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AF | PDBR | CY2013 | PD-2013-02069
Original file (PD-2013-02069.rtf) Auto-classification: Approved
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX    CASE: PD-2013-02069
BRANCH OF SERVICE: Army  BOARD DATE: 20150306
SEPARATION DATE: 20050711


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-5 (Human Resources Specialist) medically separated for right hip pain. The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty; however his physical profile authorized an alternate aerobic physical fitness test event. He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). The condition characterized as “chronic right hip pain, status post percutaneous pinning of femoral neck stress fracture” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other condition was submitted by the MEB. The Informal PEB adjudicated “chronic right hip pain post percutaneous pinning of a femoral neck stress fracture” as unfitting, rated 0%, c iting application of the US Army Physical Disability Agency (USAPDA) pain policy. The CI made no appeals and was medically separated.


CI CONTENTION: “*Three (sic) pins in right (sic) hip (femoral neck fracture). * Chronic pain and (sic) limited mobility for (sic) eight (sic) years. 20% disability awarded *10% high blood pressure, *10% arthritis lower back. Pins in right (sic) hip never evaluated or considered. *Constant pain. *Can’t sit/bend over. *Disturbs sleep. * I am tired-depressed-fed up. *I have asked for help for the past eight (sic) years and nothing has changed. *I need help.”


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 20050518
 VA* - (~69 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Chronic Right Hip Pain… 5099-5003 0% Right Hip S/P Stress Fracture… 5010-5252 10% 20110314
Other x 0 (Not In Scope)
 Other x 3 (equals SC, NSC & deferred)
RATING: 0%
 RATING: 20%
*Derived from VA Rating Decision (VARD) dated 20110923 (most proximate to date of separation [DOS]).
Note: Ratings in chart ar e taken from the original VARD.


ANALYSIS SUMMARY:

Chronic Right Hip Pain Condition. The narrative summary (NARSUM) and treatment record indicated the CI had a right hip (femoral neck) stress fracture and resolution of pain following surgical pinning approximately 4 years prior to separation. He was reclassified and did well until recurrence of right hip pain in 2003 interfered with performance of “some basic soldiering skills.” Pain was in the right hip and back with occasional radiation down the right leg. NARSUM exam in March 2005 documented a well healed scar with no hip tenderness. Active range-of-motion (ROM) was “full” without pain on ROM testing, but a positive FABER’s test (pain on flexion, abduction and external rotation). Strength, reflexes, and neurovascular exam of the leg were normal. X-rays documented good screw placement (x3) without evidence of loosening or failure. The MEB physical (DD Form 2808) dated 5 April 2005 noted decreased right hip ROM with increased pain on ROM of left hip. A NARSUM addendum dated 13 April 2005 documented right hip active ROM of “95/100/100” degrees (normal 125 degrees) with slight decrease in rotations and abduction with “mild pain in the right hip for all planes measured.”

There was no VA Compensation and Pension exam performed proximate to separation. Remote VA exam over 5 years remote from separation (~69 months), documented a normal gait and the CI could cross his legs and toe-out greater than 15 degrees. He had right hip flexion to 125 degrees (with painful motion) and X-ray evidence of soft tissue calcification over the right the anterior right thigh and arthritis.

The Board directed attention to its rating recommendation based on the above evidence. The PEB rated the right hip at 0% citing normal passive (versus active) ROM and the USAPDA pain policy. The VA rated the right hip remote from separation at 10% (effective on 29 July 2010) for pain limited hip motion. The Board considered the NARSUM addendum had the highest probative value for rating. The Board adjudged that there was sufficient evidence of painful motion (IAW VASRD 4.59) to warrant a 10% rating. There was no evidence of hip instability or flexion limited to 30 degrees or abduction limited to 10 degrees to warrant any higher rating. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt) and §4.59 (painful motion), the Board recommends a disability rating of 10% for the right hip 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 the hip was operant in this case and the condition was adjudicated independently of that policy by this Board. In the matter of the right hip condition, the Board unanimously recommends a disability rating of 10%, coded 5099-5003 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 his prior medical separation:

CONDITION VASRD CODE RATING
Chronic Right Hip Pain… 5099-5003 10%
COMBINED 10%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20131030, w/atchs
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, AR20150011177 (PD201302069)


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

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