DEPARTMENT OF THE AIR FORCE
WASHINGTON DC

Office of the Assistant Secretary

SAF/MRBD (PDBR)
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

MEMORANDUM FOR THE ASSISTANT SECRETARY OF THE NAVY, MANPOWER AND RESERVE AFFAIRS

SUBJECT: Physical Disability Board of Review Recommendation on Case Number PD-2018-00505

In accordance with Title 10 § 1554a and in compliance with DoDI 6040.44, the Physical Disability Board of Review (PDBR) adjudicated the disability rating accompanying the medical separation of the covered individual from the United States Marine Corps. After carefully reviewing the application and medical separation case file, the PDBR recommended no re- characterization of the separation or modification of the disability rating previously assigned. I recommend you accept this proposed decision.

The covered individual was an active duty E5, Administrative Clerk, medically separated for “left hip posttraumatic arthritis” with a disability rating of 10%. The PEB analogously coded the condition 5003 (arthritis degenerative) and listed four separate conditions of “status post (s/p) open reduction and internal fixation (ORIF) of left hip dislocation, left posterior wall acetabular fracture, s/p ORIF of acetabular fracture, and left hip dislocation” as related Category II diagnoses contributing to the primary disability in this case. The Category II diagnoses were not separate conditions which could be reasonably justified as separately unfitting; nor would separate ratings be achievable without violation of VASRD §4.14 (avoidance of pyramiding).
The VA rated the left hip condition 40%, coded 5252 (thigh, limitation of flexion), based on the Compensation and Pension examination, citing 5 degrees of left hip flexion and thus awarding the maximum rating for this condition. Panel members first considered and deliberated over the vast difference in range of motion (ROM) measurements between the narrative summary (NARSUM) at 3 months prior to separation and the VA examination at one month after separation and concluded that the VA provider, more likely than not, mislabeled and flipped the words “extension” with “flexion” for the documented ROMs, as the way they were listed did not make anatomical sense. Therefore, panel members considered that the VA ROMs were actually extension to 5 degrees and flexion to 120 degrees. Panel members further agreed that both the pre-separation NARSUM examination as well as the post-separation VA examination held near equal probative value for rating purposes. Both examinations supported the sole impairment rating of 10% for limitation of thigh extension. Absent worsening degree of ROM, fracture, or malunion with moderate disability, there were no alternate or analogous codes that would yield a rating greater than the PEB’s current adjudicated 10%. 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 left hip condition.

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

I N REPLY REFER TO:
1850
CORB: 003
10 Sep 20

From: Director. Secretary of the Navy Council of Review Boards To:

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.