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 DIRECTOR, AIR FORCE REVIEW BOARDS AGENCY
SUBJECT: Physical Disability Board of Review Recommendation on XXXXXXXXX Case Number PD-2020-00210

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 Air Force. 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 (CI) was an active duty E5, Medical Services Craftsman, medically separated from the Temporary Disability Retired List (TDRL) for “bilateral hip pain secondary to osteoarthritis” which the PEB combined under a single disability rating, dual coded 5003-5255 and rated 20%. The VA rated each hip condition 10%, coded 5003 (degenerative arthritis), for a combined rating of 20%, based on the Compensation and Pension examination, and citing painful or limited motion of a major joint or group of minor joints. The panel concluded there was not a preponderance of evidence in the service records which overcame the panel’s presumption that the bundled hips were reasonably considered separately unfitting. The panel then considered its rating recommendation for each unfitting hip beginning with the right hip. The panel first considered the 5003 code given the arthritis diagnosis and radiographic evidence of arthritis. The panel also considered the 5255 code for femur impairment, but was unable to justify a rating under that code, given no evidence of a fractured femur resulting in knee or hip disability. The panel noted there was no limitation of motion which supported a compensable rating under the diagnostic codes for limitation of thigh flexion, and extension (5251 and 5252). However, panel members agreed the 10% rating and no higher was warranted for the right hip condition based on limitation of motion of a major joint. The TDRL narrative summary (NARSUM) examiner stated the physical examination of the right hip was unchanged from “his prior exams.” Radiographs showed no significant progression of his arthritis compared to prior films. Although the examiner opined that the CI may eventually require a right hip replacement due to the severity of his arthritis, the CI noted he was able to satisfy the physical requirements of his job without significant difficulty. The panel also noted the record showed the condition remained stable over several years after TDRL removal, and without surgical intervention.

The panel then turned its attention to the rating of the left hip. Panel members agreed, the same pathology existed for the left hip, although there were no range of motion measurements

documented during the 12 months prior to TDRL removal. Therefore, there was no documented limitation of motion supporting a compensable rating under codes 5251 and 5252. Panel members agreed, a 10% rating was justified for limitation of motion with painful motion as documented in the NARSUM. The panel discussed changing the PEB code to 5003 since that code appeared to better reflect the CI’s condition, but there was no rating advantage to the code change. After due deliberation, considering all of 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 bilateral hips at the time of TDRL removal.

 SAF/MRB 
3351 Celmers Lane 
JBA NAF Washington, MD 20762-6435 

Dear XXXXXXXXXXXX 
Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2020-00210. 
After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate. Accordingly, the Board recommended no rating modification or re-characterization of your separation. 
I have carefully reviewed the evidence of record and the recommendation of the Board. I concur with that finding and their conclusion that modification of your disability rating or characterization of your separation is not warranted. Accordingly, I accept the recommendation that your application be denied

2	PD-2020-00210