Search Decisions

Decision Text

AF | PDBR | CY2012 | PD2012 01339
Original file (PD2012 01339.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:    CASE: PD1201339
BRANCH OF SERVICE: Army  BOARD DATE: 20130508
SEPARATION DATE: 20011214


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SPC/E-4 (11B/Infantryman) medically separated for a right hip pain condition. In November 2000, the CI noticed popping of his hip when he ran, prompting initial evaluation by his battalion P.A. in which he was diagnosed for a snapping hip pain syndrome. The CI failed to respond to non-steroidal anti-inflammatory medications and subsequently was referred in April 2001 to the division orthopedic surgeon, who evaluated the soldier and gave him the diagnosis of right hip snapping iliotibial band syndrome (ITBS). The condition could not be adequately rehabilitated 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 right hip pain condition was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The PEB adjudicated right hip pain condition as unfitting, rated 0% with application Veterans Affairs Schedule for Rating Disabilities (VASRD). The CI made no appeals, and was medically separated with a 0% disability rating.


CI CONTENTION: “Iliotibial Band Syndrome completely unhealed was told it would heal over time. Drasticaly holds me back from jobs and quality of life with my children. TBI and problems with left eye both caused by a heavy machine gun exploding in my face a foot from my head.”


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 right hip pain condition is addressed below; and, the requested traumatic brain injury (TBI) and left eye conditions are not within the DoDI 6040.44 defined purview of the Board. 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 Service Board for Correction of Military Records.


RATING COMPARISON:

Service IPEB – Dated 20011001
 VA - (1 Mos. Pre-Separation)
Condition
 Code Rating Condition Code Rating Exam
Right Snapping Hip Pain with Clinical Assessment of Iliotibial Band Syndrome
 5099-5003 0% Osteoarthropathy, Right Hip 5003 0% 20011119
No Additional MEB/PEB Entries
 Other x 2 20011119
Combined: 0%
 Combined: 0%


ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed in the CI’s application regarding the significant impact that his service-incurred condition has had on his current earning ability and quality of life; but must emphasize that the Disability Evaluation System (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. Post-separation evidence is probative to the Board’s recommendations only to the extent that it reasonably reflects the disability at the time of separation.

Right Hip Pain Condition. The CI developed atraumatic right hip pain with running, in November 2000. He underwent conservative treatment for likely ITBS with strict profiling. The pain persisted and he underwent further evaluation for other causes of the right hip pain. A bone scan was negative, a Magnetic resonance imaging (MRI) was positive for a right femoral neck stress reaction and plain X-rays were normal. The orthopedic surgeon concurred with the diagnosis of right hip snapping ITBS and recommended a MEB. The profile limitations included no airborne operations, no rucking, or running, no mounting vehicles and no lifting greater than 20 pounds. The commander’s statement corroborated the medical condition, profile limitations, and further documented that the injury prevented the CI from full performance as an Infantryman.

The MEB physical exam demonstrated tenderness in the iliotibial band at the proximal insertion, full range of motion with popping with posterior and anterior movements, 5 of 5 strength and no deformity or discoloration. At the VA Compensation and Pension (C&P) exam a month prior to separation, the CI additionally reported he had not developed a limp and the condition did not prevent him from walking or running. The C&P right hip exam demonstrated normal symmetry and limb length, no tenderness, and no pain.

The goniometric range-of-motion (ROM) evaluations in evidence which the Board weighed in arriving at its rating recommendation, with documentation of additional ratable criteria, are summarized in the chart below.

Right Hip (Thigh) ROM
 (Degrees)
 MEB ~ 8 Mo. Pre-Sep PT ~ 4 Mo. Pre-Sep VA C&P ~ 1 Mo. Pre-Sep
Flexion (125 Normal)
 Full 140 125
Extension (20)
 15 30
External Rotation (45)
 60
Abduction (0-45)
 25 45
Adduction (45)
 25 25
Comment
 Silent to pain Silent to pain No painful motion
§4.71a Rating
 0 % 0 % 0 %

The Board directs attention to its rating recommendation based on the above evidence. This rating includes consideration VASRD §4.10 (functional impairment), §4.40 (functional loss), §4.45 (DeLuca), and §4.59 (painful motion). While the MEB exam was not completely compliant with VASRD §4.46 (accurate measurement) and the ratable data in either the MEB or VA exam were not similar, this did not bear on the rating. The PEB and VA chose the same coding options for the condition, and both assigned a 0% for non-compensable ROM which is consistent IAW §4.71a—Schedule of ratings–musculoskeletal system. There is no evidence of painful motion, Deluca observations, or incapacitating episodes for a higher rating. There is no viable approach to a higher rating for the right hip which is countenanced by the VASRD in the absence of: compensable limitation of motion, joint laxity, ankylosis, and nonunion or malunion of the hip. The Board does not have post separation employment evidence to consider VASRD 4.10. Finally the Board considered VASRD §4.40 which states, “To perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance” and agreed the evidence at the time of separation does not support this criteria. Additionally, the Board notes the original VA rating decision does not invoke application of VASRD §4.40 in this case. 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 right snapping hip pain 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 right snapping hip pain 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:

UNFITTING CONDITION
 VASRD CODE RATING
Right Snapping Hip Pain
 5099-5003 0%
COMBINED
 0%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20120606, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record





