AF | PDBR | CY2010 | PD2010-00117
Mental Condition/Major Depressive Disorder/Anxiety Disorder. The Board noted the recommendation made by the AFBCMR medical consultant for the contributions of the pre-existing component of her condition, the presence of the paranoid personality disorder and the examiners implication that the CI failed to disclose her psychiatric issues prior to enlistment; however, there was no evidence whatsoever in the record that the CI ever received medical treatment for a psychiatric condition prior to...
AF | PDBR | CY2010 | PD2010-00118
AF | PDBR | CY2010 | PD2010-00119
Also, the 2001 Veterans Administration Schedule for Rating Disabilities (VASRD) coding and rating standards for the spine was in effect at the time of TDRL entry and the 2003 VASRD was in effect for the TDRL exit rating (the current §4.71a rating standards were adopted on 26 September 2003). The examiner noted “extreme difficulty transitioning from a seated to a standing position,” temporary abnormal posture after standing, and “unable to extend his knees or flex his hips against resistance...
AF | PDBR | CY2010 | PD2010-00120
CI CONTENTION : The CI requests that the ratings he received from the PEB be increased due to worsening of his condition since separation from the service. The VA’s 10% rating is supported by the physical examination findings from the C&P examinations. Other PEB Conditions .
AF | PDBR | CY2010 | PD2010-00121
The Board cannot find any evidence to support an opinion that the headache condition had risen to the level of an unfitting impairment at the time of separation. There are therefore no additional conditions in this case appropriate for Board recommendation as additionally unfitting for separation rating. In the matter of the neck condition (cervical spine fusion with radiation of pain in the upper extremity), and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB...
AF | PDBR | CY2010 | PD2010-00123
Since no evidence of functional impairment exists in this case, the Board cannot support a recommendation for additional rating based on nerve impairment. The CI was given a P2/L3 profile for LBP, sarcoidosis and plantar fasciitis in July 2005. The VA C&P examination post-separation noted that there was some tenderness over the right foot calcaneous, without limitation of motion along with normal right and left foot x-rays.
AF | PDBR | CY2010 | PD2010-00124
SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (42A, Human Resources Specialist) medically separated for bilateral carpal tunnel syndrome (CTS) with median nerve neuropathies. The Board therefore has no reasonable basis for recommending any additional unfitting conditions for separation rating. In the matter of the bilateral carpal tunnel syndrome condition, the Board unanimously recommends that...
AF | PDBR | CY2010 | PD2010-00125
It has also been found that the ICD-9 codes were misdiagnosis; May-Thurner Syndrome (45181): Compress iliac vein; Left Lower Extremity Deep Venous Thrombosis (4539): Blood clot. The Board first considered the TDRL entry rating and notes that the FPEB IAW SECNAVINST 1850.4E rating increased the 40% rating during the period of TDRL solely due to the recency of the DVT. The Board does not have the authority under DoDI 6040.44 to render fitness or rating recommendations for any conditions not...
AF | PDBR | CY2010 | PD2010-00126
The IPEB adjudicated the bilateral foot and calf pain condition as separate right and left foot, calf pain unfitting conditions, rated 10% each, IAW the Veterans Administration Schedule for Rating Disabilities (VASRD) and with consideration of the bilateral factor. Other Conditions . In the matter of the bilateral shoulder pain, back pain, depressive disorder, skin abscess, tender scar, hypertension, or any other medical conditions eligible for Board consideration; the Board unanimously...
AF | PDBR | CY2010 | PD2010-00128
The CI appealed to the formal PEB (FPEB), which made no rating changes and the CI was medically separated with a 20% disability rating. The VA coded using 5262 (impairment of tibia and fibula) and rated the condition as malunion with marked knee disability. In the matter of the right knee condition, the Board unanimously recommends a rating of 30% coded 5262 IAW VASRD §4.71a.
