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AF | PDBR | CY2012 | PD-2012-00594
Original file (PD-2012-00594.pdf) Auto-classification: Denied
RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:   ARMY 
SEPARATION DATE:  20020918 

 
NAME:  XXXXXXXXXXXX 
CASE NUMBER:  PD1200594 
BOARD DATE:  20121206 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  SPC/E‐4,  (31S/Satellite  Communications  Systems 
Operator/Maintainer),  medically  separated  for  a  right  hip  condition.    The  CI  did  not  respond 
adequately  to  conservative  treatment  and  was  unable  to  perform  within  his  Military 
Occupational Specialty (MOS), meet worldwide deployment standards or meet physical fitness 
standards.  He was issued a permanent L3 profile and referred for a Medical Evaluation Board 
(MEB).  Right avulsion fracture of lesser trochanter was forwarded to the Physical Evaluation 
Board (PEB) IAW AR 40‐501.  No other conditions appeared on the MEB’s submission.  The PEB 
adjudicated  the  right  hip  condition  as  unfitting,  rated  10%,  with  application  of  the  US  Army 
Physical Disability Agency (USAPDA) pain policy.  The CI made no appeals, and was medically 
separated with a 10% disability rating.   
 
 
CI CONTENTION:  “Flexibility was the only criteria for assessment.  I will never be able to run or 
play sports from my condition.”  The CI elaborated no specific contention in his application.   
 
 
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.    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:   
 

VA (18 Mos. Post‐Separation) – All Effective Date 20031031

*Effective date is date of application, not day after separation 
 
 
ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
that only flexibility was considered in the rating and also regarding the significant impairment 
with which his service‐incurred condition continues to burden him.  The Board wishes to clarify 
that it is subject to the same laws for service disability entitlements as those under which the 
Disability Evaluation System (DES) operates.  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.    That  role  and  authority  is  granted  by  Congress  to  the 
Department of Veterans Affairs (DVA), operating under a different set of laws (Title 38, United 
States  Code).    The  Board  evaluates  DVA  evidence  proximal  to  separation  in  arriving  at  its 

Service IPEB – Dated 20020530 
Condition 

Code 

Right Hip s/p avulsion fx 
lesser trochanter 

5099‐5003 

↓No Addi(cid:415)onal MEB/PEB Entries↓ 

Combined:  10% 

Rating
10% 

Condition

Code 

Residuals, lesser trochanter
avulsion of right hip

5010‐5252 
0% X 0 / Not Service‐Connected x 0 

Combined:  10%* 

Rating 
10% 

Exam

20040318 

recommendations, but its authority resides in evaluating the fairness of DES fitness decisions 
and rating determinations for disability at the time of separation.  It is noted for the record that 
the Board recognizes the significant interval (18 months) between the date of separation and 
the  DVA  evaluation.  DoDI  6040.44,  under  which  the  Board  operates,  specifies  a  12‐month 
interval for special consideration to VA findings.  This does not mean that the VA information 
was disregarded, as it was a valuable source for clinical information and opinions relevant to 
the  Board’s  evaluation.  In  matters  germane  to  the  severity  and  disability  at  the  time  of 
separation, however, the information in the service record was assigned proportionately more 
probative value as a basis for the Board’s rating recommendations. 
 
Right Hip Condition.  The CI sustained an injury to his right hip while performing in a karate class 
which  resulted  in  chronic  residual  pain.    Extensive  evaluations  were  performed  by  the 
specialties  of  physical  therapy,  surgery,  orthopedics,  pain  management,  and  manipulative 
therapy and included the following radiographs, plain X‐ray and bone, computer tomography 
(CT) and magnetic resonance imaging (MRI) scans.  The plain X‐ray revealed an avulsion fracture 
of the lesser trochanter and the remaining radiographs were normal.  Thus he was diagnosed 
by orthopedics with chronic hip pain with no surgical intervention recommended.  Despite pain 
medications,  physical  therapy,  trigger  point  injections  and  pool  therapy,  he  had  only  25% 
improvement  and  temporary  relief  with  heat  and  ice.    The  permanent  profile  limitations 
included; no running, marching for more than 2 miles, sit‐ups, or physical fitness testing.  The 
commander’s  statement  corroborated  his  limitations  and  the  inability  to  perform  any  of  a 
number  of  simple  physical  tasks  required  of  his  MOS.    There  were  3  goniometric  range‐of‐
motion (ROM) evaluations in evidence, with documentation of additional ratable criteria, which 
the Board weighed in arriving at its rating recommendation; as summarized in the chart below.   

