RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXX	CASE: PD-2017-05100
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20060215

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, M1 Armor Crewman, medically separated for “right hip pain” with a disability rating of 10%.

CI CONTENTION: “Broken hip/hurt back.” 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 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 - 20051116	VARD - 20060626	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip Pain	5255	10%	Residuals of Right Hip Fracture with Scar, ORIF	5255	10%	20060327	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Right Hip Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI injured his right hip pain after slipping and falling off a tank in October 2003. Hip X-rays showed a comminuted fracture of the intertrochanteric area of the femoral neck with a slight rotational component, and he underwent an open reduction internal fixation. Despite conservative treatment and a steroid injection, he continued to have a moderately severe right hip pain despite good range of motion (ROM).

During the 1 September 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported right lateral thigh numbness and a decreased ability to kneel. Physical examination revealed a well-healed 10-cm scar of the right lateral thigh.  The 5 October 2005 commander’s statement noted the CI could likely perform in a less physically strenuous military specialty. At the 18 October 2005 MEB NARSUM examination, 4 months before separation, he complained of constant hip pain exacerbated by physical activity. Although he could perform the aerobic portion of the fitness test by walking, he was limited to 30 minutes/1 mile. He had difficulty with the climbing and prolonged sitting, and although he could negotiate two flights of stairs with minimal difficulty, he experienced pain in the upper right leg.

An X-ray showed post-fracture healing and no visible orthopedic hardware, which had been removed. The examiner noted that the CI had a slight antalgic gait due to a somewhat longer left leg (by 1 cm) status post injury and surgery. Both hips essentially showed full ROM with some minor limitation in right hip flexion due to discomfort and postoperative changes in position of the femoral head and neck. There was also pain to percussion and palpation.

At the 27 March 2006 VA Compensation and Pension (C&P) examination, 1 month after separation, the CI reported pain, stiffness and weakness. The pain was precipitated by activity, and alleviated by sitting down and putting the leg up, applying a hot pack, and analgesic medication. Physical examination showed a normal gait without the use of an assistive device.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right hip condition 10%, coded 5255 (femur, impairment of), citing slight hip disability. The VA also rated the right hip condition 10%, coded 5255 (femur, impairment of), based on the C&P examination, citing decreased joint motion. Panel members considered whether a higher rating was warranted under code 5255. Although the CI had a slightly antalgic gait and a minor limitation in flexion due to pain (§4.59), he was able to negotiate two flights of stairs and complete the alternate physical fitness test by walking. Additionally, hip X-rays were normal and there was no report of atrophy, muscle spasm, or loss of strength to indicate a moderate hip disability for a higher 20% 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 §4.71, 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.

2	PD-2017-05100

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Dear: XXXXXXXXXXXXXXXXX

	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.