RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY CASE NUMBER: PD1200956 SEPARATION DATE: 20020619 BOARD DATE: 20130227 SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SFC/E-7 (63H/Track Vehicle Repairer) medically separated for Type II diabetes mellitus (DM). He was treated, but was unable to fully perform his military duties. He was issued a permanent P3 profile, and underwent a Medical Evaluation Board (MEB). The MEB found his DM condition medically unacceptable IAW AR 40-501, and referred him to a Physical Evaluation Board (PEB). No other conditions were listed on the DA Form 3947. The PEB found the DM condition unfitting, and rated it 20% IAW the Veterans’ Administration Schedule for Rating Disabilities (VASRD). The CI made no appeals, and was medically separated with a 20% disability. CI’s CONTENTION: The CI elaborated no specific contentions. 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 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 unfitting diabetes condition meets the criteria prescribed in DoDI 6040.44, and is accordingly addressed below. No other conditions are within the Board’s purview. Any condition outside the Board’s defined scope of review may be eligible for future consideration by the Army Board for Correction of Military Records. RATING COMPARISON: Army PEB – dated 20020228 VA (2 mos. Pre-Separation) – All Effective 20020620 Condition Code Rating Condition Code Rating Exam Diabetes Mellitus 7913 20% Diabetes Mellitus 7913 40% 20020412 .No Additional MEB/PEB Entries. Chronic Left Ankle Sprain 5271-5024 10% 20020412 0% X 4 20020412 Combined: 20% Combined: 50% ANALYSIS SUMMARY: Diabetes Mellitus (DM). The CI was diagnosed with DM in November 1999. He was hospitalized, and his blood sugar (BS) was stabilized. On discharge from the hospital, his DM was controlled with dietary restriction and oral hypoglycemic medication. In May 2000, he underwent an MEB and was found fit for duty. Shortly thereafter, it was determined that he needed to be on Insulin therapy. The CI's unit at that time kept him on rear assignments and made accommodations for him. However, when the CI was transferred to Fort Hood TX, that situation changed. His DM condition became much more difficult to control and a second MEB was initiated to determine fitness for duty. The MEB narrative summary (NARSUM) was dictated on 31 January 2002. The examiner noted that the CI was in good health; with no limitations on physical activities, aerobic conditioning exercises, functional activities, or Army Physical Fitness Test (APFT). He was in no apparent distress, and his physical exam (PE) was essentially normal. His medications included metformin and insulin. In April 2002, the CI had a VA Compensation and Pension (C&P) exam. The physical findings from that examination were unremarkable. The CI denied any symptoms of peripheral neuropathy or sexual dysfunction. The Board carefully examined all available evidence and directs attention to its rating recommendation based on the above evidence. The PEB and VA both used VASRD code 7913 for the DM condition. IAW VASRD §4.119, a rating of 20% is appropriate for DM requiring Insulin and restricted diet. None of the criteria for higher ratings can be supported by the evidence. A rating of 40% would require medically prescribed regulation of activities (ROA). ROA is when a licensed healthcare provider prescribes or recommends that a diabetic patient avoid strenuous occupational or recreational activities. In the CI’s treatment record, there was not sufficient evidence that this was the case. 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 diabetes 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. 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 DM condition and IAW VASRD §4.119, 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, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows: UNFITTING CONDITION VASRD CODE RATING Diabetes mellitus, type 2 7913 20% COMBINED 20% The following documentary evidence was considered: Exhibit A. DD Form 294, dated 20120608, w/atchs Exhibit B. Service Treatment Record Exhibit C. Department of Veterans’ Affairs Treatment Record xxxxxxxxxxxxxxxxxxxxxxxx, DAF Acting Director Physical Disability Board of Review SFMR-RB MEMORANDUM FOR Commander, US Army Physical Disability Agency (TAPD-ZB / xxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for xxxxxxxxxxxxxxxxxxx, AR20130006035 (PD201200956) 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 and hereby deny the individual’s application. This decision is final. The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail. BY ORDER OF THE SECRETARY OF THE ARMY: Encl xxxxxxxxxxxxxxxxxxxxxxxx Deputy Assistant Secretary (Army Review Boards)