RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX	CASE:  PD-2017-05257
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070921

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a  National Guard E1, Health Care Specialist Trainee, medically separated for “right femoral neck stress fracture” with a  disability rating of 20%.  

CI CONTENTION:  Review requested of an additional condition (shoulder) 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 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 - 20070905	20080707	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Femoral Stress Fracture	5099-5003	20%	Stress Fracture Right Upper Leg	5255	10%	20080115	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right Femoral Stress Fracture.  According to the service treatment record and MEB narrative summary (NARSUM), the CI initially experienced right hip pain during military specialty training in April 2007, and on 19 June 2007, an MRI showed a grade 3 medial right femoral neck stress fracture.  She underwent a course of physical therapy with no significant relief.  The 21 August 2007 MEB NARSUM examination, 1 month prior to separation, noted complaints of persistent right hip pain, and the examiner documented tenderness.  Right hip flexion was to 107 degrees (normal 125), extension to 0 degrees (normal), and abduction to 23 degrees (normal 25), with limitation due to pain.   At the 15 January 2008 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported right thigh pain, rated at 3/10, and aggravated by standing, walking, and navigating stairs.  Physical examination showed medial thigh tenderness and a right limp, and flexion to 120 with normal extension and abduction and painful motion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 20%, analogously coded 5099-5003 (degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA rated the right leg condition 10%, coded 5255 (impairment of femur, malunion), based on the C&P examination, citing a “slight” disability.  Panel members agreed that there was no evidence of limitation of flexion to 20 degrees (5252) or marked hip disability (5255) for a higher 30% rating under those codes.  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 §4.71a, 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.  

	PD-2017-05257

ARXXXXXXXXXXX, XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXX

	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.

Sincerely,					      

Enclosure

	PD-2017-05257