RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  NAVY 
SEPARATION DATE:  20030731 

 
NAME:  XX 
CASE NUMBER:  PD1200647 
BOARD DATE:  20130219 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  UT2/E-5  (Utilities  man),  medically  separated  for 
chronic  right  hip  pain.    The  CI  injured  her  right  hip  in  October  2000  and  did  not  improve 
adequately with treatment to meet the physical requirements of her rating or satisfy physical 
fitness  standards.    She  was  placed  on  limited  duty  (LIMDU)  and  referred  for  a  Medical 
Evaluation Board (MEB).  Chronic right hip pain and lumbosacral pain were forwarded to the 
Physical  Evaluation  Board  (PEB)  as  medically  unacceptable  IAW  SECNAVINST  1850.4E.    There 
were no other conditions on the MEB submission.  The PEB adjudicated the chronic right hip 
pain  condition  as  unfitting,  rated  10%,  with  application  of  the  Veterans  Affairs  Schedule  for 
Rating Disabilities (VASRD).  The remaining conditions were determined to be conditions that 
contributed  to  the  unfitting  condition  but  were  not  separately  ratable  (Category  II).    The  CI 
made no appeals, and was medically separated with a 10% disability rating. 
 
 
CI CONTENTION:  “Test were run in New Orleans prior to Hurricane Katrina to determine reason 
of ongoing back/hip pain.  I have actually not seen the results but the pain has been consistent 
especially when I was pregnant with my son.  I find it very difficult to exercise which makes 
maintaining a healthy weight very difficult.  My hip/back also hurt while carrying my son, having 
sex and other activities up to a level 7 (of 10).”  sic 
 
 
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.  The chronic back pain (lumbosacral pain) 
condition requested for consideration and the unfitting chronic right hip pain condition meet 
the  criteria  prescribed  in  DoDI  6040.44  for  Board  purview,  and  are  accordingly  addressed 
below.  Any condition or contention not requested in this application, or otherwise outside the 
Board’s  defined  scope  of  review,  remain  eligible  for  future  consideration  by  the  Board  for 
Correction of Naval Records. 
 
 
RATING COMPARISON:   
 

Service IPEB – Dated 20030429 
Condition 
Chronic Right Hip Pain 
Lumbosacral Pain 
No Additional MEB/PEB Entries 
Combined:  10% 

Code 
5299-5003 
Category II  

Rating 
10% 

VA (<1 Mo. Post-Separation) – All Effective Date 20031001 
Rating 
Condition 
10% 
Residual, S/P Injury, R Hip w/Pain 
Low Back Pain 
10% 
Not Service-Connected x 1 
Combined:  20% 

Code 
5299-5252 
5292 

Exam 
20030811 
20030811 
20030811 

 
 

 

ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding the significant impairment with which her service-connected condition continues to 
burden her.  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 recommendations, but its authority resides in evaluating 
the  fairness  of  DES  fitness  decisions  and  rating  determinations  for  disability  at  the  time  of 
separation.  While the DES considers all of the member's medical conditions, compensation can 
only be offered for those medical conditions that cut short a member’s career, and then only to 
the  degree  of  severity  present  at  the  time  of  final  disposition.    The  DVA,  however,  is 
empowered to compensate service-connected conditions and to periodically re-evaluate said 
conditions  for  the  purpose  of  adjusting  the  Veteran’s  disability  rating  should  the  degree  of 
impairment vary over time. 
 