AF | PDBR | CY2010 | PD2010-00129
Left Foot Condition . There were several diagnoses that may have contributed to the CI’s left foot pain, and the Board considered the total disability of the left foot in its rating recommendation. The DES file, service treatment record, post-separation VA C&P exams, VA outpatient treatment records, and VA contact reports provided evidence of physical (headache, nausea, vomiting, sleep disturbance, balance disorder), cognitive (memory, concentration, speed of processing), and possibly...
AF | PDBR | CY2010 | PD2010-00130
CI CONTENTION : The CI states: “My initial VA Rating Decision granted 40% for my back condition. The Board, therefore, has no reasonable basis for recommending any additional unfitting conditions for separation rating. RECOMMENDATION : The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:
AF | PDBR | CY2010 | PD2010-00131
The Board considered the PEB rating which reflects the left saphenous nerve injury. Service Treatment Record. Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
AF | PDBR | CY2010 | PD2010-00132
ANALYSIS SUMMARY : The Board notes that the CI’s contended rating for his right groin condition references a VA rating decision based on evaluations performed over a year after separation. Right Groin Condition . The Board considered, given the actual severity and associated disability in evidence, the applicability of VASRD §4.7 (higher of two evaluations) which would favor a rating under the 8630 neuritis code.
AF | PDBR | CY2010 | PD2010-00163
The CI was placed on Limited Duty (LIMDU) on 20050908 for the GSW to the chest and RUE. Chest Condition . In light of the evidence of impairment indicated by the numerous treatment notes for chest pain (also see the PTSD condition with chest pain as a contributor), the NMA statement, and the post-separation continued disability due to the chest condition, the CI’s chest condition should be recharacterized as a separate unfitting and ratable disability at the time of separation.
AF | PDBR | CY2010 | PD2010-00168
The TBI did not result in a LIMDU and the Non Medical Assessment (NMA) did not mention any fitness limitations due to the effects of the TBI. Other Conditions. The Board, therefore, has no reasonable basis for recommending any additional unfitting conditions for separation rating.
AF | PDBR | CY2010 | PD2010-00173
IAW DODI 1332.38 this diagnosis falls under “conditions and circumstances not constituting a physical disability.” This condition cannot be adjudicated as separately unfitting, and there was no deduction from the CI’s unfitting PTSD diagnosis for any potential contribution from alcohol abuse. The Board, therefore, has no reasonable basis for recommending any additional unfitting conditions for separation rating. Exhibit C. Department of Veterans' Affairs Treatment Record
AF | PDBR | CY2010 | PD2010-00179
The CI’s mental status exam (MSE) noted his mood was anxious, cognition was grossly intact with some decreased concentration, and he displayed an increased startle response. All evidence considered, there is not reasonable doubt in the CI’s favor supporting addition of S/P GSW to right shoulder as an unfitting condition for separation rating. Exhibit C. Department of Veterans' Affairs Treatment Record.
AF | PDBR | CY2010 | PD2010-00187
The Board considered the service treatment record and post separation treatment records proximate to separation to determine the CI’s mental health disability at the time of separation. All evidence considered, the Board recommends a separation rating for Generalized Anxiety Disorder with Major Depression, coded 9413 at 30% in this case. In the matter of the Cervical Neck Pain, Thoracic Back Pain, Lumbar Spine, and Left Shoulder conditions, the Board unanimously recommends no...
AF | PDBR | CY2010 | PD2010-00196
He met criteria for a depressive disorder, largely related to his combat trauma experiences in Iraq, although there is likely some previous depression, which was exacerbated by his experiences in Iraq. The second descriptor is only partially met as his PTSD symptoms had affected social relationships but he was working and work was noted to be “therapeutic.” At the 70% level he did manifest two descriptors, expressing suicidal thoughts but stated that he would never act on those thoughts. ...
