AF | PDBR | CY2011 | PD2011-00232
The PEB found the LBP and neck pain conditions unfitting, and rated those 10% each. Pre-Sep | |Flexion (90⁰ is |90⁰ | |normal) | | |Combined (240⁰ is |225⁰ | |normal) | | |§4.71a Rating |10% | |Comments |No mention of pain | | |with ROM | The Army PEB and the VA both rated her back pain condition at 10%. The PEB rated her neck pain at 10%.
AF | PDBR | CY2011 | PD2011-00233
RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW NAME: BRANCH OF SERVICE: Army CASE NUMBER: PD1100233 SEPARATION DATE: 20061229 BOARD DATE: 20120329 SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (11B20/Infantryman), medically separated for chronic left sided scrotal pain. The Board evaluates DVA evidence proximal to separation in arriving at its recommendations, but its authority resides...
AF | PDBR | CY2011 | PD2011-00239
He was issued a U3 profile and underwent a Medical Evaluation Board (MEB). The CI was therefore medically separated with a 20% disability rating. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2011 | PD2011-00242
Chronic Low Back Pain Condition . The service treatment record shows occasional treatment for headache associated with sinusitis since 2000. The commander’s letter, 25 April 2007 mentions only back pain, states that otherwise the CI was an outstanding airman without references to problems that would be attributable to depression or adjustment disorder.
AF | PDBR | CY2011 | PD2011-00244
Asthma Condition . FEV1 (% Predicted)113%(VA 70%) 75%FEV1/FVC98.9%67%Medsalbuterol inhaler (as needed, 2-3 x/day); begin budesonide inhaler;budesonide inhaler twice daily, albuterol inhaler (as needed) - 2-3 times per dayfluticasone & salmeterol twice daily, albuterol inhaler … as needed, uses 2x/day if forgets other inhalersSpirometry NotesPositive methacholine challenge; no significant change after bronchodilatorreturned to normal after bronchodilator§4.97 Rating30%30%30%The service...
AF | PDBR | CY2011 | PD2011-00245
The Informal PEB (FPEB) adjudicated the cognitive disorder and chronic low back pain conditions as unfitting, rated 10% each IAW the Veterans Administration Schedule for Rating Disabilities (VASRD); and adjudicated the chronic left shoulder pain condition as unfitting, rated 0%, with application of the US Army Physical Disability Agency (USAPDA) pain policy. A Physical Medicine clinic note dated two months prior to the MEB exam recorded normal movement of all extremities, tenderness of the...
AF | PDBR | CY2011 | PD2011-00246
Plantar fasciitis was diagnosed as a co-existing condition at the time the CI underwent evaluation for his right ankle and is reflected in the duty limiting profile and determined to be unfitting by the PEB. Both the PEB and VA rated the condition 0%. The Board noted that the medical evidence regarding the plantar fasciitis condition following surgery was limited and overshadowed by the right ankle condition.
AF | PDBR | CY2011 | PD2011-00248
Neurologic examination performed on December 3, 2004 was normal and he was ambulating without difficulty. However, the Board also noted residuals of frontal lobe injury not merely restricted to mild memory dysfunction that included problems other cognitive functions (decreased verbal processing, attention, and concentration), irritability, anger, and problems with impulse control reflected in neuropsychological testing and the initial VA mental health clinic encounter 9 months after...
AF | PDBR | CY2011 | PD2011-00251
Chronic Neck Pain Condition . Other PEB Conditions . Service Treatment Record
AF | PDBR | CY2011 | PD2011-00254
(2) 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 service ratings for unfitting conditions will be reviewed in all cases. In addition to any condition determined to be unfitting by the PEB, the Board’s recommendations are confined to those conditions determined to be unfitting at the time of the CI’s...
AF | PDBR | CY2011 | PD2011-00257
The Board also acknowledges the CI’s assertion that his shrapnel injuries are related to his unfitting Stent placement condition and therefore should be subject to additional disability rating; although, the Board must note that a causality linkage of these contended conditions with the unfitting primary condition, even if conceded, is not a basis in itself for separation disability rating. Left Upper Extremity: (Left Subclavian Stent Placement Due to Pseudoaneurysm and Arteriovenous...
AF | PDBR | CY2011 | PD2011-00260
Bilateral Knee Condition . All evidence considered, the Board recommends that each knee be separately adjudicated as unfitting, coded 5299-5259 and rated 10%. In the matter of the bilateral knee condition, the Board by a vote of 2:1 recommends that each joint be separately adjudicated as follows: an unfitting right knee condition coded 5299-5259 and rated 10%; and, an unfitting left knee condition coded 5299-5259 and rated 10%; both IAW VASRD §4.71a.