Chronic Right Hip Pain Condition.  According to the MEB narrative summary (NARSUM) the CI 
sustained a right hip injury in November 2000 after being struck by a large tent pole (beam) 
over the right hip.  X-ray, magnetic resonance imaging (MRI) and bone scan exams of the right 
hip  were  all  normal;  however,  the  CI  complained  of  progressive  pain  unalleviated  by 
conservative  treatment.    The  CI  was  unable  to  perform  military  related  physical  activities 
including running, climbing stairs, marching, sitting for more than 20 minutes secondary to pain 
and was placed on a limited duty profile immediately after sustaining the injury.  No surgery 
treatment was recommended at any time.  The CI reported increased pain in the hip and low 
back area with her physical therapy sessions.  She stated she felt the pain along the superior 
iliac spine to the right lateral hip, extending to the right buttock and posterior thigh.  At the 
time  of  the MEB  NARSUM,  26  February  2003, 5  months prior  to  separation,  the  CI  reported 
continued pain with activity.  On physical examination, there was mild tenderness to palpation 
(TTP) over the anterior right hip.  No radicular pain or paresthesia below the knee was noted.  
The range-of-motion (ROM) of the affected right hip was the same as the opposite non-affected 
left hip indicating no limitation (flexion 120 degrees, abduction 30, adduction 20, and external 
rotation 45 degrees).  Motor and sensory exam were normal and the examination maneuvers 
for  detecting  pathology  of  the  hip  joint  and  sacroiliac  joint  were  all  negative.    At  the  VA 
Compensation  and  Pension  (C&P)  examination,  11  August  2003,  less  than  30  days  after 
separation, the CI did not have radicular pain in the legs and denied incapacitating episodes of 
back pain.  On examination, abduction of the right hip was limited by pain to 30 degrees and 
flexion was limited to 110 degrees also by pain.  Gait was normal.   
 
The Board directs attention to its rating recommendation based on the above evidence.  Both 
the PEB and VA rated the CI condition 10 % under different codes.  Considering the 5003 code 
used  by  the  PEB,  a  higher  rating  could  not  be  given  considering  the  specific  criteria  ratings 
under this code.  The VA assigned a 10% rating based on slight loss of ROM with pain (coded 
5299-5252).  The only symptoms evidenced at the C&P separation exam were subjective pain 
and  slightly  reduced  ROM.    The  limitation  of  motion  on  examinations  did  not  attain  a 
compensable  level  under  the  respective  codes  for  limitation  of  hip  motion.    The  10%  rating 
adjudicated  by  the  PEB  and  VA  was  supported  based  on  painful  motion  and  functional 
impairment  related  to  pain.    There  were  no  neurologic,  muscular,  or  vascular  symptoms  to 
increase  the  disability  ratings.    After  due  deliberation,  considering  all  of  the  evidence  and 
mindful of VASRD §4.3 (Resolution or reasonable doubt), the Board concluded that there was 
insufficient cause to recommend a change in the PEB adjudication for the chronic right hip pain 
condition. 
 

