RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  NAVY 
SEPARATION DATE:  20020708 

 
NAME:  X 
CASE NUMBER:  PD1201613 
BOARD DATE:  20130221 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty Sailor IS2/E-5 (MOS/Intelligence Specialist) medically 
separated for bilateral hip pain with associated bilateral degenerative joint disease (DJD) of the 
hips and ununited fracture of the right greater trochanter which was surgically treated.  Despite 
treatment, he continued to have hip pain and did not improve adequately to meet the physical 
requirements of his rating or satisfy physical fitness standards.  He was placed on light duty and 
referred for a Medical Evaluation Board (MEB).  The MEB forwarded bilateral hip pain and hip 
arthritis  as  medically  unacceptable.  The  MEB  forwarded  no  other  conditions  for  Physical 
Evaluation  Board  (PEB)  adjudication.  The  PEB  adjudicated  each  hip  as  individually  unfitting 
(although  designated  as  bilateral hip  pain)  and  rated  each  hip 10%  disabling  for  a  combined 
rating of 20%, including the bilateral factor, with application of the Veteran’s Affairs Schedule 
for  Rating  Disabilities  (VASRD).    Additionally,  the  PEB  adjudicated  the  bilateral  hip  DJD,  the 
surgically  repaired  ununited  fracture  of  the  right  greater  trochanter  and  the  hip  arthritis  as 
related to the unfitting condition. The CI made no appeals, and was medically separated with a 
20% disability rating. 
 
 
CI  CONTENTION:  The  CI  submitted  a  three  page  letter  to  the  Board  in  which  he  specifically 
requests unfitting ratings for the following conditions: fractured trochanter, arthritic right hip, 
and  arthritic 
its 
recommendations. 
 
 
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 
the  unfitting  bilateral  hip  pain  condition,  to  include  arthritis  and  DJD  of  both  hips  and  non-
union of right greater trochanter, will be reviewed. 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: 
 

letter  was  reviewed  by  the  Board  and  considered 

left  hip.  The 

in 

Service PEB – Dated 20020523 
Code 
Condition 
5003 

Rating 
10% 

Bilateral Hip Pain: DJD; 
Ununited Fracture Right 
Greater Trochanter; Hip 
Arthritis 

5003 

10% 

↓No Additional MEB/PEB Entries↓ 

Combined:  20% 

VA (14 Mos. Pre-Sep & 80 Mos. Post-Sep) – All Effective 20080805* 
Exam 

Condition 

S/P Greater Trochanteric Acetabular 
Fracture of Right Hip w/DJD 
Degenerative Joint Disease, Left Hip 
Mild Osteoarthritis, L Knee 

5010 
5010 
0% x1 / Not Service-Connected x1 

10% 
10% 

20090312 

20010524* 
20010524* 
20090312 

Code 
5252 

Rating 
30% 

* Effective date is date CI submitted VA application for benefits; VA used pre-separation C&P exam for two conditions. 
 

Combined:  50% with Bilateral Factor 

ANALYSIS  SUMMARY:    The  Board  notes  the  current  VA  ratings  listed  by  the  CI  for  all  of  his 
service-connected conditions, but must emphasize that its recommendations are premised on 
severity at the time of separation.  The VA ratings which it considers in that regard are those 
rendered most proximate to separation.  The VA Compensation and Pension (C&P) examination 
performed in March 2009 falls well outside the 12-month window specified in DoDI 6040.44 
regarding  VA  evaluations  for  Board  consideration;  therefore,  little  probative  value  can  be 
assigned to the subsequent VA rating.  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). 
 
Bilateral  Hip  Pain.    There  were  three  goniometric  range-of-motion  (ROM)  evaluations  in 
evidence,  with  documentation  of  additional  ratable  criteria,  which  the  Board  weighed  in 
arriving at its rating recommendation; as summarized in the chart below. 
 

Addendum to MEB report 4 

Mos. Pre-Sep 

Hip and Thigh ROM 

VA C&P 13.5 Mos. Pre-Sep 

VA C&P 80 Mos. Post-Sep. 

