RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05590
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050912

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Health Care Specialist, medically separated for “chronic right hip pain” with a disability rating of 10%.

CI CONTENTION:  “PDBR 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 - 20050621	VARD - 20060508	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain	5003	10%	Degenerative Joint Disease, Right Hip with Rotational Osteotomy	5252-5010	10%	20060320	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Chronic Right Hip Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right hip condition began in 2001 after jumping off the back of a vehicle and landing awkwardly.  An MRI revealed acetabular cartilage wear and a bony cyst in the superior lateral aspect of the acetabulum.  A CT scan showed good cartilage overlying the femoral head and an area of cartilage loss in the superior weight-bearing portion of the acetabulum.  Right femoral acetabular impingement was diagnosed, and a right hip labral debridement and repair with Ganz periacetabular osteotomy were performed on 29 November 2004.  Right hip X-rays revealed the development of heterotopic calcification, which limited range of motion (ROM).
The 1 April 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, showed a leg length discrepancy, visible right hip deformity, and limited, painful right hip motion.  The 8 April 2005 MEB NARSUM examination noted complaints of persistent right hip pain which prevented impact activities.  Physical examination showed hip flexion to 80 degrees (normal 125), external rotation to 20 degrees, and internal rotation to 0 degrees.  There was right quadriceps muscle atrophy, 4/5 hip flexor strength, right hip tenderness and painful motion.  

At the 20 March 2006 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported constant right hip pain.  Physical examination showed a mild right leg limp, a 2-cm right leg shortening, mild right hip tenderness, 4/5 strength and no atrophy.  Right hip flexion was 50 degrees, abduction was 25 degrees, and extension was 15 degrees; painful motion was present.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 10%, coded 5003 (arthritis, degenerative), citing loss of joint motion and chronic pain.  The VA also rated the right hip condition 10%, but dual coded 5252-5010 (thigh, limitation of flexion-arthritis, due to traumatic), based on the C&P examination, citing painful motion.  Members agreed that there was no limitation of hip extension or flexion to support a rating under code 5251 or 5252.  However, there was evidence of painful motion with functional loss to support a 10% rating (based on §4.59, §4.40 and §4.45).  There was no fracture, nonunion or malunion of the femur to support consideration under 5255.  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.

AR20190006214, 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.