AF | PDBR | CY2011 | PD2011-00517
He was working in his rating, and his commander recommended retention; however, the CI underwent a Medical Evaluation Board (MEB). The CI’s application asserts that compensable ratings should be considered for broken nose and surgery, broken left hand (status post flexion contracture release of the left fifth digit) with arthritis and constant pain, back condition, left knee condition, right foot condition, right and left achilles condition, and right hip condition. Exhibit C. Department...
AF | PDBR | CY2011 | PD2011-00518
Instability was not noted and ROM was slightly reduced. The IPEB rated the shoulder condition 10% VASRD code 5024, tendinitis, citing a reduced, but not compensable, ROM with pain on the examination performed on 15 April 2008. After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the any of the multiple stress fracture lower extremity condition and,...
AF | PDBR | CY2011 | PD2011-00519
The PEB adjudicated “Crohn’s disease” as unfitting, rating it 10% with application of the Veterans Administration Schedule for Rating Disabilities (VASRD). Crohn’s Disease Condition . 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.
AF | PDBR | CY2011 | PD2011-00521
At his March 2008 MEB evaluation, four months prior to separation, the CI complained of low back pain, worse with prolonged sitting. The PEB and the VA had used different codes for the low back pain condition, but both had assigned a disability rating of 20%. In the matter of the low back pain condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.
AF | PDBR | CY2011 | PD2011-00522
As noted above, the PEB found him unfit for military duty, and he was medically separated with 10% disability. All evidence considered, the Board unanimously recommends no change to the PEB’s adjudication of the scoliosis condition. The Board, therefore, has no reasonable basis for recommending any additional unfitting conditions for separation rating.
AF | PDBR | CY2011 | PD2011-00524
ROM measurements from two different MEB PT evaluations are charted above; and, it is immediately apparent that the PT evaluation at six months prior to separation (three weeks prior to the MEB physician exam) is sharply disparate with the other goniometric evidence. The Board determined therefore that none of the stated conditions were subject to service disability rating. RECOMMENDATION : The Board, therefore, recommends that there be no recharacterization of the CI’s disability and...
AF | PDBR | CY2011 | PD2011-00526
Left Wrist Condition . No other conditions were service connected with a compensable rating by the VA within 12 months of separation or contended by the CI. In the matter of the contended hypertension condition, the Board unanimously agrees that it cannot recommend a finding of unfit for additional rating at separation.
AF | PDBR | CY2011 | PD2011-00529
ConditionCodeRatingConditionCodeRatingExam Chronic Ankle Pain …872120%Residuals Right Ankle Fracture5271-527210%20050913↓No Additional MEB/PEB Entries↓Adjustment Disorder …9434-944010%20050927Not Service Connected x 320050913 Combined: 20%Combined: 20% ANALYSIS SUMMARY : The Board acknowledges the CI’s contention that suggests a Service rating should be considered for the mental health disability attendant to his unfitting ankle condition. Right Ankle Condition . I have carefully reviewed...
AF | PDBR | CY2011 | PD2011-00530
The PEB adjudicated the chronic right shoulder pain following a labral tear, S/P repair as unfitting, rated 10%, with application of the US Army Physical Disability Agency (USAPDA) pain policy. Flexion (0-180⁰)130⁰180⁰ -10 0 *Abduction (0-180⁰)No Abduction ROM noted180⁰ -10 0 *CommentsPain with overhead use; Left shoulder same ROM (see text)Painful motion; pain and discomfort with subjective weakness over shoulder level (90⁰); see text§4.71a Rating10%10%At the MEB exam, the CI reported...