Flexion (0-125⁰) 
Extension (0-20⁰) 

External Rotation (0-45⁰) 

Abduction (0-45⁰) 
Adduction (0-45⁰) 

L: 130° 

R: 115° 

L: 100° 

R: 100° 

L: 125° 

20° 
40° 
45° 
30° 

20° 
45° 
45° 
25° 

- 
30° 
45 
- 

- 
30° 
45° 
- 

30° 
45° 
45° 
25° 

R: 20° 
10° 
5° 
10° 
10° 

Comment 

Posture normal; Gait 
unremarkable; No heat, 
redness or swelling; Pos. 
pain at extremes of ROM 

Walked without limp; Pos. pain 

at extremes of ROM; Pos. 
tenderness at insertion of 

abductors into greater 

Normal Gait; Pos. tenderness 
& guarding of movement on 
right, none on left; No edema, 
effusion, weakness, redness 

or heat bilaterally; No 

trochanter; neurovascular intact 

subluxation; No additional 

bilateral lower extremities 

limitation of function 

bilaterally 

§4.71a Rating 

10%* 

10%* 

10%* 

10%* 

10%* 

30% 

* IAW VASRD §4.59 Painful Motion 
 
At  the  C&P  exam  performed  13  months  prior  to  separation,  the  CI  reported  an  injury  in 
November 1997 when he fell off of an aircraft ladder onto the flight deck, with injury to the 
right hip.  He stated that the right hip was sore for 2 weeks and then gradually improved.  He 
was not aware that it was broken.  He stated that over the past 2 years, the pain in the right hip 
had  increased.    He  was  diagnosed  with  a  groin  pull  until  an  X-ray  showed  an  old  avulsion 
fracture of the right greater trochanter, as well as a fracture of the right acetabulum.  The CI 
stated that he developed right hip pain on a daily basis, which was worse with sitting, going up 
stairs and walking.  He also had decreased ROM of the right hip.  The CI had chronic popping 
pain,  with  radiation  to  the  right  knee,  as  well  as  weakness,  instability,  fatigue,  and  lack  of 
endurance.    He  stated  that  due  to favoring the  right  hip, he  was  developing  pain  in  the  left 
knee.  He treated his symptoms with rest, aspirin and avoidance of intense activities.  Because 
of this injury he was unable to run.  He had difficulty driving long distances due to the resultant 
pain and stiffness.  He had not received any treatment or surgery for this joint condition and did 
not  have  any  prosthetic  implants.    Significant  physical  exam  findings  are  summarized  in  the 
chart above. 
 
The  narrative  summary  (NARSUM)  prepared  8  months  prior  to  separation,  noted  a  similar 
history  to  the  one  noted  above  with  the  following  significant  additions.    He  was  recently 
evaluated and X-rays showed arthritis of both hips and the aforementioned old fractures.  He 
was  evaluated  by  orthopedics  for  possible  surgical  intervention.    Significant  physical  exam 

2                                                           PD1201613 
 

findings are summarized in the chart above.  Radiographs of the pelvis and hips revealed mild 
to moderate degenerative arthritis of both hips and perhaps subtle hip dysplasia bilaterally.  He 
also had an old avulsion fracture from the tip of his right greater trochanter that had not united 
and  what  appeared  to  be  an  old  acetabular  rim  fracture,  also  on  the  right.    The  CI’s  chief 
problem was moderate degenerative arthritis of both hips, worse on the right.  His arthritis was 
not  severe  enough  to  justify  hip  replacement  surgery;  therefore,  his  only  alternative  was  to 
substantially modify his lifestyle.  The physician opined that his hip arthritis was not compatible 
with long-term military service as it was not compatible with heavy impact loading activity such 
as  prolonged  walking  or  running.    At  the  MEB  exam  also  accomplished  8  months  prior  to 
separation,  the  CI  reported  history  of  broken  bone  and  bone  or  joint  deformity.    The  MEB 
physical exam noted limited flexion of right hip and limited right lateral flexion of waist both 
due to pain. 
 