AF | PDBR | CY2011 | PD2011-00261
The CI made no appeals, and was medically separated with that service disability rating. Additionally, hypertension was noted the VA rating decision proximate to separation, but was not documented in the core DES file. RECOMMENDATION : The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:
AF | PDBR | CY2011 | PD2011-00262
At the time of the MEB exam, range-of-motion (ROM) was limited and painful. The Board does not have the authority under DoDI 6040.44 to render fitness or rating recommendations for any conditions not considered by the DES. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2011 | PD2011-00263
The CI then medically separated with a 20% disability rating. Hepatitis C Condition . The CI had “chronic fatigue, nausea, vomiting, and arthralgia” which the gastroenterologist considered “a very disabling problem for this patient.” The CI had subjective complaint of right upper quadrant pain with a normal abdominal (non-tender) exam.
AF | PDBR | CY2011 | PD2011-00265
Right shoulder condition . As noted above, the Army PEB found the right shoulder condition unfitting, and the CI was separated with a disability rating of 0%. The Board does not have the authority to render fitness or rating recommendations for any conditions not considered by the DES.
AF | PDBR | CY2011 | PD2011-00268
Antalgic gait and used cane§4.71a Rating20%40%40%40%The VA C&P exam, utilized for the VA decision most proximate to separation, was done for an increase in the disability for the back on 30 May 2003, almost 16 months prior to separation. In this case, the CI first had radiculopathy noted by an orthopedist in 1980, 24 years prior to separation, following an injury at his civilian workplace. Providing a correction to the individual’s separation document showing that the individual was...
AF | PDBR | CY2011 | PD2011-00273
The PEB adjudicated the chronic radiating low back pain condition as unfitting, rated 10% with application of the US Army Physical Disability Agency (USAPDA) pain policy. Low Back Condition . In assigning probative value to these somewhat conflicting data, the dissenting Board member notes that: (1) neither the more restricted MEB nor VA measurements are consistent with corroborating evidence; (2) neither the more restricted MEB nor VA measurements are consistent with the other collateral...
AF | PDBR | CY2011 | PD2011-00274
The PEB adjudicated the chronic neck pain condition as unfitting, rated 10% with application of the US Army Physical Disability Agency (USAPDA) pain policy. The Board’s role is confined to the review of medical records and all evidence at hand to assess the fairness of PEB rating determinations, compared to VASRD standards, based on severity at the time of separation. RECOMMENDATION : The Board recommends that the CI’s prior determination be modified as follows; and, that the discharge...
AF | PDBR | CY2011 | PD2011-00275
(2) 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 ratings for unfitting conditions will be reviewed in all cases. Chronic Low Back Pain with Fusion L4 to S1 Condition . RECOMMENDATION : The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior...
AF | PDBR | CY2011 | PD2011-00277
ConditionCodeRatingConditionCodeRatingExam Chronic Pericarditis with Exercise Limiting Chest Pain Secondary to Acute Viral Myopericarditis Chronic Serous Pericarditis70020%Post-viral Cardiomyopathy w/Recurring Atrial Fibrillation7099-702010%*20050802History of Paroxysmal Atrial Fibrillation Medically ControlledNot Unfitting↓No Additional MEB/PEB Entries↓PTSD941130%**STR0% x 0/Not Service Connected x 2 Combined: 0%Combined: 40%*** *Post-viral Cardiomyopathy w/Recurring Atrial Fibrillation...
AF | PDBR | CY2011 | PD2011-00279
The CI mentioned left leg pain and left foot numbness in his contention. This review was performed 23 March 2009. All evidence considered there is not reasonable doubt in the CI’s favor supporting addition of the neurologic symptoms in left lower extremity, associated with the low back condition as an unfitting condition for separation rating.
AF | PDBR | CY2011 | PD2011-00282
She was then medically separated with a 20% disability rating. The Board evaluates VA evidence proximal 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. The FPEB, as upheld by the USAF Personnel Council, and the VA both adjudicated a 20% disability rating for chronic angioedema with urticaria, coded 7118 based on attacks with laryngeal...
AF | PDBR | CY2011 | PD2011-00284
Although this condition did worsen over time, both the MEB NARSUM and the VA C&P examinations near the time of separation support a 10% disability rating. Providing a correction to the individual’s separation document showing that the individual was separated by reason of permanent disability retirement effective the date of the original medical separation for disability with severance pay. Providing orders showing that the individual was retired with permanent disability effective the...
AF | PDBR | CY2011 | PD2011-00286
The Board next considered the rating at separation from military service. The Board considered impairments attributed to the CI’s PTSD in its overall §4.130 rating recommendation for bipolar disorder. The Board determined therefore that none of the stated conditions were subject to service disability rating.
