RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  NAVY 
SEPARATION DATE:  20040130 

 
NAME:  XX 
CASE NUMBER:  PD1200821 
BOARD DATE:  20130212 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  a  Reserve  E-5  (E02/Equipment  Operator  [Seabee]),  medically 
separated  for  comminuted  right  intertrochanteric  and  subtrochanteric  fractures,  status  post 
(s/p)  open  reduction  internal  fixation  (ORIF).    The  CI  was  involved  in  an  ATV  accident  on 
24 November 2001 while on liberty and sustained severe injuries to his right femur and clavicle.  
Despite a right hip ORIF, orthopedic evaluations, aggressive physical therapy (PT), medications, 
and  a  built  up  shoe,  the  CI  failed  to  meet  the  physical  requirements  of  his  rating  or  satisfy 
physical  fitness  standards.    The  CI  was  placed  on  light  duty  and  referred  for  a  Medical 
Evaluation  Board  (MEB).    The  MEB  forwarded  “Comminuted  Right  Intertrochanteric  and 
Subtrochanteric Fractures, Status Post (S/P) Open Reduction Internal Fixation (ORIF) and Left 
Clavicular Fracture” to the Informal Physical Evaluation Board (IPEB).  The IPEB adjudicated the 
“Comminuted  Right  Intertrochanteric  and  Subtrochanteric  Fractures,  S/P  ORIF”  condition  as 
unfitting,  rated  10%  with  application  of  the  Veteran’s  Affairs  Schedule  for  Rating  Disabilities 
(VASRD).    The  PEB  also  determined  the  left  clavicular  fracture  condition  was  Category  III 
(conditions not separately unfitting and do not contribute to the unfitting condition).  The CI 
appealed to the Formal PEB (FPEB), which increased the rating of the hip fracture to 20%.  The 
CI made no further appeals and he was then medically separated with a 20% disability rating. 
 
 
CI CONTENTION:  “Accident while on active duty, bolt in hip joint, plate and screws in femur, 
after accident administrative duty in Command.  Command fought to retain me.  Panel denied.”   
 
 
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.    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 Board for Correction of Naval Records. 
 
 
RATING COMPARISON:   
 

VA (3 Mos. Post-Separation) – All Effective Date 20040131 

Code 

Rating 

Exam 

Service FPEB – Dated 20030625 
Condition 
Comminuted Right 
Intertrochanteric and 
Subtrochanteric Fractures, 
Status Post ORIF 
Left Clavicular Fracture 

5299-5003 

Code 

CAT III 

Combined:  20% 

Rating 

20% 

Condition 

Residual, Fracture; Femur, Right, 
Post-Operative with DJD Right 
Hip, and Right Knee Loss of 
motion 
Residual Fracture left Clavicle 

5255 

20% 

20040402 

5201-5010 

10% 

20040402 

Combined:  30% 

 
 
ANALYSIS SUMMARY:  The Board’s authority as defined in DoDI 6040.44, resides in evaluating 
the fairness of Disability Evaluation System (DES) fitness determinations and rating decisions for 

disability at the time of separation.  The Board utilizes VA evidence proximal to separation in 
arriving  at  its  recommendations;  and,  DoDI  6040.44  defines  a  12-month  interval  for  special 
consideration to post-separation evidence.  Post-separation evidence is probative only to the 
extent  that  it  reasonably  reflects  the  disability  and  fitness  implications  at  the  time  of 
separation. 
 
Comminuted  Right  Intertrochanteric  and  Subtrochanteric  Fractures,  Status  Post  (ORIF) 
Condition. 
in  evidence,  with 
documentation of additional ratable criteria, which the Board weighed in arriving at its rating 
recommendation; as summarized in the chart below.   

  There  were  three  range-of-motion  (ROM)  evaluations 

 

Right Hip (Thigh) ROM 

MEB~15 Mo. Pre Sep 

Ortho ~10 Mo. Pre-Sep 

VA C&P ~2 Mo. Post-Sep 

Flexion (0-125⁰) 
Extension (0-20⁰) 

External Rotation (0-45⁰) 

Internal Rotation (0-45⁰) 

Abduction (0-45⁰) 
Adduction (0-45⁰) 

Comment 

0-110⁰ 

- 
0-45⁰ (70⁰) 

0-30⁰ 

- 
- 

90⁰ 
- 

40⁰ 

0-30⁰ 
0-30⁰ 

- 

65⁰ (67⁰) 

