XXXXXXXXXXXXX 

Dear  XXXXXX:

	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.
 
	A copy of this decision has been provided to the counsel you listed on your application; 

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXX. 	CASE:  PD-2017-05098
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070816

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

CI CONTENTION:  Review all conditions. 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 - 20070712	VARD – 20071003 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Hip Pain 	5099-5003	10%	Left Hip Pain 	5253	0% 	20070830	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Left Hip Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left hip condition began in late 2004 while in basic training without any specific inciting or traumatic event.  A bone scan performed on 16 December 2004 demonstrated “a very small lesion at the left pubic ramus consistent with mini minor stress fracture.”  Despite physical restrictions, physical therapy and medications, the CI continued to have hip pain.  

The 2 May 2007 orthopedic examination, 4 months prior to separation, noted complaints of left hip pain with prolonged running, sitting, marching or standing.  The physical examination (PE) was limited and noted full range of motion (ROM) of both hips.”  There was no comment with regard to the presence of painful motion.  At the 16 May 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI’s PE revealed tenderness in the left groin and hip.  The provider specifically noted “no limitation of movement” in reference to the left hip, but painful motion was present. 

At the 30 August 2007 VA Compensation and Pension (C&P) examination, 2 weeks after separation, the CI reported constant left hip pain aggravated by physical activity or prolonged sitting or standing.   There had been no hospitalizations or periods of incapacitation due to the hip condition in the previous 12 months.  The PE showed normal hip ROM without painful motion.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip condition 10%, analogously coded as 5003 (degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA rated the left hip condition 0%, coded 5253 (impairment of thigh), based on the C&P examination, citing no objective evidence of pain or tenderness.  

Panel members first agreed that the greatest degree of probative value was apportioned to the VA examination due to its close reference to separation.  Panel members additionally agreed that the pathology and clinical relevance near the time of separation did not support a rating under any limitation of motion code (5251, 5252 or 5253) and VASRD §4.59 (painful motion) was not applicable.  There were no other codes available within VASRD §4.71a that were applicable to the CI’s diagnosis or disability.  However, IAW DoDI 6040.44, the panel may not recommend a rating lower than the PEB’s combined rating.  Therefore, 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’s 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.