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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