RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-05673 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20070215

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Basic Electronics Maintenance Marine, medically separated for “bilateral trochanteric bursitis” with a disability rating of 0%.

CI CONTENTION: Currently receiving a 40% a rating from the VA and requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and/or 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 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 - 20061219	VARD - 20080207	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Trochanteric Bursitis	5099-5003	0%	Right Hip Trochanteric Bursitis	5019-5252	10%	20071010	
			Left Hip Trochanteric Bursitis	5019-5252	10%		
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Bilateral Trochanteric Bursitis. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s bilateral hip condition began in December 2005 after the stresses of boot camp. The 12 November 2006 MEB NARSUM examination, 3 months prior to separation, noted complaints of hip pain, greater on the left than the right, and a diagnosis of bilateral trochanteric bursitis. The CI used a cane, was being treated with medications, and received chiropractic care which provided a few hours of relief after each visit. Physical examination showed an antalgic gait and tenderness, and the examiner recorded “hip range of motion [ROM] from 0 to approximately 110 degrees bilaterally,” internal rotation to 50 degrees (normal 60), and external rotation to 20 degrees (normal 60). Hip X-rays were unremarkable. At the 15 November 2006 orthopedic follow-up, the provider documented “bilateral hips-no pain with IR/ER hips IR 20 arid ER 60 full flexion and extension, +TTP at greater trochanter, good abduction strength, negative Faber, skin intact and NVI distally…” which was the exact same notation from 8 September and 18 October 2006 treatment entries. During the 28 November 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), the CI reported bilateral hip

pain, and the examiner found a slight limp favoring the left lower extremity with full active ROM of both hips (no measurements provided).

At the 10 October 2007 VA Compensation and Pension (C&P) examination, 8 months after separation, the CI reported bilateral hip pain and use of a cane. Physical examination showed a normal gait. Measured ROM showed right hip flexion to 110 degrees and left hip flexion to 105 degrees. Bilateral abduction (normal 45) and external rotation were to 45 degrees in both planes, and there was pain with repetitive movement of both hips. Bilateral hip X-rays showed a large femoral/intertrochanteric bone island on the right, but were otherwise unremarkable.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the bilateral hip condition 0%, analogously coded as 5003 (degenerative arthritis). The VA rated the right and left hip conditions separately at 10% each, dual coded 5019-5252 (bursitis- limitation of flexion of thigh), based on the C&P examination, citing objective evidence of pain with active and repetitive movement of both hips. Both hip conditions were forwarded to the PEB and implicated by the NARSUM and commander’s non-medical assessment. Other STR evidence did not provide any information which would discriminate the performance limitations attributable to either hip over the other. Since undue speculation would be required to conclude that either left and/or right hip impairment would not have unacceptably interfered with the performance of military duties, panel members agreed each hip was reasonably justified as separately unfitting.

The hip ROM “from 0 to approximately 110 degrees” recorded by the NARSUM examiner could be interpreted as indicating extension of less than 5 degrees, which could support a 10% rating under code 5251 (thigh, limitation of extension). Alternatively, the NARSUM, MEB examination and other STR entries indicated an antalgic gait and other evidence of painful motion, and the VA examination, which was most detailed and considered repetitive motion, also documented painful motion. Thus, there was sufficient evidence of painful motion causing functional loss (based on §4.59, §4.40 and §4.45) to support a 10% rating for each hip. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% each for the unfitting right and left hip conditions, both coded 5019-5252.

BOARD FINDINGS: In the matter of the bilateral hip condition, the panel recommends that each hip joint be separately adjudicated as follows: an unfitting right hip condition, coded 5019-5252 and rated 10%; and an unfitting left hip condition, coded 5019-5252 and rated 10%, both IAW VASRD §4.71a. There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Right Trochanteric Bursitis	5019-5252	10%	
Left Trochanteric Bursitis	5019-5252	10%	
	COMBINED	20%	

DEPARTI1ENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO:
1850
CORB:003 12 Oct 20

From: To:
Subj:

Ref:

Director, Secretary of the Navy Council of Review Boards 
PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)
(a) DoDI 6040.44
(b)	PDBR ltr of 15 Jan 20
(b)	

1.	Pursuant to reference {a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy for appropriate action.

2.	On 7 October 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) took action in your case by accepting the recommendation of the PDBR. Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEB) from 0% to 20% without re-characterization of your discharge.

3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement to additional compensation.

4.	

The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, has been forwarded to the office of the Deputy Commandant, Manpower and Reserve Affairs, for appropriate changes to your personnel records and notification to you upon completion.

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