RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXXXXXXXXXXXXXX                                                                 BRANCH OF SERVICE:  ARMY 
CASE:  PD1200487                                                                                    SEPARATION DATE: 20030803 
BOARD DATE:  20121106 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  activated  National  Guard  PFC/E-3  (63W/Light  Wheeled 
Mechanic),  medically  separated  for  chronic  pain,  left  hip,  status  post  open  reduction  and 
internal  fixation  of femoral  neck  stress  fracture.    She  complained of  left  hip pain  since  2002 
while undergoing basic training, and was diagnosed with a stress fracture.  She subsequently 
underwent an open reduction and internal fixation of the left femoral neck; and she was able to 
graduate from basic training.  She had the same complaints after the surgery.  A second surgery 
was  performed  in  May  2002  but  the  CI  could  not  be  adequately  rehabilitated  to  meet  the 
physical  requirements  of  her  Military  Occupational  Specialty  or  satisfy  physical  fitness 
standards.  She was issued a permanent L3 profile and referred for a Medical Evaluation Board 
(MEB).    The  MEB  forwarded  no  other  conditions  for  Physical  Evaluation  Board  (PEB) 
adjudication.    The  PEB  adjudicated  chronic  pain,  left  hip,  status  post  open  reduction  and 
internal fixation of femoral neck stress fracture as unfitting, rated 10% with cited application of 
the US Army Physical Disability Agency (USAPDA) pain policy.  The CI rebutted her PEB findings 
and the USAPDA upheld the PEB findings, and the CI was medically separated due to medical 
disability.   
 
 
CI CONTENTION:  “The issue with my left leg has not improved over time, has gotten worse + 
limited my ability to be physically active.“   
 
 
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.    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.  Also IAW DoDI 6040.44, the Board’s authority is 
limited to making recommendations on correcting disability determinations.  The Board’s role is 
thus confined to the review of medical records and all evidence at hand to assess the fairness of 
PEB  rating  determinations,  compared  to  Veteran’s  Administration  Schedule  for  Rating 
Disabilities (VASRD) standards, based on ratable severity at the time of separation.  The Board 
acknowledges the CI’s information regarding the significant impairment with which the service-
connected  condition  continues  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  Veterans’ 
Affairs, operating under a different set of laws.   
 
 

 
RATING COMPARISON:   
 

Chronic Pain, Left Hip, 
Status Post Open 
Reduction and Internal 
Fixation of Femoral Neck 
Stress Fracture 

Service IPEB – Dated 20030516 
Condition 

Code 

VA -   (~2 Mos. Post-Separation)  VARD 20040322 (most proximate to 

Date of Separation)   

Rating 

Condition 

Code 

Rating 

Exam 

5099-5003 

10% 

5255 

20% 

20030926 

Residuals of Fibrous Dysplasia 
and Femoral Neck Stress 
Fracture Status Post Open 
Reduction and Internal 
Fixation, Left Hip 

Combined:  10% 

Combined:  20% 

 
 
ANALYSIS SUMMARY:   
 
Left Hip Condition.  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.   
 

MEB ~ 4 Mo. Pre-Sep 

(20030409) p.32 

VA C&P ~2 Mo. Post-Sep 

(20030926) p.107 

Left Hip ROM 

(Degrees) 

Flexion (125 Normal) 

Extension (20) 

External Rotation (45) 

Abduction (0-45) 
Adduction (45) 

Comment 

110 
- 
55 
- 
- 

Fex and Ext rot symmetric bilat; 
tender; + heel tap; L int rot 30 / R 
45; occ L knee pain; c/o lat thigh 

occ goes numb 

115 
15 
45 
45 
5 

Painful ROM; normal gait; 5 of in 
rot; see text for adduction and 

flares comments.   
10-20% (VA 20%) 

§4.71a Rating 

10% 

 
The narrative summary (NARSUM) diagnosis was status post left femoral neck stress fracture 
with open reduction and internal fixation.  The CI complained of left hip pain with occasional 
knee  pain  and  lateral  thigh  numbness.    She  was  unable  to  run,  do  sit-ups  or  do  any  type  of 
lifting.  Exam is summarized above and there was no knee ROM, motor, or sensory evaluation 
noted.  Radiographs indicated good healing with hardware in place.  The DD Form 2808 MEB 
Physical,  indicated  “left  hip  weakness.”    The  detailed  orthopedic  physical  therapy  summary 
indicated post-therapy knee and hip pain with “weakness in her gluteals, particularly her deep 
intrinsic hip muscles that externally rotate the hip”. 
 
At the VA Compensation and Pension (C&P) exam performed 2 months after separation, history 
indicated  transcutaneous  pinning  of the hip  and  a  second  surgery  for  open  repair  of  a  bone 
lesion.    The  CI  reported  hip  pain,  weakness,  and  flares  with  use  of  occasional  narcotic  pain 
medication.  ROMs are summarized above with the examiner indicating particularly limited on 
“internal  rotation  and  adduction  with  additional  loss  during  flares,  without  specifying  an 
additional loss of ROM.” 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB coded analogously to 5003 (Arthritis) at 10% using the pain policy.  The VA coded using 
5255 (Femur, impairment) at 20% (with moderate knee or hip disability).  The Board considered 
the VA exam had much more detail and had the highest probative value for rating.  After due 

deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt) and 
§4.40  (functional  loss),  the  Board  recommends  a  disability  rating  of  20%  for  the  left  hip 
condition as “moderate” coded 5255.   
 
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/femur condition 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 20%, 
coded 5255 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 her prior medical separation:   
 

UNFITTING CONDITION 

Chronic Pain, Left Hip, Status Post Open Reduction and Internal 
Fixation of Femoral Neck Stress Fracture 

VASRD CODE  RATING 

5255 

COMBINED 

20% 
20% 

 
 
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 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

 
 
 

 
 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB /  ), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for XXXXXXXXXXXXXXXXXX, AR20120020609 (PD201200487) 
 
 
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 20% 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. 
7 
 BY ORDER OF THE SECRETARY OF THE ARMY: 
 
 
 
 
Encl 
 
 
 
CF:  
(  ) DoD PDBR 
(  ) DVA 
 

     XXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)