Search Decisions

Decision Text

AF | PDBR | CY2013 | PD-2013-01475
Original file (PD-2013-01475.rtf) Auto-classification: Approved
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX    CASE: PD-2013-01475
BRANCH OF SERVICE: Army  BOARD DATE: 20150122
SEPARATION DATE: 20040329


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4 (Interrogator) medically separated for osteitis pubis with persistent pubic symphyseal pain and scoliosis with recurrent thoracic back pain. The conditions could not be adequately rehabilitated to meet the physical requirements of her Military Occupational Specialty. She was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). The osteitis pubis and scoliosis were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other condition was submitted by the MEB. The Informal PEB adjudicated “chronic recurrent pelvic pain diagnosed as osteitis pubis” as unfitting, rated 0% with application of US Army Physical Disability Agency (USAPDA) pain policy.
“Recurrent thoracic back pain attributed to moderate (12 degree) scoliosis, a preexisting developmental abnormality” was determined to be unfitting but unratable due to existed prior to service (EPTS) without permanent service aggravation. The CI made no appeals and was medically separated.


CI CONTENTION: “Osteitis pubis was not caused by “adult onset scoliosis”; and after discharge – neck pain; muscle spasms; and pubic pain were all successfully treated by chiro and interspacial steroid injections Requiring me to sit at desk 8 hrs a day learning Korean; and being required to ruck at an Infantry standard - caused spinal sublarations that could have been treated immediately – wearing a helmet on top of pinched discs made conditions worse. I missed appointment in Jackson in 05 because I went to Iraq as a civilian to continue serving my country.” [sic]


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 when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting. Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military/Naval Records. Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate. The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions. That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws. The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.





RATING COMPARISON :

IPEB – Dated 20040205
 VA* - (~2 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Pelvic Pain/Osteitis Pubis 5099-5003 0% Ostetitis Pubis/Pubic Pain 5022-5252 NSC* 20040505
Thoracic Back Pain/Scoliosis EPTS ---% Mild Scoliosis (Back Disorder with Muscle Spasm) 5299-5237 NSC* 20040505
Other x 0 (Not In Scope)
 Other x 7
RATING: 0%
 RATING: 0%
* Original VA Rating Decision (VARD) dated 20040505 deferred rating decisions for both conditions. Second VA RD dated 200 50301 determined both conditions Not Service Connected .


ANALYSIS SUMMARY:

Osteitis Pubis with Persistent Pubic Symphyseal Pain. According to service treatment records (STRs) and the MEB narrative summary (NARSUM), the CI experienced pain at the front of her pelvis diagnosed as osteitis pubis. Clinic examination on 4 November 2003, noted a history of pubic symphysis pain since the birth of her last child (November 1996, over 3 years prior to entry into service), which had significantly worsened to nearly incapacitating. There had been no specific injury other than physical and military training. Examination was noted to show tenderness in the area of the pubic symphysis. The MEB NARSUM performed on 5 January 2004, recorded report of pubic pain with nearly all activities. On examination toe and heel walking were intact without difficulty. At the time of the VA Compensation and Pension (C&P) examination performed on 5 May 2004, the CI reported continued pubic pain with activity. On examination there was tenderness of the pubic bone. An X-ray pelvis of the pelvis was normal with no radiographic changes of osteitis pubis.

The Board directed its attention to its rating recommendation based on the above evidence. The PEB rated the osteitis pubis with persistent pubic symphyseal pain 0% with application of the USAPDA pain policy. The STRs reflected functional loss due to pubic symphysis pain with activity diagnosed as osteitis pubis. There is no specific diagnostic code in the VA Schedule for Rating Disabilities (VASRD) for the pubic symphysis however in accordance with VASRD §4.40 a 10% rating is supported by the functional loss recorded in the service treatment records. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the osteitis pubis condition (5099-5022).

Recurrent Thoracic Back Pain with Scoliosis. STRs reflected care for recurrent thoracic level back pain with spasms without any specific injury. X-rays demonstrated the presence of scoliosis of the spine, a developmental condition. No other abnormality was noted on examinations or X-rays and providers considered the scoliosis to be a significant factor in her pain. The MEB NARSUM noted the thoracic back pain was aggravated by activities such as sit-ups. Other than the scoliosis, the examination was normal. At the VA C&P examination performed on 5 May 2004, a month after separation, the CI reported intermittent upper back pain occurring once a month and lasting 4 days. There was no history of specific injury or trauma. The examination was normal and X-rays showed mild scoliosis. According to the CI on her application, the pain was treated successfully after separation by chiropractic and injections.

The Board directed its attention to its rating recommendation based on the above evidence. The PEB determined the recurrent thoracic pain attributed to scoliosis EPTS without service aggravation and therefore did not provide a rating. In accordance with DoD policy, conditions which EPTS and are not permanently aggravated by service beyond the natural history of the condition are not compensable. Scoliosis is condition which develops with skeletal growth and therefore existed prior to entry into military service. There was no evidence of injury or disease in service which would cause or aggravate the scoliosis condition.
The thoracic pain was aggravated by strenuous activities but no permanent injury was shown to have resulted from those activities. 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 recurrent thoracic back pain attributed to scoliosis condition.