AF | PDBR | CY2011 | PD2011-00287
The PEB combined back pain, right knee pain and left knee pain as a single unfitting condition, coded analogously to 5003 and rated 0%. It was concluded, however, that the normal ROM documented by the MEB and the minimally impaired ROMs (without painful motion) documented on the post-separation VA C&P examination would not support application of that code; and, furthermore, would not justify a compensable rating if it were applied. In the matter of the back and left knee condition, the...
AF | PDBR | CY2011 | PD2011-00288
“Chronic right wrist pain” and “limited right wrist range of motion” were forwarded to the Physical Evaluation Board (PEB) as separate medically unacceptable conditions IAW AR 40-501. Right Wrist Condition . Wrist joint ROMs were markedly limited as charted above; but, the examiner documented normal pronation and supination of the forearm.
AF | PDBR | CY2011 | PD2011-00290
Chronic low back pain was forwarded to the Informal Physical Evaluation Board (IPEB) as medically unacceptable IAW AFI 48-123. At the pre-separation MEB exam, the CI reported mild low back pain. In the matter of the contended migraine headache and left shoulder conditions, the Board unanimously agrees that it cannot recommend any finding of unfit for additional rating at separation.
AF | PDBR | CY2011 | PD2011-00291
Mental Health Condition . The Board noted the CI honorably separated in 2003 and was rated 10% by the VA for panic disorder and reenlisted one month later without disclosing his mental health condition. The Board does not have the authority under DoDI 6040.44 to render fitness or rating recommendations for any conditions not considered by the DES.
AF | PDBR | CY2011 | PD2011-00292
Bilateral Ankle Pain Condition . At the MEB narrative summary (NARSUM) evaluation obtained three months before separation, the CI reported chronic pain in both ankles, right greater than left with pain progressing from 1/10 to 5/10 with activity throughout the day. In the matter of the bilateral ankle pain condition, the Board unanimously recommends that the right and left ankle conditions each be separately adjudicated.
AF | PDBR | CY2011 | PD2011-00294
Persistent left wrist pain and degenerative changes on the wrist joint were forwarded to the Physical Evaluation Board (PEB) as two separate medically unacceptable conditions IAW AR 40-501. Additionally left wrist fusion, left wrist scar, depression, and several other non-acute conditions were noted in the VA rating decision proximal to separation, but were not documented in the DES file. Left Wrist Pain5099-500310% COMBINED10%...
AF | PDBR | CY2011 | PD2011-00295
However, Board members agreed that the rating approach by the PEB using the VASRD code for malunion of the calcaneus did not completely describe the unfitting impairments resulting from the blast injury to his right foot and lower leg. Both the MEB and VA exams noted residual arthrogenic disease resulting in ankylosis of the subtalar joint and limited ROM of the ankle, right ankle weakness, right foot sensory loss and right ankle and foot pain requiring the CI to permanently use three...
AF | PDBR | CY2011 | PD2011-00296
Six other conditions, as identified in the rating chart below, were forwarded on the MEB submission as medically acceptable conditions. An Informal PEB adjudicated the low back condition as unfitting, rated 10%, with application of the US Army Physical Disability Agency (USAPDA) pain policy. Besides the increased pain and a very minor change in the ROM, there were no other significant changes in the CI’s condition from that recorded in the MEB exam.
AF | PDBR | CY2011 | PD2011-00300
Left Knee Condition . The Board further considered if dual coding of the knee condition was justified, given that there was a history of painful motion and of instability. Other PEB Conditions .
AF | PDBR | CY2011 | PD2011-00301
CI CONTENTION : The CI states: “After 6.5 years dedicated to the Service of the Air Force (4 at USAFA and 2.5 full-time active), I was determined unfit physically due to the onset of Type 1 Diabetes Mellitus. Unfitting Condition: DM Type I Condition . Therefore, the Board determined that neither condition could be argued as unfitting at the time of separation from Service and subject to separation rating.
AF | PDBR | CY2011 | PD2011-00302
Migraine Headache Condition . The 17 May 2005 VA neurology encounter documented report of three headaches in the prior three months but with good response to abortive medication treatment. The Board does not have the authority under DoDI 6040.44 to render fitness or rating recommendations for any conditions not considered by the DES.
AF | PDBR | CY2011 | PD2011-00307
Neck and Back Pain Conditions . The examiner noted that the CI “has failed all conservative treatment measures and is not a surgical candidate and is unable to perform his military duties.” The IPEB of 9 November 2007 adjudicated the neck and upper back pain as two separate unfitting conditions; cervical strain, VA code 5237, at 10% disability and thoracic strain, VA code 5237, also at 10% disability for a combined 20% disability rating. RECOMMENDATION : The Board, therefore, recommends...
