RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX CASE: PD1201488 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130327 

SEPARATION DATE: 20031212 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an activated active duty SPC/E-4 (71L/Administrative Specialist) 
medically separated for left hip pain. He sustained a hip dislocation in 2002 while running. The 
condition could not be adequately rehabilitated after surgery 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, characterized as “left hip dislocation with posterior wall acetabula fracture 
status post (s/p) open reduction and internal fixation (ORIF),” was forwarded to the Physical 
Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The 
Informal PEB (IPEB) adjudicated the left hip condition as unfitting, rated 0%, with likely 
application of the US Army Physical Disability Agency (USAPDA) pain policy. The CI did not 
concur with the IPEB findings and after review by the USAPDA the IPEB findings were affirmed. 
The CI was medically separated with a 0% disability rating. 

 

 

CI CONTENTION: “After separating from the Army, I am heavily disabled and barely able to go 
about daily activities.” 

 

 

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. Ratings for unfitting conditions will be reviewed 
in all cases. The rated, unfitting left hip pain condition meets the criteria prescribed in DoDI 
6040.44 for Board 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 respective Board for Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20030821 

VA - (12 Mos Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Left Hip Pain 

5099-5003 

0% 

Residuals, Left Hip Dislocation 
with Posterior Wall Acetabular 
Fracture Status Post ORIF 

5252 

20% 

20040225 

No Additional MEB/PEB Entries 

Other x 4 

20041207 

Combined: 0% 

30% 



Derived from VA Rating Decision (VARD) dated 20041025 (most proximate to date of separation [DOS). 

 

 

ANALYSIS SUMMARY: 

 

Left Hip Condition. The narrative summary (NARSUM - coupled with the MEB DD Form 2807) 
notes a left hip injury with running with a posterior wall acetabular fracture and subsequent 
ORIF on 18 September 2002 (15 months prior to separation). At the MEB exam, the CI reported 


always being in pain from his hip and being severely limited in what he could do. The MEB 
physical exam noted a non-antalgic gait and left hip range-of-motion (ROM) of 0-95 degrees 
(normal 125 degrees), normal motor strength and no sensory or vascular deficit. Current 
function was noted as “on profile restricting him from running, unable to do sit-ups or 
marching. He was unable to do side-straddle hops, jumping or lift any heavy weight.” 
Recommendation noted PEB referral “secondary to the seriousness of his injury and the 
potential complications of avascular necrosis of the femoral head and in addition to subsequent 
post fracture arthritis which could all be accelerated by continued active service demands of his 
MOS and duty in the United States Army.” 

 

At the VA Compensation and Pension (C&P) exam performed 12 months after separation, the CI 
reported immediate left hip pain with walking. Exam documented left quadriceps (thigh 
muscle) circumference of 62 cm (compared to 66 cm on the opposite side), a limp on his left 
hip, and painful flexion to 70 degrees (normal 125 degrees). The examiner stated “I would 
expect chronic pain, loss of motion, lack of endurance in the left hip. Range of motion loss 
would be 40 degrees or more with flareups or repetitive use. I would expect a chronic gait 
disturbance (DeLuca ROM of 30°).” 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the CI at 0% coded 5099-5003 and rated for pain. The VA rated the CI at 20% coded 
5252 based on exam 12 months after separation and with consideration of DeLuca criteria. The 
ROM was to 95 degrees while the VA exam ROM was to 30 degrees. It is obvious that there is a 
clear disparity between these examinations, with very significant implications regarding the 
Board's rating recommendation. The Board considered the tenants of VASRD §4.7 (Higher of 
two evaluations) and thus deliberated the probative value assignment to these conflicting 
evaluations, and carefully reviewed the file for corroborating evidence. The VA ROM was more 
remote from separation and the service record did not demonstrate episodes of similarly 
limited ROM. The Board adjudged that the MEB exam had the highest probative value for 
rating at the time of separation and that there was sufficient evidence of pain-limited motion to 
concede painful motion IAW VASRD §4.59. After due deliberation, considering all of the 
evidence and mindful of VASRD §4.3 (Resolution of reasonable doubt), the Board recommends 
a disability rating of 10% for the left 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. As discussed above, PEB 
reliance on the USAPDA pain policy for rating the left hip was operant in this case and the 
condition was adjudicated independently of that policy by the Board. In the matter of the left 
hip condition, the Board unanimously recommends a disability rating of 10%, coded 5099-5003 
IAW VASRD §4.71a. 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 his prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Left Hip Pain s/p Dislocation, Acetabular fracture and ORIF 

5099-5003 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120808, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxx, AR20130008739 (PD201201488) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)