RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX CASE: PD12001430 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130327 

SEPARATION DATE: 20031215 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (63W10/Wheel Vehicle Repairer), medically 
separated for a bilateral hip condition. She experienced an onset of right hip pain in 2002; was 
seen by multiple Primary Care and Orthopedic providers; and, underwent an array of treatment 
modalities. Over time she developed bilateral hip pain, diagnosed as trochanteric bursitis, 
which could not be adequately rehabilitated to meet the physical requirements of her Military 
Occupational Specialty (MOS). She was consequently issued a permanent L3 profile and 
referred for a Medical Evaluation Board (MEB). The condition was forwarded, as a bilateral 
diagnosis, to the Informal Physical Evaluation Board (IPEB) IAW AR 40-501. No other conditions 
were submitted by the MEB. The IPEB adjudicated the condition as a single unfitting bilateral 
condition, rated 0%, citing criteria of the Veterans Affairs Schedule for Rating Disabilities 
(VASRD). The CI appealed to a Formal PEB (FPEB), which affirmed the IPEB findings; and, was 
thus medically separated with a 0% disability rating. 

 

 

CI CONTENTION: “This to letter is to explain why I feel that the rating I received for the 
conditions which rendered me unfit for duty should be changed. When I first enlisted in the 
military I did not have any problems with my feet or my hips. While serving in the military I 
suffered and continue to suffer from pain in my hips, legs, and feet. Since being discharged 
from active duty I have had to have surgery on my right foot and still need surgery on the left 
foot. I have also had other problems to develop due to the conditions that rendered me unfit. I 
now have a bulging disc in my lower back which causes major pain and sometimes causes me to 
have limited mobility. These reasons and others not listed should warrant a change in my 
rating.” [sic] 

 

 

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 hip condition(s) is 
addressed below. The requested foot and lumbar conditions were not identified by the PEB, 
and thus are not within the DoDI 6040.44 defined purview of the Board. Those, and any other 
conditions or contention not requested in this application, remain eligible for future 
consideration by the respective Board for Correction of Military Records. The Board 
acknowledges the CI’s information regarding the significant impairment with which her service-
connected conditions continue to burden her 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 Veteran Affairs, operating under a 
different set of laws. 

 

 


RATING COMPARISON: 

 

Service FPEB – Dated 20031001 

VA - (4 Mos. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Trochanteric Bursitis, Bilateral Hips 

5019 

0% 

Bilateral Trochanteric Bursitis 

5019 

0%* 

20040415 

No Additional MEB/PEB Entries 

Not Service-Connected x 1 

20040415 

Combined: 0% 

Combined: 0% 



Derived from VA Rating Decision (VARD) dated 20040706, most proximate to date of separation (DOS). 

* 5019 was increased to 10% left and 10% right in VARD dated 20071114 effective 20050228. 

 

 

ANALYSIS SUMMARY: 

 

Bilateral Hip Condition (Chronic Trochanteric Bursitis). The narrative summary (NARSUM) notes 
a chief complaint of chronic bilateral hip pain with the right being worse than the left. The CI 
was seen multiple times for her hips and was treated with physical therapy, non-steroidal anti-
inflammatory medication, occasional narcotic pain medication for severe pain and two steroid 
injections without improvement. The examiner stated “the pain is made worse with normal 
daily activities required for her MOS and also with running, jumping, marching and sit-ups. The 
patient also states that carrying a ruck sac with increased weight seems to make the pain much 
worse.” X-rays were normal and bone scan demonstrated mild uptake in the right hip. 

 

The NARSUM, 5 months prior to separation, noted bilateral hip tenderness (right greater than 
left) with bilateral flexion to 90 degrees (normal 125 degrees), abduction 45 degrees (normal 45 
degrees) and adduction of 10 degrees (normal 45 degrees). The examiner specified “negative 
pain with internal/external rotation” with negative pelvic rock. The DD Form 2808 two months 
prior to the NARSUM documented painful rotation bilateral hips. A treatment note 2 months 
after the NARSUM indicated “full active ROM (range-of-motion) with discomfort” and the 
physician started Elavil for neuromodulator effect (for pain) and refilled narcotic pain 
medication. The preponderance of treatment notes and the injections were for the right hip. 
The left hip pain was first noted in March 2003, 10 months prior to separation as part of 
bilateral hip pain. The left hip was next addressed in the record in July 2003, with diagnosis of 
left hip bursitis in August 2003 (4 months prior to separation). 