 

Right Hip (Thigh) ROM 

MEB ~12 Mo. Pre‐Sep 

PM&R ~6 Mo. Pre‐Sep 

VA C&P ~18 Mo. Post‐Sep 

Flexion (0‐125⁰) 
Extension (0‐20⁰) 

External Rotation (0‐45⁰) 

Abduction (0‐45⁰) 
Adduction (0‐45⁰) 

Comment 

0‐110⁰ 
silent 
30⁰ 
40⁰ 
10⁰ 

90⁰ 

Full range 
Full range 
Full range 

10⁰ 

Mild discomfort with IR and 

loading, 30⁰(IR) 

Painful motion 

95⁰ 

Approx 20⁰ 

70⁰ 
45⁰ 
20⁰ 

 

10% 

10% 

§4.71a Rating 

10% 

 
At the MEB exam, the CI reported constant non radiating groin pain, 2 of 10 in intensity at rest, 
worsened  to  9  of  10  in  intensity  with  walking,  running  or  jumping  and  sit‐ups,  and  relieved 
temporarily  with  transcutaneous  electrical  nerve  stimulation  (TENS)  treatment,  heat  and  ice.  
The MEB physical exam demonstrated tenderness of the right groin, negative special testing for 
active  hip  disease  (Patrick  testing),  4/5  motor  testing  with  hip  flexion  due  to  pain  with  a 
remaining  normal  motor  exam  and  normal  sensory  and  reflex  findings. 
  At  the  VA 
Compensation and Pension (C&P) exam after separation, the CI reported; able to walk for two 
miles yet was unable to run and took over the counter medications for pain.  The C&P exam 
demonstrated no new additional findings from the MEB exam.  X‐ray of the right hip revealed 
early degenerative changes. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and VA chose different coding options for the condition, but this did not bear on rating.  
The PEB’s DA Form 199 reflected application of the USAPDA pain policy for rating, but its 10% 
determination is consistent with §4.71a standards under the analogous diagnostic code 5003 
(arthritis, degenerative).  The VA assigned a 10% rating analogous to 5252 (Thigh, limitation of 
flexion of) for non compensable pain limited motion and degenerative changes on X‐ray which 
is  also  consistent  with  §4.71a  standards.    The  Board  agreed  there  is  no  evidence  of 

   2                                                           PD1200594 
 

incapacitating episodes to support additional or a 20% rating under the 5003 code.  There are 
no other viable approaches to a higher rating for the right hip which are countenanced by the 
VASRD.    After  due  deliberation,  considering  all  of  the  evidence  and  mindful  of  VASRD  §4.3 
(reasonable  doubt),  the  Board  concluded  that  there  is  insufficient  cause  to  recommend  a 
change in the PEB adjudication for the right hip 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.  As discussed above, PEB reliance on the USAPDA pain policy for rating right hip 
condition  was  operant  in  this  case  and  the  condition  was  adjudicated  independently  of  that 
policy by the Board.  In the matter of the right hip 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:   
 

VASRD CODE  RATING
5099‐5003 
COMBINED 

10%
10%

Right Hip s/p avulsion fx lesser trochanter

UNFITTING CONDITION

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120601, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 
SFMR‐RB 
 

 
 

 

 

 

           XXXXXXXXXXXXX, DAF 
           President 
           Physical Disability Board of Review 

 
 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency  

(TAPD‐ZB / XXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA  22202‐3557 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 

XXXXXXXXXXXXX, AR20130000271 (PD201200594) 

 
 

 

 
 

   3                                                           PD1200594 
 

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: 

 

 
 
 
 

 

 

 

 

 
CF:  

(  ) DoD PDBR 

(  ) DVA 

Encl 

 

 

 

 

 

 

 

 

 

 

 

 

     XXXXXXXXXXXX 

     Deputy Assistant Secretary 
         (Army Review Boards) 

 

 

 

   4                                                           PD1200594 
 



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