AF | PDBR | CY2010 | PD2010-00198
RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW NAME: BRANCH OF SERVICE: NAVY CASE NUMBER: PD1000198 SEPARATION DATE: 20080815 BOARD DATE: 20101208 ___________________________________________________________________________ SUMMARY OF CASE: This covered individual (CI) was an active duty E-4 (HM3, Hospital Corpsman Third Class) medically separated from the Navy in 2008 after 4 years 11 months of service. There was no indication that any examiner separated the contributions of MDD...
AF | PDBR | CY2010 | PD2010-00199
CI CONTENTION : The CI states: “I feel that my claim should be re-evaluated due to the severity of my disability and my additional disabilities found under VA evaluation should be considered. The Board therefore has no reasonable basis for recommending this condition as an additional unfitting condition for separation rating. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2010 | PD2010-00209
The PEB’s unfitting determination under the PTSD diagnosis is considered administratively final for the Board, and the Board focused on adjudicating the CI’s mental health disability under Veterans Administration Schedule for Rating Disabilities (VASRD) coding for PTSD 9411. The most proximate source of comprehensive evidence on which to base the permanent rating recommendation in this case is the VA examination 4 months after separation, summary of psychiatric hospitalizations in Nov 2008...
AF | PDBR | CY2010 | PD2010-00217
(including Bipolar Disorder) The Board unanimously agrees with the PEB, that the Bipolar disorder was not separately unfitting but was related to the PTSD condition. Exhibit C. Department of Veterans' Affairs Treatment Record.
AF | PDBR | CY2010 | PD2010-00228
The other two right knee conditions (LCL and PLC deficiency) were determined to be category II (related to the unfitting ACL condition). Right Knee Condition . As noted above, the Navy PEB found the ACL deficiency unfitting, and rated it as 20% disabling.
AF | PDBR | CY2010 | PD2010-00254
CI CONTENTION : The CI states, “I was assigned less than 50% disability rating by the military for my unfitting PTSD upon discharge from active duty. In the matter of the status post IED blast (TBI), ankle sprain, or any other medical conditions eligible for Board consideration, the Board unanimously agrees that it cannot recommend any findings of unfit for additional rating at separation. Exhibit C. Department of Veterans' Affairs Treatment Record.
AF | PDBR | CY2010 | PD2010-00264
SUMMARY OF CASE : This covered individual (CI) was an active duty SSGT/E-5 (4A151, Medical Material Journeyman) medically separated from the Air Force in 2006 after more than eight years of service. An Informal PEB determined she was unfit secondary to her bilateral hip condition with a disability rating of 0% for each hip. The VA rated each hip separately under 5010-5013 with 10% each hip for ROM limited by pain.
AF | PDBR | CY2010 | PD2010-00266
Flexion (0-180)110⁰165⁰ w/pain at 165⁰Abduction (0-180)110⁰90⁰w/pain at 90⁰Internal Rotation (0⁰-90⁰)50⁰90⁰External Rotation (0⁰-90⁰)30⁰90⁰Comment4/5 strength; pain w/ resistance impingement test + (Neers); Obrien’s +, tight joint capsuleNo stiffness, swelling weakness§4.71a Rating10% painful motion20% lim motion shoulder levelThe MEB exam (27 July 2005) four months pre-separation documented that the CI had undergone a left shoulder Bankert repair arthroscopy on 14 February 2005. The...
AF | PDBR | CY2010 | PD2010-00306
He was referred for a Medical Evaluation Board (MEB), and the MEB forwarded the PTSD condition to the Physical Evaluation Board (PEB) on the NAVMED 6100/1 as medically unacceptable without listing any other medical conditions. The CI was thus medically separated with a 10% disability rating. Symptoms of fatigue noted during VA evaluations were attributed to the CI’s unfitting PTSD condition.