- 

20⁰ (23⁰) 

20⁰ (22⁰) 

30⁰ 

15⁰ (16⁰) 

sensation intact 
bilaterally; right leg 
length shortening 1 inch 

Wears built up shoe on right; “hip 
pain”; motor 5/5 right lower 
extremity; sensation intact bilaterally 

Walks with limp; scar 14 
inches long x ½ inch wide; 
right  leg 1 inch shorter 

20% 

20% 

§4.71a Rating 

20% 

 
In  November  2001,  the  CI  suffered  a  comminuted  right  Intertrochanteric  fracture  that  was 
confirmed by X-ray.   He underwent a right hip ORIF surgical procedure.  Subsequently, the CI 
developed a right hip methicillin resistant staphylococcus aureus (MRSA) infection that required 
several outpatient visits for intravenous medication (IV).  The CI had a bone scan that verified 
the  hardware  in  place,  a  fracture  in  the  right  greater  trochanter,  and  a  moderate  focally 
increased  uptake  in  the  right  femoral  head  consistent  with  infection.    Magnetic  resonance 
imaging (MRI) 6 days later confirmed a right femoral head abscess.  The CI underwent a right 
hip needle aspiration that was negative for purulent fluid.  The CI was referred to podiatry for a 
lift  shoe  due to  a  discrepancy  of  a  one-inch  right  limb  shortening.    The  initial  MEB  narrative 
summary  (NARSUM)  examination  approximately  15  months  prior  to  separation,  which  was 
discussed in the FPEB rationale, indicated that there was right leg shortening of one inch.  The 
NARSUM physical exam findings are summarized in the chart above.  A reevaluation completed 
by orthopedics in April 2003, approximately 10 months prior to separation, was discussed in the 
FPEB hearing rationale. This examination indicated that the CI wore a built up shoe on the right 
foot and had pain in the hip and knee that was aggravated with prolonged walking and walking 
up hill.  The physical exam findings are summarized in the chart above.  The CI had five non-
medical assessments (NMA) between 2002 and 2003 and all of the NMA’s recommended that 
the  CI  be  continued  in  his  reserve  status.    The  VA  Compensation  and  Pension  (C&P) 
examination documented a right leg limp.  The C&P physical exam findings are summarized in 
the chart above. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  coded  the  comminuted  right  intertrochanteric  and  subtrochanteric  fractures,  s/p  (ORIF) 
condition analogous to 5003 [Arthritis, degenerative (hypertrophic or osteoarthritis)] and rated 
10%.  The VA coded the residual, fracture; femur, right, post-operative with degenerative joint 
disease (DJD) right hip and right knee loss of motion conditions 5255 Femur, impairment of and 
rated 20% (With moderate knee or hip disability).  The FPEB increased the Informal PEB (IPEB) 
10% rating to 20% but continued the same analogous coding.  The rationale for the 20% rating 
with VASRD code 5299-5003 is unclear.   

2                                                           PD1200821 
 

All  exams  demonstrated  limited  hip flexion  and internal  rotation  ROM.   The  initial  NARSUM, 
orthopedics, and the C&P examinations noted that the right leg was one inch shorter than the 
left and the orthopedics and C&P examinations specifically documented that the CI wore a right 
foot built up shoe.  Although the CI wore the built up shoe, the C&P exam further indicated that 
the CI walked with a limp.  The Board agreed that the CI’s disability condition more aligned with 
the 5255 coding (Femur, impairment of); however, there is no advantage to the CI in changing 
the  code  as  the  rating  would  remain  at  20%.    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  comminuted  right 
intertrochanteric and subtrochanteric fractures, s/p (ORIF).  
 
 
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 comminuted right intertrochanteric and subtrochanteric 
fractures, s/p (ORIF) 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 rating and separation determination as follows: 
 

UNFITTING CONDITION 

Comminuted Right Intertrochanteric and Subtrochanteric 
Fractures, S/P ORIF 

VASRD CODE  RATING 
5299-5003 
COMBINED 

20% 
20% 

 
 
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 

3                                                           PD1200821 
 

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 22 Mar 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: 
 
 
 

 
 

 

 

     
 
 
 
 

-   former USMC 
-   former USN  
-   former USMC 
-   former USMC 
-   former USN  
-   former USMC 
-   former USMC 
  

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  xx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

4                                                           PD1200821