AF | PDBR | CY2011 | PD2011-00308
The Board also acknowledges the CI's contention suggesting that service ratings should have been conferred for other conditions documented at the time of separation and for conditions not diagnosed while in the service (but later determined to be service connected by the DVA). The VA based its 10% rating decision on likely application of §4.40 (pain with use) or §4.59 (painful motion), since ROM assessments by the C&P examiner were normal. The Board thus has no basis for recommending any...
AF | PDBR | CY2011 | PD2011-00309
The examiner did not, however, describe activity restrictions, and specifically stated, “His current fitness regimen consists of full participation in unit PT, doing calisthenics and running two miles three-times/week.” In addition, the commander’s statement related the CI was “a highly motivated top performer who has shown no ill effects from his medical condition and treatment,” and further stated “he is fully capable of performing all of his assigned duties, deploy and participate in...
AF | PDBR | CY2011 | PD2011-00310
The severity of the condition prior to the MEB is not a consideration in the rating, which is based on the evidence of examinations at the time of evaluation in the DES. While deployed in August 2002 he experienced acute low back pain radiating to the left leg while lifting boxes, and was hospitalization in Kuwait for 11 days for diagnosis and treatment. RECOMMENDATION : The Board therefore recommends that there be no recharacterization of the CI’s disability and separation determination.
AF | PDBR | CY2011 | PD2011-00311
The examiner stated, “he is employable from a psychiatric standpoint and will do best in settings in which he has little or no contact with the public and very loose supervision secondary to his posttraumatic stress disorder symptoms.” The examiner applied the §4.130 30% language, stating the CI’s psychiatric symptoms caused “occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks….” The VA rated the CI’s PTSD at 30%, citing this exam and...
AF | PDBR | CY2011 | PD2011-00313
The CI’s bilateral knee pain began in November 1995; and, the back pain and OSA conditions surfaced as clinical issues during the MEB process. The PEB adjudicated the bilateral knee pain and low back pain as one unfitting condition, rated 10% referencing the US Army Physical Disability Agency (USAPDA) pain policy; and, OSA as unfitting, rated 0% citing criteria from Department of Defense Instruction (DoDI) 1332.39. The Board first considered whether the lumbar condition remains separately...
AF | PDBR | CY2011 | PD2011-00314
However, IAW VASRD §4.40, §4.45, and §4.59; a 10% rating is warranted when there is satisfactory evidence of functional limitation due to painful motion of a major joint. OSA and obesity were adjudicated by the PEB as not unfitting. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2011 | PD2011-00315
Headache Condition . Review of service treatment records reflected CI pain report of mild (two) to moderate (four) including encounters in the afternoon. Because neck pain was related to the unfitting headache condition and the PEB applied a cervical spine code in its rating, the Board considered whether the cervical spine condition associated with the tension headaches was a separately unfitting and ratable condition when de-coupled from the unfitting headache.
AF | PDBR | CY2011 | PD2011-00316
CI CONTENTION : The CI states: “The PEB gave me 0% for lumbar radiculitis and degenerative disease. The neurosurgeon completing the NARSUM evaluation did not provide measured ROMs, although he commented, “low back range of motion is not particularly compromised.” He noted a “mild limp favoring the right lower extremity” (not directly linked to spine by exam; therefore not ratable IAW §4.71a), normal response to straight leg raise, and normal reflexes. The Board does not have the authority...
AF | PDBR | CY2011 | PD2011-00319
He was placed on limited duty (LIMDU) and underwent a Medical Evaluation Board (MEB). Right Shoulder. Other Conditions.
AF | PDBR | CY2011 | PD2011-00326
Reactive Arthritis Condition . The Board agreed that the PEB’s coding approach was appropriate, and considered the severity of the CI’s condition based on the evidence at hand. In the matter of the hypertension, headaches and chest 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 | CY2011 | PD2011-00328
Post-separation evidence therefore is probative only to the extent that it reasonably reflects the disability and fitness implications at the time of separation. RECOMMENDATION : The Board therefore recommends that there be no recharacterization of the CI’s disability and separation determination. Chronic Back Pain associated with L4-5 Disc Disease524310% COMBINED10% ______________________________________________________________________________
AF | PDBR | CY2011 | PD2011-00330
After more than three years on TDRL and a third hospitalization (December 2006), the PEB adjudicated a permanent disability rating for the PTSD condition of 10% with application of the Veterans Administration Schedule for Rating Disabilities (VASRD). PTSD Condition . The Board therefore has no reasonable basis for recommending any additional unfitting conditions for separation rating.
AF | PDBR | CY2011 | PD2011-00333
There is no record of any further treatment of the hernia condition during the TDRL period, and the TDRL examiner did not note hernias as a presently active condition. No other conditions were service connected with a compensable rating by the VA within 12 months of separation or contended by the CI. After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your...