 

At the VA Compensation and Pension (C&P) exam 4 months after separation, the CI reported 
bilateral hip problems with bilateral popping with motions. She noted pain of 7 out of 10 was 
constant and similar in both hips; it increased to 8 out of 10 with walking greater than a-half to 
a mile, prolonged standing or sitting. ROM was specified as active 0-125 degrees (normal 125 
degrees) with increased pain on repetition and left hip decreased flexion to 120°. Gait was 
normal and the CI was able to squat without difficulty. The VA examiner specified “no facial 
grimacing” on knee exams and “complains of pain she has no grimacing, no change in her facial 
expression” on feet exams, with no similar comments on the hip exams. Radiographs were 
normal. Fourteen months remote from separation (February 2005), the VA record indicated 
bilateral hips with pain-limited motion. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB combined the left and right hip conditions under a single disability rating, coded 5019. 
Although VASRD §4.71a permits combined ratings of two or more joints under 5019, it allows 
separate ratings for separately compensable joints. IAW DoDI 6040.44 the Board must follow 
suit if the PEB combined adjudication is not VASRD compliant, provided that each “unbundled” 
condition can be reasonably justified as separately unfitting in order to remain eligible for 


service rating. If the members judge that separately ratable conditions are justified by 
performance based fitness criteria and indicated IAW VASRD §4.7 (Higher of two evaluations), 
separate ratings are recommended with the stipulation that the result may not be lower than 
the overall combined rating from the PEB. The Board’s initial charge in this case was therefore 
directed at determining if the PEB’s combined adjudication was justified in lieu of separate 
ratings. The issues concerned whether each hip was separately unfitting if unbundled from a 
combined FPEB determination, and if each hip were separately compensable. 

 

The Board first considered if the right hip condition met the unfitting threshold for separate 
rating. The right hip was specifically profiled, had abnormal bone scan, was injected twice and 
was of the longest duration. Members agreed, therefore, that the right hip condition was 
reasonably justified as separately unfitting and that it met VASRD §4.71a criteria for separate 
rating, conceding painful motion for a 10% rating. The Board next considered if the left hip 
condition met the unfitting threshold for separate rating. The left hip was noted in the 
treatment notes, NARSUM, and PEBs as being much less symptomatic than the right hip. The 
left hip was not listed on the profile, but it would be speculative to separate restrictions from 
the right hip as not applying to the left hip. The NARSUM indicated bilateral hip worsening over 
the course of treatment, and it is common for the opposite paired leg to have increased 
stresses and symptoms with chronic disabilities. The Board considered that the record was very 
sparse on left hip pain or functional limitations until proximate to the MEB, the left hip was not 
noted on the profile, and did not have any imaging abnormalities. The Board consensus was 
that there was questionable basis for a separately unfitting left hip and that rating it, if 
separately unfit, would be 0%. The Board discussed VASRD §4.40 (Functional loss), §4.59 
(Painful motion), ROM ratings under codes 5019, and code 5003 criteria, separately rating each 
hip, and combining both hips IAW VASRD 4.71a. The Board consensus was there was no benefit 
to the CI for separately rating each hip versus rating both hips analogously to VASRD code 5003 
(or any of the diagnostic codes 5019 through 5024 which use the criteria from 5003). After due 
deliberation, considering all of the evidence and mindful of VASRD §4.3 (Resolution of 
reasonable doubt), §4.40 (Functional loss), and §4.59 (Painful motion), the Board majority 
recommends a disability rating of 10% for the Bilateral Hips condition coded 5099-5003. 

 

 

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 bilateral hip condition, the Board by a 2:1 vote 
recommends that the bilateral hips condition, coded 5099-5003 be rated at 10% IAW VASRD 
§4.71a. The single voter for dissent (who recommended each hip be separately unfitting coded 
5019 at 10% each), did not elect to submit a minority opinion. There were no other conditions 
within the Board’s scope of review for consideration. 

 

 

RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as 
follows, effective as of the date of her prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Trochanteric Bursitis, Bilateral Hips 

5099-5003 

10% 

COMBINED 

10% 



 


 


The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120608, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxxx, 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 xxxxxxxxxxxxxxxxxxxxxx, AR20130008722 (PD201201430) 

 

 

1. 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 to modify the individual’s disability rating to 10% without recharacterization 
of the individual’s separation. This decision is final. 

 

2. I direct that all the Department of the Army records of the individual concerned be corrected 
accordingly no later than 120 days from the date of this memorandum. 

 

3. I request that a copy of the corrections and any related correspondence be provided to the 
individual concerned, counsel (if any), any Members of Congress who have shown interest, and 
to the Army Review Boards Agency with a copy of this memorandum without enclosures. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)