RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201585 SEPARATION DATE: 20020422 

BOARD DATE: 20130214 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty PV2/E-2 (92A/AFSC, JOB), medically separated for left 
inferior pubic ramus stress fracture, with multiple stress reactions, lower extremities. The CI 
was in basic training for only 4 weeks and began to develop left hip pain and groin pain. 
Multiple stress fractures were identified on bone scan. The left inferior pubic ramus stress 
fracture condition could not be adequately rehabilitated to meet the physical requirements of 
her Military Occupational Specialty (MOS) or satisfy physical fitness standards. She was issued 
a permanent P3 and referred for a Medical Evaluation Board (MEB). The MEB forwarded no 
other conditions for Physical Evaluation Board (PEB) adjudication. The PEB adjudicated the left 
inferior pubic ramus stress fracture condition as unfitting, rated 0%. The CI made no appeals, 
and was medically separated with a 0% disability rating. 

 

 

CI CONTENTION: “I got a medical discharge where two conditions evaluated. I got a rate of 
10% for one of the condition. It have (sic) been more than 10 years and I still have episodes of 
pain, difficulty for exercise or spend much time standing.” 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44, Enclosure 3, paragraph 5.e.(2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.” The ratings 
for unfitting conditions will be reviewed in all cases. The condition left inferior pubic ramus 
stress fracture as requested for consideration meets the criteria prescribed in DoDI 6040.44 for 
Board purview; and, is addressed below, in addition to a review of the ratings for the unfitting 
conditions. The other condition implied in the request is not within the Board’s purview. 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 20020403 

VA (2 Mos. Post-Separation) – All Effective Date 20020423 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Left Inferior Pubic Ramus 
Stress Fracture with 
multiple stress reactions, 
lower extremities. 

5022 

0% 

Status Post Left Pelvic Ramus 
Stress Fracture 

5299-5003 

10% 

20020610 

.No Additional MEB/PEB Entries. 

0% X 2 

 

Combined: 0% 

Combined: 10% 



 

 


ANALYSIS SUMMARY: The Disability Evaluation System (DES) is responsible for maintaining a fit 
and vital fighting force. While the DES considers all of the service member's medical conditions, 
compensation can only be offered for those medical conditions that cut short a member’s 
career, and then only to the degree of severity present at the time of final disposition. The DES 
has neither the role nor the authority to compensate members for anticipated future severity 
or potential complications of conditions resulting in medical separation nor for conditions 
determined to be service-connected by the Department of Veterans Affairs (DVA) but not 
determined to be unfitting by the PEB. However, the DVA, operating under a different set of 
laws (Title 38, United States Code), is empowered to compensate all service-connected 
conditions and to periodically re-evaluate said conditions for the purpose of adjusting the 
Veteran’s disability rating should the degree of impairment vary over time. The Board’s role is 
confined to the review of medical records and all evidence at hand to assess the fairness of PEB 
rating determinations, compared to VASRD standards, based on severity at the time of 
separation. 

 

Left Inferior Pubic Ramus Stress Fracture. The CI developed pain in the left upper hip and groin 
areas during basic training in February 2002. A bone scan revealed a stress fracture of the 
inferior left pubic ramus and bilateral lower legs. Despite treatment with medication, inactivity 
and bed rest, pain in the groin area persisted. At the MEB/narrative summary (NARSUM) 
evaluation on 6 March 2002, a month before separation, the CI reported painful weight 
bearing. On examination range-of-motion (ROM) of the hip was full with slight pain. The CI 
could cross her legs without difficulty. At the VA Compensation and Pension (C&P) exam 10 
June 2002, 2 months after separation, the CI reported throbbing pain in the left anterior hip 
with prolonged walking. She stated she was independent in her activities of daily living and did 
not require a crutch for ambulatory support. ROM of the hip was slightly reduced with mild 
pain on rotation. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the hip condition 0% coded 5022, citing the normal ROM of the hip. The VA rated at 
10%, analogous to code 5003 citing the painful ROM. The Board noted the PEB combined the 
left inferior pubis fracture condition and multiple stress fractures of the lower extremities 
condition and rated, as a single unfitting condition, at 0%, coded 5022. Not uncommonly this 
approach by the PEB reflected its judgment that the constellation of conditions was unfitting, 
and there was no need for separate fitness adjudications or implied adjudication that each 
condition was separately unfitting. The Board undertook to determine if the PEB’s approach of 
combining conditions under a single rating was justified in lieu of separate ratings. The Board 
must apply separate codes and ratings in its recommendations if compensable ratings for each 
condition are achieved IAW VASRD §4.71a. If the Board judges separate ratings are warranted, 
however, it must satisfy the requirement that each ‘unbundled’ condition was unfitting in and 
of itself. 1) Left pubic ramus stress fracture-the Board unanimously agreed that the 
preponderance of evidence in the record supports the left pubic ramus pelvic fracture condition 
to be unfitting. The Board agreed a rating of 10% was appropriate IAW §4.59. The Board 
agreed the condition was not compensable under §4.71a, ROM and rating under code 5255, 
femur impairment with slight hip disability and could achieve no rating higher than 10%; 2) 
Bilateral tibial stress fractures- the Board noted the CI to have bilateral tibial stress fractures on 
bone scan of 24 August 2001. Symptoms for this had resolved by February 2002 with 
treatment. On C&P exam, 10 June 2002, 2 months after separation, examination of both lower 
extremities revealed only minimal tenderness to palpation. Neither lower extremity was 
declared in any permanent profile. The Board unanimously agreed that the preponderance of 
evidence supports that the stress fracture conditions of the lower extremities were healed at 
the time of separation and would not have caused the member to be referred into the DES or 


be found unfit because of physical disability. The Board concluded, therefore, that these 
conditions were not unfitting and could not be recommended for additional disability rating. 
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 pubic stress fracture 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. The Board did not 
surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD 
were exercised. In the matter of the left inferior pubic ramus stress fracture condition, 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 

Left Inferior Pubic Ramus Stress Fracture 

5022 

0% 

COMBINED 

0% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120812, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxxxxxx, AR20130003922 (PD201201585) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)