RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05091
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20080701

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Quartermaster and Chemical Equipment Repairer, medically separated for “osteoarthritis of bilateral hips,” each hip rated 10%, with a combined disability rating of 20%.  

CI CONTENTION:  The CI 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 - 20080428	VARD - 20090211	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Osteoarthritis of Bilateral Hips	5003	10%	Degenerative Joint Disease Both Hips	5003	10%	20090121	
		10%					
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Osteoarthritis of Bilateral Hips.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right and left hip conditions began insidiously in April 2006 and August 2006, respectively.  X-rays in February 2007 showed bilateral hip osteoarthritis.  

During the 16 January 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, physical examination showed a normal gait, but there was painful range of motion (ROM) of both hips.  The 12 March 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of constant right hip pain and intermittent left hip pain, aggravated by running or ruck marching.  Physical examination showed a normal gait.  There was pain of the right hip with weight bearing.  Right hip ROM in degrees after three repetitions was flexion of 120 (normal 125), extension of 10 (normal 30), abduction of 30 (normal 45) and external rotation of 45 degrees (normal 60).  Left hip ROM was flexion of 120, extension of 15, abduction of 45 and external rotation of 45.  Painful motion was not addressed.  There was normal strength.  

At the 21 January 2009 VA Compensation and Pension (C&P) examination, 7 months after separation, the CI reported pain in the right hip only.  He reported the left hip had full ROM without pain and had been asymptomatic in recent months.  Physical examination showed a normal gait.  There was no joint swelling, tenderness or instability.  Right hip ROM in degrees was flexion of 110, with painful motion, extension 30, abduction 45, and external rotation of 60.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated each hip condition 10%, coded 5003 (arthritis, degenerative), citing painful motion.  The VA rated the bilateral hip condition 10%, coded 5003 (arthritis, degenerative), based on the C&P examination, citing painful or limited motion of a major joint or group of minor joints.  

There was no limitation of motion which supported a higher rating under the diagnostic codes for limitation of thigh flexion, extension or thigh impairment (5251, 5252, 5253).  However, there was evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45) for each hip.  The panel considered other VASRD hip 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 right or left hip conditions.  

BOARD FINDINGS:  In the matter of the left and right hip conditions, 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 

AR20180015239, 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.