RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  	CASE:  PD1201341
BRANCH OF SERVICE:  Army	BOARD DATE:  20130305
SEPARATION DATE:  20020403

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty Private First Class/E-1 (31F1O/Network Switching Systems Operator/Maintainer) medically separated for a left hip condition.  He developed left hip pain in basic training, which persisted and worsened throughout the balance of his service.  He was subsequently diagnosed with trochanteric bursitis and did not respond adequately to a protracted trial of conservative treatments.  He was unable to meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards.  He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB).  The left hip condition was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other conditions were submitted by the MEB.  The PEB adjudicated the condition as unfitting, rated 0%, referencing the US Army Physical Disability Agency (USAPDA) pain policy.  The CI made no appeals and was medically separated with a 0% disability rating.

CI CONTENTION:  “Limited to employability options due to pain (constant) such as construction, etc. that requires long periods of time standing or Bending or requiring the Body to be in unnatural position to do work.  Burcitus still persistant.”

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e. (2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI.  The rating for the unfitting left hip condition is addressed below.  Any conditions or contention not requested in this application, or otherwise outside the Board’s defined scope of review, remain eligible for future consideration by the Army Board for Correction of Military Records.

RATING COMPARISON:  
   
Service IPEB – Dated 20020225	VA - Based on Service Treatment Records (STR)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Hip Pain	5099-5003	0%	Bursitis, Left Hip	5299-5251	0%	STR	
No Additional MEB/PEB Entries	No Other Conditions	STR	
Combined:  0%	Combined:  0%	

ANALYSIS SUMMARY:  The Board acknowledges the significant impairment with which the CI’s service-connected condition continues to burden him but must emphasize that the Disability Evaluation System has neither the role nor the authority to compensate members for anticipated future severity or potential complications of conditions resulting in medical separation.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.

Chronic Left Hip Pain Condition.  Two weeks after developing left hip pain without history of trauma, the CI was diagnosed with bursitis.  Radiographs, bone scan, and magnetic resonance imaging (MRI) of the hips were all negative for hip pathology.  The hip pain was treated conservatively with unsustained improvement.  Physical therapy examination, 9 months prior to separation, noted pain was not solicited on motion and CI had full range-of-motion (ROM).  He reported hip snapping on motion.  The CI was referred to orthopedics for evaluation.  On this examination, approximately 6 months prior to separation, flexion of the hip was 100 degrees, abduction of 45 and internal rotation of 35, external of 60 degrees, with normal sensory and strength exams, and tenderness to palpation over the greater left trochanter.  The CI received a permanent profile that stated he could walk, run, swim, and bike at his own pace and could march up to one quarter of a mile.  At the MEB narrative summary (NARSUM) evaluation on 13 November 2001, approximately 5 months prior to separation, the CI reported pain of the hip with running, jumping, marching, sit ups and walking.  The MEB evaluator referred to the physical exam findings of physical therapy and orthopedic exam above.  The referenced physical therapy examination dated 24 October 2001 revealed hip flexion of 110 degrees and extension of 10, and abduction at 25 with pain on motion.  The MEB examination performed on 1 November 2001, approximately 5 months prior to separation, noted musculoskeletal, neurological and lower extremities examination of strength and ROM were all normal.  Chronic left hip pain, trochanteric bursitis and snapping hip syndrome (with joint stability) were diagnosed.  

The Board directs attention to its rating recommendation based on the above evidence.  The PEB rated the condition IAW the USAPDA pain policy coded 5099-5003 at 0% and the VA used the service treatment record (STR) to rate the condition at 0% coded 5299-5251 (limitation of extension).  The Board agreed that the record did not sufficiently document objective evidence of pain on motion or corresponding pathology to meet the requirement of §4.59.  The Board unanimously agreed the records in evidence document no significant limitation of motion, debilitating pain, or radiographic evidence of joint pathology for compensable rating under any applicable VARSD code.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the chronic left hip pain condition.

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  As discussed above, PEB reliance on the USAPDA pain policy DoDI 1332.39 for rating hip pain was operant in this case and the condition was adjudicated independently of that policy/instruction by the Board.  In the matter of the chronic hip pain condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration. 

RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:  

UNFITTING CONDITION	VASRD CODE	RATING	
Condition	5099-5003	0%	
COMBINED	0%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20120722, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

		Physical Disability Board of Review

SFMR-RB									

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(TAPD-ZB), 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for AR20130006281 (PD201201341)

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a,   I accept the Board’s recommendation and hereby deny the individual’s application.  
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

 BY ORDER OF THE SECRETARY OF THE ARMY:

Encl						
						
						         (Army Review Boards)

CF: 
(  ) DoD PDBR
(  ) DVA