AF | PDBR | CY2011 | PD2011-00534
PHYSICAL DISABILITY BOARD OF REVIEW The VA 20% rating decision was based on the additional 20 degrees loss of ROM reported by the C&P examiner 6 months after separation. Physical Disability Board of Review
AF | PDBR | CY2011 | PD2011-00536
The conditions, exercise induced asthma and OSA requiring C-PAP as requested for consideration, meet the criteria prescribed in DoDI 6040.44 for Board purview; and, are addressed below, in addition to a review of the ratings for the unfitting conditions. In the matter of the exercise induced asthma with OSA requiring CPAP conditions, the Board unanimously recommends a TDRL and permanent service disability rating of 50%, coded 6602-6847 IAW VASRD §4.96 and §4.97. RECOMMENDATION : The Board...
AF | PDBR | CY2011 | PD2011-00537
SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SPC/E-4 (25L/Cable Systems Installer), medically separated for chronic nausea and vomiting of unknown etiology, with normal nutritional state. The PEB awarded 0% disability for the chronic nausea and vomiting condition and determined the GERD condition to be not unfitting. It notes the normal laboratory findings, other than the evidence for mononucleosis, and...
AF | PDBR | CY2011 | PD2011-00542
The PEB adjudicated the left knee condition as unfitting, rated 20%, with application of the US Army Physical Disability Agency (USAPDA) pain policy. PTSD was not included in my Army rating but rated at 30% from the VA and I was placed on anti-depressants upon returning from the combat theatre.” He elaborates no specific contentions regarding rating or coding and mentions no additionally contended conditions. The VA originally conferred two identical ratings for the left knee under code...
AF | PDBR | CY2011 | PD2011-00543
The VA looked at the rating criteria from the time of separation in 2003 and noted his condition more nearly approximated that of severe (rather than moderate) limitation of motion of the low back for the entire period of the appeal, from the initial rating in 2003 through 2007. Both the NARSUM and VA C&P exams documented pain on flexion and tenderness of the spine which could be interpreted as “with characteristic pain on motion” and probable moderate degree of pain. The VASRD in place at...
AF | PDBR | CY2011 | PD2011-00544
He was diagnosed with retropatellar pain syndrome (RPS); and, did not improve adequately with conservative measures to meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards. The VA examiner specifically stated “there is no pain at limitations of motion of either knee.” 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 left knee...
AF | PDBR | CY2011 | PD2011-00546
SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (2844, Systems Repair Specialist), medically separated for left shoulder condition. Service Treatment Record Exhibit C. Department of Veterans’ Affairs Treatment Record
AF | PDBR | CY2011 | PD2011-00547
ConditionCodeRatingConditionCodeRatingExam Chronic Thoracic Back Pain523710%Thoracic, Lumbar and Left Sacroiliac Joint Strain523710%20081106↓No Additional MEB/PEB Entries↓Cervical Strain523710%20081106Major Depression943440%20081027Tinnitus626010%20081027Residuals of Traumatic Brain Injury/Chronic Headaches804510%200810300% x 1/Not Service-Connected x 320081106 Combined: 10%Combined: 60% ANALYSIS SUMMARY : In opening, the Board wishes to clarify that the scope of its review as defined in...
AF | PDBR | CY2011 | PD2011-00548
Right Foot/Ankle Condition . The Board therefore has no reasonable basis for recommending any additional unfitting conditions for service 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.
AF | PDBR | CY2011 | PD2011-00550
The PEB adjudicated the right shoulder condition as unfitting, rated 20%, citing criteria of the Veterans Administration Schedule for Rating Disabilities (VASRD). The Board utilizes DVA evidence proximal to separation in arriving at its recommendations; but, Board’s authority as defined in DoDI 6044.40, however, resides in evaluating the fairness of DES fitness determinations and rating decisions for disability at the time of separation. Right Shoulder Condition .
AF | PDBR | CY2011 | PD2011-00551
In 1999, the CI was referred for MEB due to chronic back pain, and he experienced increased symptoms of depression due to worry about his ability to remain in the U.S. and care for his family since he was not yet a U.S. citizen. VA C&P examinations therefore would be expected to be performed in a manner that would report examination findings consistent with the rating guidelines, in this case a lumbar range of motion rather than the combined thoracolumbar ROM that is measured and used under...