AF | PDBR | CY2010 | PD2010-00317
The severity of the CI’s symptoms at the time of the MEB psychiatric NARSUM three months prior to separation was documented as moderate by the examiner. He denied suicidal ideation, but had thoughts of hurting others. Pre-separation documentation records satisfactory performance of duties, and VA evidence 11 to 15 months post-separation reflects status as a full-time student (the later C&P examination in December 2008 documented CI report of difficulties with school due to his symptoms).
AF | PDBR | CY2010 | PD2010-00321
The Informal PEB (IPEB) adjudicated the CMP right knee with complex regional pain syndrome (CRPS) as unfitting rated 20% disability IAW Veterans Administration Schedule for Rating Disabilities (VASRD). The Board determined that the rating for the right knee is 10% for painful motion based on the orthopedic exam proximate to separation and the C&P exam after separation. In the matter of the left knee, endometriosis or any other condition eligible for Board consideration, the Board...
AF | PDBR | CY2010 | PD2010-00329
The VA rating decision on 13 February 2008, two months post-separation, rated the conditions separately with the OSA condition, code 6847 (sleep apnea syndromes), rated 50%. The VA rating decision two months post-separation on 13 February 2008 rated the conditions separately, with the panic disorder with agoraphobia condition, code 9412 (panic disorder and/or agoraphobia), rated at 10%. Exhibit C. Department of Veterans' Affairs Treatment Record
AF | PDBR | CY2010 | PD2010-00336
CI CONTENTION : The CI contends his shoulder condition was improperly rated by the PEB: ‘’USMC rated under code 5399-5003. Shoulder Condition . The MEB NARSUM was 5 months prior to separation and has higher probative value with regard to rating the severity of the CI’s conditions based on proximity in time to separation, however the VA C&P 11 months after separation was reviewed and taken into consideration during Board deliberations as was the VA rating code selection.
AF | PDBR | CY2010 | PD2010-00344
Except for the 27 January 2006 ROM results, the ROM measurements reported by Teche Regional Medical Center (TRMC) physical therapy were lumbar ROMs, not thoracolumbar ROMs. A TRMC physical therapy appointment on 27 January 2006, expressly for measurement of thoracolumbar ROM in accordance with the VASRD, recorded thoracolumbar flexions of 25, 25 and 28 degrees (after exercise) that are essentially no different than the lumbar ROM measurements (that exclude thoracic ROM) from 1 December...
AF | PDBR | CY2010 | PD2010-00353
There was no evidence that this was a separately unfitting condition and warranted a separate rating. ____________________________________________________________________________ __ RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical separation. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2010 | PD2010-00360
Left Wrist Condition. The Board therefore has no reasonable basis for recommending any additional unfitting conditions for separation rating. In the matter of the right knee pain, right ankle pain, and left knee pain conditions or any other medical conditions eligible for Board consideration, the Board unanimously agrees that it cannot recommend any findings of unfit for additional rating at separation.
AF | PDBR | CY2010 | PD2010-00364
The Board evaluates DVA evidence proximate to separation in arriving at its recommendations, but its authority resides in evaluating the fairness of DES fitness decisions and rating determinations for disability at the time of separation. Service Treatment Record I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2010 | PD2010-00370
PHYSICAL DISABILITY BOARD OF REVIEW The physical exam indicated tenderness to the lower thoracic spine and left paraspinals muscles and the ROM was limited by pain. With application of the VASRD notes, the CI’s combined ROM was 225° for the military ROM exam.
AF | PDBR | CY2010 | PD2010-00374
The PEB adjudicated the right and left wrist carpal tunnel syndrome condition as unfitting, rated 10% each, with a combined disability rating of 20%. In the matter of ulnar neuropathy or any other medical conditions eligible for Board consideration, the Board unanimously agrees that it cannot recommend any findings of unfit for additional rating at separation. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2010 | PD2010-00377
After due deliberation, considering all of the evidence, the Board recommends a service disability rating of 20% for the cervical (neck) condition. The Board determined therefore that none of the stated conditions were subject to service disability rating. The PEB disability description specified that there was ROM limited by pain and that the PEB used the PT exam (which was closer to the date of separation) as their rating exam.
