RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2021-00014
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20061205

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E6, Human Resources Specialist, medically separated for “bilateral trochanteric bursitis” with a disability rating of 10%. 

CI CONTENTION:  In addition to the bilateral hips, the CI requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and 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 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 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 - 20060830 | VARD - 20070412
Condition | Code | Rating | Condition | Code | Rating | Exam
Bilateral Trochanteric Bursitis | 5019 | 10% | Trochanteric Bursitis, Left Hip | 5252 | 10% | 20070308
| | | Trochanteric Bursitis, Right Hip | 5252 | 10% | 20070308
COMBINED RATING:  10% | COMBINED RATING OF ALL VA CONDITIONS:  50%

ANALYSIS SUMMARY:  

Bilateral Trochcanteric Bursitis.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s bilateral hip condition began in September 1999 after running.  An MRI in May 2006 showed degenerative changes of the left hip and minimal right hip arthritic changes.

During the 2 June 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported bursitis in both hips and a recent (“2 nights ago”) trip to the emergency room for hip pain.  Physical examination showed a normal lower extremity. The 14 June 2006 MEB NARSUM examination noted complaints of pain with running, sit-ups, stairs, and popping sensations in the hips.  Physical examination showed “pain with palpation of the greater trochanter region of both left and right hips and with external rotation and abduction. 

At the 8 March 2007 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported 7/10 daily hip pain aggravated by standing, sitting for long periods of time, walking for long distances, or any type of repetitive movement.  Repetitive movement also caused increased pain and decreased range of motion (ROM).  Physical examination showed the ability to heel-walk and toe-walk, but with great difficulty due to hip pain.  Gait was antalgic and hips were tender over the greater trochanter bilaterally.  The ROM study showed bilateral hip flexion of 90 degrees (normal 125), extension of 0 degrees (normal 30), and abduction of 20 degrees (normal 45) with pain in all planes of movement.  There was increased pain on repetitive motion, but no additional limitation of motion.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB bundled the left and right hip conditions and applied a single 10% rating, coded 5019 (bursitis), citing “bilateral spurring in the lateral hip area by X-ray examination.”  The VA rated each hip 10%, coded 5252 (limitation of thigh flexion), based on the C&P examination, citing limitation of flexion.  The panel first considered if the bilateral hip condition, having been de-coupled from the combined PEB adjudication, remained separately unfitting.  Panel members agreed the same pathology existed for each hip. The panel then considered its rating recommendation for each unfitting hip. There was no limitation of motion which supported a compensable rating under the diagnostic codes for limitation of thigh flexion (5251) and extension (5252) for either hip.   However, panel members agreed that IAW VASRD §§4.59 and 4.40, a 10% rating for each hip was warranted based on painful limitation of motion demonstrated during the NARSUM and C&P examinations with MRI evidence of mild degenerative changes in each hip joint.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the left hip condition, coded 5019, and 10% for the right hip condition, coded 5019.  

BOARD FINDINGS:  In the matter of the bilateral hip condition, the panel recommends that each joint be separately adjudicated as follows: an unfitting right hip condition coded 5019 and rated 10%, and an unfitting left hip condition coded 5019 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
Left Hip Condition | 5019 | 10%
Right Hip Condition | 5019 | 10%
COMBINED | 20%

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20210208, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

	

AR20210013425, XXXXXXXXXX 

Dear XXXXXXXXXX:

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. 

Sincerely,