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 chronic recurrent pelvic pain diagnosed as osteitis pubis was operant in this case and the condition was adjudicated independently of that policy by this Board. In the matter of the chronic recurrent pelvic pain diagnosed as osteitis pubis condition, the Board unanimously recommends a disability rating of 10%, coded 5099-5022IAW VASRD §4.71a. In the matter of the recurrent thoracic pain attributed to scoliosis condition 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 recommends that the CI’s prior determination be modified as follows, effective as of the date of her prior medical separation:

CONDITION VASRD CODE RATING
Chronic Recurrent Pelvic Pain Diagnosed As Osteitis Pubis 5099-5022 10%
Recurrent Thoracic Pain Attributed To Scoliosis EPTS --
COMBINED 10%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20130913
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record



                                   
XXXXXXXXXXXXXXX
President
DoD Physical Disability Board of Review

SAMR-RB                                                                         


MEMORANDUM FOR Commander, US Army Physical Disability Agency
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557


SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXXX, AR20150009868 (PD201301475)


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              XXXXXXXXXXXXXXX
                  Deputy Assistant Secretary of the Army
                  (Review Boards)

CF:
( ) DoD PDBR
( ) DVA

Similar Decisions

  • AF | PDBR | CY2014 | PD-2014-01154

    Original file (PD-2014-01154.rtf) Auto-classification: Denied

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of theVeterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. Examination noted normal lumbar spine ROM with pain and normal bilateral hip ROM.An orthopedic evaluation on 27 March 2009, 5 months prior to separation, noted a 16-month history of pelvic pain following pregnancy. At...

  • AF | PDBR | CY2012 | PD 2012 01711

    Original file (PD 2012 01711.txt) Auto-classification: Denied

    In the matter of the pelvic stress fracture condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication. 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 Stress Fracture of Inferior Pubic Ramus 5099-5022 0% COMBINED 0% The following documentary evidence was considered: Exhibit A. DD Form 294, dated 20120717,...

  • AF | PDBR | CY2011 | PD2011-00384

    Original file (PD2011-00384.docx) Auto-classification: Denied

    SCOPE OF REVIEW : The Board’s scope of review, as defined in DoDI 6040.44, is limited to those conditions which were determined by the PEB to be unfitting for continued military service; or, when requested by the CI, those condition(s) identified but not determined to be unfitting by the PEB. Left hip condition . At his Army MEB exam, the CI reported that he was having some left hip pain.

  • AF | PDBR | CY2011 | PD2011-01021

    Original file (PD2011-01021.docx) Auto-classification: Approved

    SCOPE OF REVIEW : The Board wishes to clarify that the scope of its review as defined in Department of Defense Instruction (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 rating for the unfitting bilateral hip condition is addressed below; and, no additional...

  • AF | PDBR | CY2014 | PD-2014-00329

    Original file (PD-2014-00329.rtf) Auto-classification: Denied

    Post-Separation) ConditionCodeRatingConditionCodeRatingExam Persistent Back Pain…Fractured Pelvis (Healed)523710%S/P Healed Fractures of the Sacrum and Right Inferior Pubis Ramus5299-523610%20060606Post-Traumatic DDD of the Thoracic and Lumbar Spine w/Chronic Thoracolumbar Strain524210%20060606Other x 0 (Not in Scope)Other x 9 Rating: 10%Combined: 40%Derived from VA Rating Decision (VARD)dated 20060818 ( most proximate to date of separation [DOS]). Back Pain With Healed Pelvic Fracture . ...

  • AF | PDBR | CY2013 | PD-2013-01215

    Original file (PD-2013-01215.rtf) Auto-classification: Approved

    The bilateral feet, pubic symphysis, bilateral wrist and left ankle condition, characterized as “bilateral foot bunionectomies with chronic pain,”“pubic symphysis pain,” “bilateral wrist pain,” and “left ankle pain” were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. Post-Separation)ConditionCodeRatingConditionCodeRatingExam Chronic Pain Bilateral Feet Following Bunionectomy, Pubic Symphysis, Bilateral Wrists, Left Ankle5099-500310%Residuals of Bunionectomies Both...

  • AF | PDBR | CY2014 | PD-2014-01040

    Original file (PD-2014-01040.rtf) Auto-classification: Approved

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation. The PT performed ROMs for the MEB exam and noted an abnormal spine motion. 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.

  • AF | PDBR | CY2012 | PD 2012 01585

    Original file (PD 2012 01585.txt) Auto-classification: Denied

    I got a rate of 10% for one of the condition. The Board noted the PEB combined the left inferior pubis fracture condition and multiple stress fractures of the lower extremities condition and rated, as a single unfitting condition, at 0%, coded 5022. The Board must apply separate codes and ratings in its recommendations if compensable ratings for each condition are achieved IAW VASRD §4.71a.

  • AF | PDBR | CY2011 | PD2011-00397

    Original file (PD2011-00397.docx) Auto-classification: Denied

    These other conditions include left ilioinguinal strain (claimed as left hip pain), meralgia paresthetica, lumbar radiculopathy, synovial herniated pit (left) as documented by VA, and other sources, as well as pubic synthesis dysfunction, lumbargo, symptoms of all began during Basic, AIT, yet ignored, never diagnosed, or fully examined, just discharged from Army. Left Hip Condition . The Board does not have the authority under DoDI 6040.44 to render fitness or rating recommendations for...

  • AF | PDBR | CY2013 | PD 2013 00624

    Original file (PD 2013 00624.rtf) Auto-classification: Denied

    Post-Separation)ConditionCodeRatingConditionCodeRatingExam Multiple Area Pain (Back, Feet, Left Hip)5099-50030%Dysfunction at T4, T55291NSC20030224Back Condition5295NSC20030224Rib Condition, Left Side L3, L45299-5297NSC20030224Bilateral Plantar Fasciitis5299-52760%20030224Left Hip Condition w/ Arthralgia5255NSC20030224History of Left Superior Pubic Ramus Stress fracture (EPTS)Not UnfittingS/P Fracture of Left Superior Pubic Ramus5299-5255NSC20030224Polyneuropathy Etiology UnknownNot...