Additional  significant  historical  information  was  contained  in  the  service  treatment  records 
(STRs).  Seven and a half months prior to separation, the CI underwent a surgical procedure to 
correct the right hip pain due to the ununited avulsion fracture of the greater trochanter.  This 
surgical procedure was performed 19 days after the MEB convened and referred his case to the 
PEB.    That  surgical  procedure  resulted  in  termination  of  PEB  proceedings  until  the  CI 
recuperated.    After  recuperation  and  receipt  of  the  additional  information  requested  by  the 
PEB, the CI’s case was completed with the adjudication noted above based on the Addendum to 
the Report of the Medical Board, accomplished 4 months prior to separation, summarized in 
the ROM chart above. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB adjudicated the bilateral hip pain as two separately unfitting hip conditions and rated each 
hip as 10% disabling under VASRD code 5003, degenerative arthritis.  This adjudication occurred 
after  the  CI’s  right  hip  surgery  and  the  addendum  to  the  MEB  report  utilized  for  rating 
accounted for full recuperation from the procedure.  There is a C&P examination accomplished 
13 months prior to separation; however, that exam is not useful for rating purposes as it was 
accomplished  well  before  the  CI’s  surgical  procedure  and  is  outside  the  Board’s  12-month 
period for rating consideration.  The CI applied for VA benefits approximately 72 months after 
separation  and  the  VA  accomplished  another  C&P  examination  in  March  2009.    That  C&P 
examination  performed  80  months  after  separation  is  the  only  post-separation  evidence 
available  to  the  Board  for  consideration.    Since  it  falls  significantly  outside  the  12-month 
window  specified  in  DoDI  6040.44  regarding  VA  evaluations  for  Board  consideration,  little 
probative value can be assigned to the subsequent VA rating.  This leaves the Board with only 
one probative exam for rating purposes, the MEB addendum exam performed 4 months prior 
to separation and after the CI recuperated from his surgical procedure.  There was no ankylosis, 
flail joint or fracture of the femoral shaft or anatomical neck present in either hip nullifying the 
use of VASRD codes 5250, 5254 and 5255 respectively.  The MEB addendum exam documents 
non-compensable  ROM  measurements  for  each  hip  in  extension  and  flexion  as  required  for 
rating  under  VASRD  codes  5251  and  5252  respectively.    Additionally,  the  ROM  limitations 
required for rating under VASRD code 5253 were also not documented proximate to the date of 
separation.    There  was  no  muscle  injury  in  the  record  obviating  the  use  of  VASRD  rating 
guidance under §4.73 Schedule of ratings for muscle injuries.  This leaves VASRD code 5003 as 
the only appropriate rating option, proximate to the day of separation, for the CI’s right and left 
hip  pain  condition.    The  VA’s  remote  use  of  VASRD  code  5010  for  rating  the  CI’s  left  hip 
condition also relies on the use of code 5003 for rating purposes.  Application of VASRD code 
5003 requires demonstrated joint limitation due to painful motion (VASRD §4.59), adequately 
demonstrated  in  this  case,  be  granted  a  10%  evaluation  unless  incapacitating  episodes  were 
present.  The  presence  of  incapacitating  episode  would  garner  a  20%  evaluation;  none  were 
evidenced in this case.  Therefore, under VASRD code 5003 each hip would be separately rated 
as  10%  disabling  with  evidence  of  non-compensable  ROM  measurements  and  adequate 
evidence of painful motion.  There is no appropriate coding and rating scheme that would be of 

3                                                           PD1201613 
 

greater benefit to the CI.  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 left and right (bilateral) hip pain condition. 
 
Contended PEB Conditions.  The contended conditions adjudicated as related to the bilateral 
hip pain were arthritis and DJD of both hips and non-union of right greater trochanter.  These 
contended  conditions  were  found  to  be  related  to  the  unfitting  left  and  right  hip  pain  and 
therefore were not independently unfitting.  Additionally, the disability related to impairment 
caused  by  those  conditions  would  be  rated  using  the  same  criteria  as  the  bilateral  hip  pain.  
Under VARSD policy §4.14, avoidance of pyramiding, which states the evaluation of the same 
manifestation under different diagnoses is to be avoided; the Board is not allowed to assign the 
hip  pain  to  more  than  one  diagnosis  for  rating  the  hip  disability.    After  due  deliberation  in 
consideration of the PEB adjudication and VASRD policy §4.14, the Board concluded that there 
was no basis to recommend a change in the PEB determination for the any of the contended 
conditions 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 left and 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 arthritis and DJD of both hips and non-union of right greater trochanter conditions, 
the Board unanimously recommends no change from the PEB determination as related to the 
bilateral hip pain condition.  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 

5003 
5003 

COMBINED (w/ BLF) 

10% 
10% 
20% 

Left Hip Pain Condition 
Right Hip Pain Condition 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120714, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

           X 
           Acting Director 
           Physical Disability Board of Review 

4                                                           PD1201613 
 

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                                                           PD1201613