AF | PDBR | CY2011 | PD2011-00555
The PEB adjudicated the neck and low back conditions as unfitting, each rated 10% with application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD) and the US Army Physical Disability Agency (USAPDA) pain policy. (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...
AF | PDBR | CY2011 | PD2011-00556
Six other conditions, as identified in the rating chart below, were forwarded on the Medical Evaluation Board (MEB) submission as medically acceptable conditions. The PEB adjudicated the bilateral SNHL as unfitting, rated 0% with application of the Veterans Administration Schedule for Rating Disabilities (VASRD). The service ratings for unfitting conditions will be reviewed in all cases.
AF | PDBR | CY2011 | PD2011-00557
The PEB adjudicated the cervical spine and OSA conditions as unfitting; assigning a disability rating of 10% to the cervical condition citing criteria of the Veterans Administration Schedule for Rating Disabilities (VASRD); and, 0% to the OSA condition referencing Department of Defense Instruction (DoDI) 1332.39. Other PEB Conditions . The other conditions forwarded by the MEB and adjudicated as not unfitting by the PEB were lumbar spondylosis (pain dating to same fall as for the cervical...
AF | PDBR | CY2011 | PD2011-00558
Both the PEB and VA coded the condition as 5284 foot injuries, other, but the PEB rated the condition 10% and the VA rated the condition 0%. Left Ankle Condition. The Board acknowledges the CI’s assertion that his left ankle condition is related to his unfitting comminuted fracture, left first digit condition and therefore should be subject to additional disability rating.
AF | PDBR | CY2011 | PD2011-00559
PHYSICAL DISABILITY BOARD OF REVIEW In the matter of the lumbar spine condition, the Board unanimously recommends a service disability rating of 20%, coded 5243 IAW VASRD §4.71a. Physical Disability Board of Review
AF | PDBR | CY2011 | PD2011-00560
The Board concluded that the evidence of the record did not support rating using the code for pulmonary vascular disease as there were no duty limiting respiratory symptoms and no evidence of chronic or recurrent pulmonary embolism. 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. RECOMMENDATION : The Board recommends that the CI’s prior determination be modified as follows, effective as of...
AF | PDBR | CY2011 | PD2011-00561
The Physical Evaluation Board (PEB) (PEB) adjudicated chronic anti-coagulation secondary to recurrent pulmonary embolism as unfitting (service incurred and/or aggravated), rated 0%, with application of the Department of Defense Instruction (DoDI) 1332.39 and guidance from the US Army Physical Disability Agency (USAPDA). These are accordingly addressed below in addition to a review of the service rating for the unfitting chronic anti-coagulation secondary to recurrent pulmonary embolism...
AF | PDBR | CY2011 | PD2011-00562
Both exams most proximate to separation would rate 20% IAW the General Rating Formula. 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. Service Treatment Record Exhibit C. Department of Veterans Affairs Treatment Record SFMR-RB MEMORANDUM FOR Commander, US Army Physical Disability Agency Crystal Drive, Suite 300, Arlington, VA 22202 SUBJECT: Department of Defense Physical Disability Board of...
AF | PDBR | CY2011 | PD2011-00563
The examiner stated, “The severity of the patient's condition appears to have been underestimated due to his working in the mental health field and his close proximity to mental health care providers.” In addition to “moderate” bipolar I disorder, the examiner diagnosed ADHD and “anxiety disorder NOS (manifested by combat stress related symptoms not meeting criteria for PTSD and which have gradually improving since his return from combat).” The examiner noted the CI’s psychiatric symptoms...
AF | PDBR | CY2011 | PD2011-00565
Please re-evaluate my Medical Evaluation Board from the Army and my medical records from my extensive period of active duty service (11 years, 5 months total) as well as VA medical records.” Bilateral Foot Pain Condition . The Board thus recommends separate 10% ratings for each foot under the code 5399-5310.