AF | PDBR | CY2010 | PD2010-00378
CI CONTENTION : The CI states: “At the time of discharge, I also had other issues. I concur with that finding, accept their recommendation and direct that your records be corrected as set forth in the attached copy of a Memorandum for the Chief of Staff, United States Air Force. The pertinent military records of the Department of the Air Force relating xxxxxxxxxxxxxx, be corrected to show that the diagnosis in his finding of unfitness was Left Chronic Knee Pain, VASRD code 5099-5003, rated...
AF | PDBR | CY2010 | PD2010-00383
The Board notes that the CI contends that the left lower radiculopathy, abnormal MRI and EMC/NCV were overlooked by the PEB. An exam at a pain clinic, three weeks later, showed normal sensory and motor exams with normal deep tendon reflexes. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2010 | PD2010-00386
Right Knee Condition . The Board considered that the MEB’s “7mm free body” (right knee) condition is considered in the overall knee ratings and is not separately ratable. Other Conditions .
AF | PDBR | CY2010 | PD2010-00401
The CI was referred to the Physical Evaluation Board (PEB), determined unfit for the Back Condition, and separated at 10% disability using the Veterans Affairs Schedule for Rating Disabilities (VASRD) and applicable Air Force and Department of Defense regulations. However, the Board must rate her condition as it was when she separated from service. The Board also considered the condition of Surgical Scar Status Post Lumbar Laminectomy and unanimously determined that this condition was not...
AF | PDBR | CY2010 | PD2010-00407
No evidence of a thought disorder. RECOMMENDATION : The Board recommends that the CI’s prior separation be re-characterized to reflect that, rather than discharge with severance pay, the CI was placed on the TDRL at 50% for a period of six months (PTSD at 50% IAW §4.129 and DoD direction) and then permanently retired by reason of physical disability with a final 30% rating as indicated below. Exhibit C. Department of Veterans' Affairs Treatment Record.
AF | PDBR | CY2010 | PD2010-00415
The medical bases for separation were posttraumatic stress disorder (PTSD) associated with panic disorder and social phobia, both designated as EPTS (existed prior to service) and alcohol abuse. However, clear evidence within the VA clinic notes and the 15-month examination that covered the CI’s condition within the six-month TDRL timeframe had to be considered. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2010 | PD2010-00416
Since the comprehensive VA Compensation and Pension (C&P) Initial PTSD examination was accomplished three months prior to separation, the most proximate source of evidence on which to base the permanent rating recommendation in this case are the VA mental health outpatient treatment notes from 20060626 to 20060814 (separation was 20051223). Right Knee Condition . Exhibit C. Department of Veterans' Affairs Treatment Record.
AF | PDBR | CY2010 | PD2010-00423
The most proximate source of comprehensive evidence on which to base the permanent rating recommendation in this case is the VA psychiatric rating evaluation three months after separation. The VA had not rated the CI for PTSD as a disability until this examination. There are therefore no additional conditions in this case appropriate for Board recommendation as additionally unfitting for separation rating.
AF | PDBR | CY2010 | PD2010-00431
The Board considered that the MEB and pre-separation VA exams could be rated 30% under §4.130. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a separation rating of 30% as the permanent PTSD disability rating in this case. The Board, therefore, has no reasonable basis for recommending any additional unfitting conditions for separation rating.
AF | PDBR | CY2010 | PD2010-00448
CI’s CONTENTION : The CI states, “I respectfully request that the board re-evaluate the decision issued on 12 May 2009 by the Department of the Navy Physical Evaluation Board. As mentioned above, the Board must base its permanent disability rating recommendation on the CI’s medical condition at the time of separation from service. The Board therefore unanimously recommends that peripheral neuropathy be considered not unfitting at the time of separation from service.