tenderness.  Flexion was 100 degrees with pain, but abduction and extension were not reported.  Right hip X-rays revealed no fracture or dislocation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 0%, analogously coded 5099-5003 (arthritis, degenerative), citing an antalgic gait and painful motion.  The VA rated the right hip condition 10%, coded 5009 (arthritis, other types), based on the C&P examination, citing postoperative pain and limited ROM.  The panel agreed there was no limitation of motion to support a rating under codes 5251, 5252 or 5253.  However, there was sufficient STR and VA evidence of painful motion to support a 10% rating IAW VASRD §4.59.  There was no evidence to support a higher rating IAW VASRD §4.71a.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right hip condition, coded 5299-5252. 

BOARD FINDINGS:  In the matter of the right hip condition, the panel recommends a disability rating of 10%, coded 5299-5252 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Right Hip Pain 	5299-5252	10%	

XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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 also been provided to the Department of Veterans Affairs.

Sincerely,					      
Enclosure