RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME:  XXXXXXXXXXXXXXX                                                                  BRANCH OF SERVICE:  ARMY 
CASE NUMBER:  PD1201012                                                            SEPARATION DATE:  20030917 
BOARD DATE:  20130201 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty PV2 /E-2 (Basic Trainee), medically separated for right 
femoral  neck  fracture  with  closed  reduction  and  percutaneous  pinning.    The  CI  was  in  basic 
training in 2003 and felt some pain in her right hip.  She was taken urgently to the operating 
room and had screw fixation of the hip.  She 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  right  femoral  neck  fracture  with  closed  reduction  and 
percutaneous pinning as unfitting, rated 0% with application of the US Army Physical Disability 
Agency (USAPDA) pain policy.  The CI made no appeals, and was medically separated.  
 
 
CI  CONTENTION:    “I  was  given  a  zero  percent  disability  rating  for  a  femoral  neck  injury  that 
resulted  in  my  leg  (right)  being  3  inches  shorter  than  the  other.    I  suffer  with  a  limp  and 
secondary injuries due to my service connected disability.”   
 
 
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 right femoral neck fracture as requested for consideration meets the criteria 
prescribed  in  DoDI  6040.44  for  Board  purview;  and,  is  addressed  below.    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. 
 
The Board acknowledges the CI’s information regarding the significant impairment with which 
her  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  Veteran 
Affairs, operating under a different set of laws.   
 
 
RATING COMPARISON:   
 

Service IPEB – Dated 20030805 
Condition 
Right Femoral Neck Fracture  
No Additional MEB/PEB Entries 
Combined:  0% 

Code 
5099- 5003 

Rating 
0%  

VA -   (~12 Mos. Post-Separation)   
Condition 
Right Femoral Neck Fracture 
Not Service-Connected x 1 
Combined:  10% 

Code 
5255 

Rating 
10% 

Exam 
20040907 
20040907 

VARD 20041027 most proximate to date of separation.  No other VARDSs in evidence.   
 
 
ANALYSIS SUMMARY:   
 
Right Femoral Neck Fracture Condition.   The CI injured her right hip, 9 March 2003 and was 
found to have a right displaced femur neck fracture on X-ray the following day.  She underwent 
surgery with open reduction with percutaneous pinning that same day.  The MEB examination, 
27 June 2003 stated that the CI had remained on restricted ambulation during her convalescent 
period  following  surgery  and  had  excellent  healing.    The  examiner  reported  that  the  CI  had 
some  residual  limp  likely  due  muscular  weakness  secondary  to  activity  restrictions  following 
surgery.  During the examination, the CI reported no pain but said she experienced episodes of 
increased  pain  with  weather  changes.    The  examination  noted  that  the  right  hip  range-of-
motion (ROM) was 0 to 110 degrees without pain.  X-ray examination, 27 June 2003 revealed 
screw  fixation  with  healing  femoral  neck  fracture,  almost  completely  healed.    No  leg  length 
measurements  of  the  lower  extremities  were  recorded.    The  VA  Compensation  and  Pension 
(C&P) examination, 7 September 2004, performed almost 12 months after separation, reports 
that  the  CI  complained  of  pain  especially  while  standing  for  long  periods  of  time.    The  CI 
reported  that  her  right hip  was  stiff.    On examination, the  examiner  noted  that the  CI’s  gait 
slightly favored her right hip.  There was a well-healed 5 cm scar to the lateral side of the right 
proximal thigh.  The right lower extremity was measured to be 1.5 inches shorter than the left.  
The ROM in the lower extremities was reported as normal without complaints of pain but the 
examiner noted that there seemed to be a slight grimace during ROM examination.  The CI’s 
muscle strength, sensation, and distal tendon reflexes were normal. 
 
The Board directs attention to its rating recommendation based on the above evidence.  There 
was  no  ankylosis,  limitation  of  motion,  or  flail  joint  to  warrant  a  rating  under  the  Veterans 
Affairs  Schedule  for  Rating  Disabilities  (VASRD)  diagnostic  codes  5250,  5251,  5252,  5253,  or 
5254.  The Board noted the analogous use of code 5003 by the PEB.  The PEB coded the right 
femoral neck fracture analogously using 5099-5003 for degenerative arthritis with a rating of 
0%.  There was no evidence of two or more major or minor joint involvement on X-rays and 
therefore  the  condition  using  this  rating  would  be  0%.    The  Board  considered  code  5255; 
impairment of the femur used by the VA, and noted that the rating is based on the severity of 
non-union or malunion of a femur fracture.  In this case, there was a fracture of the neck of the 
femur with healing.  There was no evidence of non-union or evidence that the alignment was 
incorrect after surgical correction to establish presence of a malunion.  Reviewing the service 
treatment  records  indicated  that  there  was  some  continued  complaints  of  mild  symptoms 
proximate to the time of separation and the Board agreed there was evidence of residual hip 
disability  to  support  a  10%  rating  either  analogously  using  this  code  or  with  application  of 
Painful motion (§4.59) or Functional loss (§4.40).  Board members concluded the evidence did 
not support a conclusion the impairment reached the moderate or marked hip disability.  The 
Board noted the C&P examination finding of a leg length discrepancy of 1.5 inches.  The Board 
agreed  that,  although  no  measurement  was  accomplished  at  the  time  of  the  MEB,  it  was 
reasonable to conclude this leg length discrepancy existed at the time of separation.  The rating 
for the leg length discrepancy under code 5275 would be 10%; however this rating cannot be 
combined with the other ratings for fracture in the same extremity.  This would not result in a 
higher rating than using the code 5255, as used by the VA.  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 right femoral neck fracture condition, 5299-5255. 
   
 

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 right hip condition was operant in this case 
and the condition was adjudicated independently of that policy by the Board.  In the matter of 
the  right  femoral  neck  fracture  condition,  the  Board  unanimously  recommends  a  disability 
rating of 10%, coded 5299-5255 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 
Right Femoral Neck Fracture with Open Reduction and 
Percutaneous Pinning 

VASRD CODE  RATING 
5299-5255 
COMBINED 

10% 
10% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120604, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

           xxxxxxxxxxxxxxxxxxxxxxxxx, DAF 
           Acting Director 
           Physical Disability Board of Review 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / xxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for xxxxxxxxxxxxxxxxxxxxxx, AR20130003817 (PD201201012) 
 
 
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 
 
 
 

xxxxxxxxxxxxxxxxxxxxxxxxxxx 
     Deputy Assistant Secretary 
         (Army Review Boards)