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Contended PEB Conditions.  The contended conditions adjudicated as not separately unfitting 
by the PEB was lumbosacral pain.  The PEB considered the lumbosacral pain as a condition that 
contributed to the unfitting condition but was not separately unfitting or ratable.  The Board’s 
first  charge  with  respect  to  these  conditions  is  an  assessment  of  the  appropriateness  of  the 
PEB’s  fitness  adjudications.    The  Board’s  threshold  for  countering  fitness  determinations  is 
higher  than  the  VASRD  §4.3  (Resolution  or  reasonable  doubt)  standard  used  for  its  rating 
recommendations,  but  remains  adherent to  the  DoDI  6040.44  “fair  and  equitable”  standard.  
The  MEB  NARSUM  mentioned  both  hip  and  low  back  pain  (LBP)  secondary  to  the  injury 
sustained by the CI in October 2000.  Medical documents from the time of injury do not record 
a complaint of back pain.  However, a clinic note dated 4 May 2001 evidenced the occurrence 
of back pain at the end of March 2001.  The CI denied any back injury in the 2000 accident.  She 
stated  that  she  noticed  the  pain  at  the  end  of  March  2001  starting  in  the  scapula  area  and 
radiating to the lower back.  The physical exam evidenced TTP in the lower back area.  At that 
time, the treating physician considered the pain mechanical, secondary to overuse.  A referral 
to  physical  therapy  in  June  2001  recorded  a  history  of  LBP  since  1998.    After  August  2001, 
service treatment records (STRs) reflected intermittent care for LBP.  The 26 January 2002 clinic 
encounter recorded increased LBP for one day.  The next encounter was 21 May 2002 recording 
LBP for two days.  A 17 December 2002 orthopedic evaluation makes no mention of back pain, 
only  the  right  hip  pain.    An  8  January  2003  orthopedic  follow  up  notes  right  hip  and  right 
buttock pain.  A 5 February 2003 clinic follow up for LIMDU mentions only hip pain.  The MEB 
NARSUM, 26 February 2003, reported “chronic right hip pain with associated low back pain” 
describing  the  pain  as  reported  to  be  along  the  superior  iliac  spine  to  the  right  lateral  hip, 
extending to the right buttock and posterior thigh.  The NARSUM noted there was no radicular 
pain  and  that  there  were  no  incapacitating  episodes  of  back  pain.    The  MEB  NARSUM 
examination  focused  on  the  hip  and  did  not  record  an  examination  of  the  back.    The  MEB 
physical examination 11 March 2003, documented on DD Form 2808, recorded tenderness of 
the  lumbar  spine  and  paravertebral  areas,  with  full  range  of  motion.   A  7  March  2003  clinic 
encounter recorded a history of occasional back pain.  At the C&P exam performed less than 30 
days  after  separation,  the  gait  was  normal  and  the  lumbar  spine  curvature  was  normal.  
Forward flexion was 90 degrees with pain noted at 80 degrees, all other ranges of motion were 
normal.  The Board first considered whether the LBP back pain was separately unfit for duty.  
Although the hip and back pains were reported to be associated, the Board noted the medical 
record  indicated  the  CI  experience  back  pain  one  year  later  after  the  hip  injury.    Primary 
treatment  records  also  indicated  the  right  hip  pain  was  the  predominant  chronic  problem 
interfering  with  duty  and  that  complaints  of  back  pain  were  intermittent  after  August  2001.  
The description of pain in the MEB NARSUM describes hip girdle pain but not separate back 
pain.  The Board members concluded the intermittent symptoms from the LBP did not prevent 
performance of  duty.    Therefore, the  Board  did  not  conclude  there  was  a  preponderance of 
evidence to support a separately unfit determination.  There was no indication from the record 
that this condition separately significantly interfered with satisfactory duty performance.  After 
due deliberation in consideration of the preponderance of the evidence, the Board concluded 
that there was insufficient cause to recommend a change in the PEB fitness determination for 
the contended back pain (lumbosacral pain) condition; and, therefore, no additional disability 
ratings can be recommended. 
 
 
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 chronic right hip pain condition and IAW VASRD §4.71a, 
the Board unanimously recommends no change in the PEB adjudication.  In the matter of the 
contended  back  pain  (lumbosacral  pain)  condition,  the  Board  unanimously  recommends  no 

3                                                           PD1200647 

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 
5299-5252 
Cat II 
COMBINED 

10% 
 
10% 

UNFITTING CONDITION 
Chronic Right Hip Pain 
Lumbosacral Pain 

 
 
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 
 
 
 
 
 
 
 
 

xx 

 
 
 

 

 
  Acting Director 
  Physical Disability Board of Review 

4                                                           PD1200647 

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW  
                                        BOARDS  

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 

Ref:   (a) DoDI 6040.44 

             (b) CORB ltr dtd 04 Apr 13 
 

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for 
the reasons provided in their forwarding memorandum, approve the recommendations of the PDBR 
that the following individual’s records not be corrected to reflect a change in either characterization 
of separation or in the disability rating previously assigned by the Department of the Navy’s 
Physical Evaluation Board: 
 
 
 
 
 
 
 
 
 
 
 
 

-  xformer USMC 
-  xformer USN  
-  xformer USMC 
-  xformer USMC 
-  xformer USN  
-  xformer USMC 
-  xformer USMC 
-  xformer USN  
-  xformer USMC 
-  xformer USN  
-  xformer USMC 
  
 

 
 
 
 
 
 
 
 
 
 
 

 

 

     
 
 
 
 

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  x 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

5                                                           PD1200647