RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05984
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050622

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Petroleum Supply Specialist, medically separated for “chronic left hip and groin pain” with a disability rating of 0%.   

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 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 – 20050315	VARD - 20050830	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Hip and Groin Pain	5099-5019	0%	... Chronic Hip Pain	5253-5019	10%	20050622	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Left Hip and Groin Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI had a history of chronic left hip pain dating to 2001 (onset with marching) that remained persistent after an exacerbation in 2004.  Diagnostic imaging (serial X-rays and MRI’s, arthrogram, and bone scan) was normal with an incidental finding of degenerative disc disease.  Empirical treatment for possible neuropathy (femoral cutaneous) was unsuccessful, and the working diagnoses were trochanteric bursitis and snapping hip syndrome.  Provider entries in the STR documented grossly normal left hip range of motion (ROM), with no indication of significantly severe ROM limitation, and there was no record of gait disturbance or other VASRD-ratable criteria.

Goniometric left hip ROM measurements conducted for the MEB by physical therapy (PT) on 29 September 2004, 9 months before separation, revealed flexion to 110 degrees (normal 125), extension to 20 degrees (normal 30), external rotation to 45 degrees (normal), and adduction to 25 degrees (normal), specifying painful motion.  The 29 January 2005 MEB NARSUM examination, 5 months prior to separation, documented nonspecific left hip pain that prohibited running, jumping, marching, and protracted loadbearing.  The physical examination recorded a normal gait and joint strength, and “tenderness and stiffness in the left hip” without note of ROM limitation or other positive findings. 

At the 22 June 2005 VA Compensation and Pension (C&P) examination, the day of separation, the CI reported constant left hip pain, rated at 10/10 at baseline, and 5/10 with rest and medication.  Documented functional limitations were recreational activities and prolonged standing, walking, or sitting.  The physical examination recorded an antalgic gait without assistive device (possibly from concurrent back pain, unclear), normal strength, and no note of other positive joint findings.  The only ROM measurement provided was flexion to 125 degrees, with painful motion but no ROM degradation after repetition.   

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip/groin condition 0%, coded 5099-5019 (analogous to bursitis), citing “rated for pain” implying application of the US Army Physical Disability Agency pain policy.  The VA rated the condition 10%, coded 5253-5019 (thigh, impairment of-bursitis), based on the C&P examination, citing painful motion.  Panel members agreed that while there was no evidence for limitation of motion in any plane which supported a compensable rating under the applicable joint codes (5252, 5252, and 5253), there was satisfactory evidence of painful motion (MEB PT examiner and temporally proximate C&P examination) that would provide for a minimum 10% rating IAW §4.59 (painful motion).  The panel considered other VASRD hip and analogous codes, but all were less applicable and/or not advantageous for rating.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a 10% rating for the left hip condition, coded 5099-5019.  

BOARD FINDINGS:  In the matter of the left hip condition, the panel recommends a disability rating of 10%, coded 5099-5019 IAW VASRD §4.59 and §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

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

CONDITION	VASRD CODE	PERMANENT RATING	
Trochanteric Bursitis with Chronic Pain, Left Hip	5099-5019	10% 	

The following documentary evidence was considered:

AR20200004039 

Dear XXXXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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 also been provided to the Department of Veterans Affairs.