         Physical Disability Board of Review


SFMR-RB                                                                         


MEMORANDUM FOR Commander, US Army Physical Disability Agency
(TAPD-ZB),

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130010815 (PD201201339)

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                                                 
                                                      (Army Review Boards)

CF:
( ) DoD PDBR
( ) DVA

Similar Decisions

  • AF | PDBR | CY2014 | PD-2014-00771

    Original file (PD-2014-00771.rtf) Auto-classification: Denied

    One other condition, sleepwalking, was submitted by the MEB.The Informal PEBadjudicated “chronic right hip pain and snapping hip from an iliotibial band syndrome” as unfitting, rated 0%, citing criteria of the Veterans Affairs Schedule for Rating Disabilities (VASRD). Chronic Right Hip Pain Condition . Persistent pain was eventually determined to be due to snapping hip syndrome, a condition resulting from movement of the iliotibial band across the lateral aspect of the hip.

  • AF | PDBR | CY2012 | PD2012 01934

    Original file (PD2012 01934.rtf) Auto-classification: Denied

    The left knee condition was characterized as “chronic left knee pain status post lateral release” and “iliotibial band syndrome.” These two conditions were forwarded to the Physical Evaluation Board (PEB), IAW SECNAVINST 1850.4E. Other PEB Condition . The other PEB condition was, “Chronic left knee pain, status post lateral release.” This condition was adjudicated by the PEB as Category II (related to and contributing to the unfitting ITBS condition).The Board determined that this...

  • AF | PDBR | CY2012 | PD2012 01719

    Original file (PD2012 01719.rtf) Auto-classification: Denied

    5292 Spine, limitation of motion of, lumbar The VA rating under 5292 referenced “slightly limited motion of the lumbar spine”, although the evidence cited full ROM. 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...

  • AF | PDBR | CY2014 | PD-2014-02098

    Original file (PD-2014-02098.rtf) Auto-classification: Approved

    The PEB adjudicated “bilateral ilio-tibial band syndrome (snapping hip)…”as unfitting, rated 0%, with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).The remaining condition was determined to be not unfitting.The CI made no appeals and was medically separated. Range-of-motion (ROM) of the knees was not in evidence.His hip examination revealed a notable “pop” in the ITB, bilaterally. BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military...

  • AF | PDBR | CY2014 | PD-2014-02250

    Original file (PD-2014-02250.rtf) Auto-classification: Approved

    Plantar fasciitis bilateral, bilateral knee retropatellar pain syndrome and left iliotibial band were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.The Informal PEBadjudicated bilateral planter fasciitis as unfitting, rated 0%,with likely application of the VA Schedule for Rating Disabilities (VASRD).The remaining conditions were determined to be not unfitting. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board...

  • AF | PDBR | CY2012 | PD2012-00604

    Original file (PD2012-00604.pdf) Auto-classification: Approved

    RATING COMPARISON: Condition Bilateral Knee Pain Army PEB – dated 20030611 Code 5099-5003 Rating 0% VA (No C&P Exam done, until years later) – All Effective 20030703 Exam MEB* MEB* Left Knee Pain Right Knee Pain Rating 10% 10% Code 5099-5014 5099-5014 Condition RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW ↓No Additional MEB/PEB Entries↓ Combined: 0% Combined: 20% *VA Rating Decision (VARD) dated 20030708 was based on evidence from the Service Treatment Record, MEB, and...

  • AF | PDBR | CY2012 | PD2012-00751

    Original file (PD2012-00751.pdf) Auto-classification: Denied

    The PEB adjudicated the left hip condition as unfitting, rated 20%, with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). Left Hip Condition. The Board acknowledges the X-ray evidence revealed a healed stress fracture therefore the VA could not consider coding with the 5255 code and further notes the VA ratable data allows the minimum compensable 10% rating for painful motion.

  • AF | PDBR | CY2014 | PD 2014 01017

    Original file (PD 2014 01017.rtf) Auto-classification: Denied

    The InformalPEBadjudicated the snapping hip syndrome [bilateral] condition as unfitting, rated 10%, with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).The CI made no appeals and was medically separated. RATING COMPARISON : Service IPEB – Dated 20090402VA* - Based on Service Treatment Records (STR)ConditionCodeRatingConditionCodeRatingExam Snapping Hip Syndrome [Bilateral]531610%Snapping Hip Condition, Left5299-52550%**STRSnapping Hip Condition,...

  • AF | PDBR | CY2012 | PD2012 00732

    Original file (PD2012 00732.rtf) Auto-classification: Approved

    Lumbar spine films, 13November 2001, were normal except for an increased lordotic curve.Despite treatment, the CI’s right hip pain persisted and she developed left hip pain.At the MEB exam, 4 February 2003, approximately 5 months prior to separation, the CI reported bilateral hip pain, right greater than left. Bilateral hip ROM was normal. The Board opined that the evidence in the record supports that at the time of separation the right hip pain was an unfitting condition.The first...

  • AF | PDBR | CY2012 | PD2012 01717

    Original file (PD2012 01717.rtf) Auto-classification: Approved

    CI CONTENTION : “I was rated at I0 percent for service connected snapping hip (Left Hip), I have much less range of motion in my left hip. Physical Disability Board of Review 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.