AF | PDBR | CY2011 | PD2011-00566
He was placed on limited duty (LIMDU) and underwent a Medical Evaluation Board (MEB). Left Ankle Condition . Ankle motion was mildly limited, and painful.
AF | PDBR | CY2011 | PD2011-00569
The PEB adjudicated the bilateral exophthalmos condition as unfitting, rated 20% with application of the Veterans Administration Schedule for Rating Disabilities (VASRD). The Board evaluates DVA 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. Bilateral Eye Condition .
AF | PDBR | CY2011 | PD2011-00572
The Board evaluates DVA evidence in arriving at its recommendations, but its authority resides in evaluating the fairness of DES fitness and rating determinations at the time of separation. Post‐Separation) – All Effective 20090807 Condition Lumbar Degenerative Changes Radiculopathy, Left Leg Left Shoulder Strain Combined: 30% Code 5242 8520 5299‐5203 Rating 10% 10% 10% Exam 20091215 20091215 20091215 for the degree of severity present at separation. RECOMMENDATION: The Board, therefore,...
AF | PDBR | CY2011 | PD2011-00573
The severity of the ADHD symptoms was assessed as “moderate” and the DoDI 1332.39 defined level of social/industrial impairment was entered as “definite.” The VA rating psychiatrist proximal to TDRL placement formally concurred with the MEB psychiatric opinion, listing ADHD as a separate axis I diagnosis; although, not providing a separate assessment of severity as did the MEB examiner. The TDRL examination prior to separation, documented that the CI’s “psychiatric illness has continued...
AF | PDBR | CY2011 | PD2011-00576
CI CONTENTION : “Veteran condition of low back pain due to lumbar degenerative disc disease was more severe than range of motion result indicated. Low Back 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 | PD2011-00577
The PEB found the left ankle pain unfitting, and rated it 10% IAW the U.S. Army Physical Disability Agency (USAPDA) pain policy. Chronic Left Ankle Pain . Other PEB Conditions .
AF | PDBR | CY2011 | PD2011-00580
The CI was then medically separated with a 0% combined disability rating. His physical activity should be limited as tolerated.” The 10 August 2001 PEB found the CI fit for duty. The examiner agreed with the original NARSUM diagnoses and stated, “my recommendation stands along with [the first NARSUM examiner] that the patient is not fit for mobility or world wide duty and should perform physical activity as tolerated.” On 6 November 2001, the FPEB found the CI unfit under VASRD Code 5295...
AF | PDBR | CY2011 | PD2011-00584
The core DES file consists of the MEB referral document (DA Form 3947), the PEB adjudication document (DA Form 199), the narrative summary (NARSUM) (including any addendums or referenced examinations), the MEB physical exam, the commander’s statement, the physical profile(s), and any written appeals or internal DES correspondence. Right Fibula Stress Fracture Delayed Union and Pain (Right Lower Leg/Ankle) Condition . The Board also considered if the entirety of the record including the...
AF | PDBR | CY2011 | PD2011-00589
Chronic heel spur syndrome and plantar fasciitis were forwarded to the Physical Evaluation Board (PEB) as medically unacceptable IAW SECNAVINST 1850.4E. ConditionCodeRatingConditionCodeRatingExam Plantar Fasciitis5399-531010%Plantar Fasciitis/ Heel Spurs, Left Foot5299-528410%20030922Chronic Heel Spur SyndromeCAT IIPlantar Fasciitis/ Heel Spurs, Right Foot5299-528410%20030922↓No Additional MEB/PEB Entries↓Obstructive Sleep Apnea684750%20030922Migraine...
