You already know that the call is rare to keep a batter in the box who was hit by a pitch. The only time I keep a batter in the box, FED or OBR, is if he clearly made a move to get hit by a pitch. I had a game last year where the same player moved his leg into a pitch on two consecutive at bats. The second time I said "I don't believe you did that again". He stayed in the box both times. His coach put up a mild argument both times.
Side note - I don't think anybody wants to intentionally get hit on a bone (ie elbow).
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