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AF | PDBR | CY2013 | PD-2013-02320
Original file (PD-2013-02320.rtf) Auto-classification: Approved
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXX  CASE: PD-2013-02320
BRANCH OF SERVICE: Army          BOARD DATE: 20140911
SEPARATION DATE: 20020806


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty PV2/E-2 (31U10/Signal Support Systems Specialist) medically separated for right snapping hip with pain. The right hip condition 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). Right snapping hip with right hip pain was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. The MEB also identified and forwarded one other condition (migraine headaches) for PEB adjudication. The Informal PEB adjudicated the “right snapping hip with pain” condition as unfitting, rated at 0%, referencing application of the US Army Physical Disability Agency (USAPDA) pain policy. The remaining condition was determined to be not unfitting , not rated. The CI made no appeals and was medically separated.


CI CONTENTION : invalid font number 31502 “ invalid font number 31502 The rating was too low for the injury. invalid font number 31502 invalid font number 31502 This condition left me at many times invalid font number 31502 invalid font number 31502 unable to sleep, unable to walk for a reasonable distance, and above invalid font number 31502 invalid font number 31502 anything else, unable to perform my job. invalid font number 31502 invalid font number 31502 Also, the issues I had with my feet were not rated on my discharge but do continue to cause issues invalid font number 31502 .”


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. The rating for the unfitting right hip condition is addressed below. The requested “feet” issues were not identified by the PEB and thus are not within the DoDI 6040.44 defined purview of the Board; and, no additional conditions are within the DoDI 6040.44 defined purview of the Board. 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 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 service 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, operating under a different set of laws.







RA TING COMPARISON :

Service IPEB – Dated 20020607
 VA – No Exams or Rating Determinations
Condition
 Code Rating Condition Code Rating Exam
Right Snapping Hip w/Pain 5099-5003 0% N/A
Other x 1 (Not is Scope)
Rating: 0%
 Rating: N/A
invalid font number 31502 Per VA, invalid font number 31502 the invalid font number 31502 CI never file invalid font number 31502 d invalid font number 31502 invalid font number 31502 to invalid font number 31502 establish invalid font number 31502 a invalid font number 31502 claim invalid font number 31502 ; therefore the CI did not invalid font number 31502 have any C&P exams or Rating Decisions invalid font number 31502 . invalid font number 31502 invalid font number 31502


ANALYSIS SUMMARY:

Right Snapping Hip Condition. The narrative summary (NARSUM) dated 23 April 2002 note d a history of snapping right hip pain since running in basic training. A slight limp noted in July 2001 cleared following medication, profile restriction and physical therapy. X-rays of the right h ip (July 2001) and b one s can (August 2001) were normal. The MEB physical exam (DD Form 2808 ) dated 13 February 2002 documented that “p atient can willfully dislocate/snap bilateral hips.” The f ormal physical therapy range-of- motion (ROM) evaluation dated 25 February 2002 documented flexion 110⁰ (normal list ed 120⁰/ VASRD normal is 125⁰) with pain at end ROM ; mild weakness on abduction, extension and flexion , noticeable “snaps” with muscle testing of abduction. The NARSUM documented “ full range of her hips 0 to 120 degrees of flexion” with no tenderness and normal straight leg tests. Neurovascular exam was normal. The 19   November 2001 orthopedic note indicating dictation of the MEB addendum documented a positive snap from the fascia with ambulation. There was no VA Compensation and Pension (C&P) exam, VA treatment notes or VA rating decisions in the evidence of record.

The Board directs attention to its rating recommendation based on the above evidence. The record indicated painful motion of the hip on the highest probative value examinations and also documented snapping which is an indicator of joint pathology (orthopedics indicated fascia as the likely origin) IAW VASRD §4.40 (functional loss) and §4.45 (the joints). The ideal analogous coding would be 5024 (tenosynovitis), but diagnostic codes 5013 through 5024 are rated using the same criteria as 5003 and 5009-5003 is acceptable VASRD coding. IAW VASRD §4.59 (painful motion), despite no compensable limitation of ROM under the specific hip ROM codes, the hip condition warrants the minimum compensable rating for the hip. 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 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 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 her prior medical separation:



UNFITTING CONDITION VASRD CODE RATING
Right Snapping Hip Condition 5099-5003 10%
RATING 10%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20130106, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record



                 
XXXXXXXXXXXXXXXXX
President
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 XXXXXXXXXXXXXXXXX, AR20150002503 (PD201302320)
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                                                  XXXXXXXXXXXXXXXXX
                                                      Deputy Assistant Secretary of the Army
                                                      (Review Boards)

CF:
( ) DoD PDBR
( ) DVA

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