AF | PDBR | CY2011 | PD2011-00591
The MEB forwarded no other conditions for Physical Evaluation Board (PEB) adjudication. The CI was medically separated with a 20% disability rating. On examination, the surgeon documented normal gait, strength, reflexes and sensation and concluded the back pain was “mechanical pain to testing.” He noted the MRI findings with multilevel spondylitic disease (degenerative disc and joint) and thought that some of the pain was discogenic in nature, and possibly an annular tear at L5-S1.
AF | PDBR | CY2011 | PD2011-00593
When I was injured, I tried to work and perform as I always had but was unable due to the pain in both knees from my injury. Accordingly, the Board recommends a separate service disability rating for each knee. In the matter of the bilateral knee pain, the Board unanimously recommends that each joint be separately adjudicated as follows: an unfitting right knee condition coded 5259-5010 and rated 10%, and an unfitting left knee condition coded 5259-5010 and rated 10%, IAW VASRD §4.40,...
AF | PDBR | CY2011 | PD2011-00596
The PEB adjudicated the mild cognitive dysfunction condition as unfitting, rated 10%; with application of the Veterans Administration Schedule for Rating Disabilities (VASRD). A general C&P exam 10 months prior to separation, stated that in addition to his daily headaches and dizziness, the CI had experienced ten episodes of syncope over the past year, had not been able to work since the head injury, and had “significant functional impairment as he cannot concentrate,” although he was...
AF | PDBR | CY2011 | PD2011-00599
PHYSICAL DISABILITY BOARD OF REVIEW The Board’s authority as defined in DoDI 6044.40, however, resides in evaluating the fairness of DES fitness determinations and rating decisions for disability at the time of separation. The PEB adjudicated the foot condition as chronic foot pain secondary to stress fractures and plantar fasciitis under code 5279 metatarsalgia at 10 % disability rating, the only rating under this code.
AF | PDBR | CY2011 | PD2011-00600
The Board further acknowledges the CI’s contention for service ratings for other conditions documented at the time of separation, and notes that its recommendations in that regard must comply with the same governance. The Board determined therefore that none of the stated conditions were subject to service disability rating. The Board therefore has no reasonable basis for recommending any additional unfitting conditions for service disability rating.
AF | PDBR | CY2011 | PD2011-00601
The PEB adjudicated the chronic anterior abdominal pain condition as unfitting, rated 10% with application of the USAPDA pain policy. Remote from separation, based on exam of July 2008, the VA rated the CI at 10% for painful abdominal scar as a residual of the hernia surgery. 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.
AF | PDBR | CY2011 | PD2011-00602
The PEB adjudicated the condition as vasodepressor syncope associated with seizure activity, and found the condition unfitting, rated 10%, IAW the Veterans Administration Schedule for Rating Disabilities (VASRD). The Board concurs with the PEB decision to code the CI’s syncope condition as analogous to code 8210, paralysis of the tenth (vagus) cranial nerve, since several of the CI’s syncopal and presyncopal episodes had no associated seizure activity, and neurological evaluation and...
AF | PDBR | CY2011 | PD2011-00604
He was then medically separated with that disability rating. 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 | PD2011-00605
He has back pain 90% of the time, averaging a 4/10, but flare-ups occur twice monthly and last 4 to 5 days at an 8/10 pain. Although the NARSUM raised the question of a motor weakness, this was more likely an artifact of pain and guarding; since all formal strength testing in evidence was normal. 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.
AF | PDBR | CY2011 | PD2011-00609
The PEB adjudicated the chronic right knee pain condition as unfitting, rated 10% with specified application of the US Army Physical Disability Agency (USAPDA) pain policy. He was then medically separated with a 10% disability rating. Right Knee Condition .
AF | PDBR | CY2011 | PD2011-00611
The VA C&P examination completed on the same day as the mental health C&P noted the CI was very reluctant to answer questions. The Board agreed that the symptoms reported on the MEB examination were consistent with a §4.130 rating of 70% (occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood) considering the CI’s poor interpersonal functioning and strong history of suicidal ideation. The VA examiner noted a...