AF | PDBR | CY2012 | PD2012 01572
The examiner further opined that the CI had severe military and civilian impairment and that without therapy or medication, the probability for his continued mental deterioration was “extremely high” and that even with ongoing treatment theprognosis was “still guarded.” He also stated the CI’s mental illness was severe, chronic, and unfitting and he highly recommended the CI initiate psychotherapy and medication at the VA.The C&P examination approximately 4 monthsafter permanent separation...
AF | PDBR | CY2012 | PD2012 01576
IAW the Veterans Affairs Schedule for Rating Disabilities (VASRD), a 40% rating would require “Daily fatigue, malaise, and anorexia, with minor weight loss and hepatomegaly” or “incapacitating episodes having a total duration of at least four weeks, but less than six weeks, during the past 12 month period.” Since the treatment record did not show sufficient evidence of these findings, the Board has no basis to recommend a rating higher than 30%, at the time of initial placement on TDRL.On 7...
AF | PDBR | CY2012 | PD2012 01577
SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active dutySpecialist/E-4 (44E10/Machinist),medically separated for benign idiopathic tremor (essential tremor), rated as mild, involving only the hands.The CI complained of aninsidious onset of a bilateral hand tremor which interfered with his ability to do work-related tasks beginning in June of 2001. Physical Disability Board of Review SUBJECT: Department of Defense...
AF | PDBR | CY2012 | PD2012 01578
The Physical Evaluation Board (PEB) adjudicated the FM, urinary incontinence and chronic abdominal pain conditions as unfitting, bundled into one rating of 10%with application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD).The remaining conditionwas determined to be not disqualifying.The CI made no appeals, and was medically separated with a 10% disability rating. The diagnoses of FM, urinary incontinence and chronic abdominal pain with diarrhea were forwarded to the PEB....
AF | PDBR | CY2012 | PD2012 01579
His fracture healed but he had pain in his left femur and his left hip at the bone graft site. **Limited extension.The Board directs attention to its rating recommendationbased on the above evidence.The PEB rated the chronic pain left femur fracture condition at 10% using an analogous 5003 code (degenerative arthritis) based on the USAPDA pain policy.The VA separately rated the left lower extremity for twoinjuries: 5262 (impairment of tibia and fibula) and 5257 (knee, other impairment of)...
AF | PDBR | CY2012 | PD2012 01581
The left leg, lower backand right wristconditions, characterized as “ fibrous dysplasia of the left proximal tibia, Status Post (S/P) excision and biopsy of the tumor mass,” “ back pain, pain is mild to moderate intensity,increased with activities, and occasional frequency” and “ right wrist pain, possible carpal tunnel syndrome” were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.The PEB adjudicated “ chronic pain to include...
AF | PDBR | CY2012 | PD2012 01583
ThePEB adjudicated “chronic pain, low back and left leg due to L4-5 herniated nucleus pulposus”as unfitting, rated 10%, with likely application of the US Army Physical Disability Agency (USAPDA) pain policy, noting that this decision was based on all three MEB conditions . The Board directs attention to its rating recommendation based on the above evidence.Both the PEB and the VA rated the condition using the 5293 code (intervertebral disc syndrome). Physical Disability Board of Review
AF | PDBR | CY2012 | PD2012 01592
The CI was medically separated with a 10% disability rating. RECOMMENDATION : The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination, as follows: UNFITTING CONDITION VASRD CODE RATINGTDRLPERMANENT Completed Stress Fracture Right Femoral Neck Condition525530%10% COMBINED30%10% The following documentary evidence was considered: Physical Disability Board of Review
AF | PDBR | CY2012 | PD2012 01594
RECORD OF PROCEEDINGSPHYSICAL DISABILITY BOARD OF REVIEWNAME: CASE: PD1201594BRANCH OF SERVICE: Army BOARD DATE: 20130418 Physical Disability Board of Review SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130010178 (PD201201594)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.
AF | PDBR | CY2012 | PD2012 01598
Lumbago and positive TB skin test conditions, identified in the rating chart below, were also identified and forwarded by the MEB as meeting retention standards.The PEB adjudicated the bilateral plantar fasciitis condition as unfitting, rated 10% for the right foot and 10% for the left foot for a combined rating of 20%, with application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD).The remaining conditions were determined to be not unfitting.The CI made no appeals, and...
AF | PDBR | CY2012 | PD2012 01599
Left Knee Condition . Therefore the Board conclude there not sufficient evidence for consideration of a rating under diagnostic code 5257 (other impairment, instability). SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130018487 (PD201201599)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.
AF | PDBR | CY2012 | PD2012 01600
The PEB assigned a 10% rating for the conversion disorder, factitious disorder condition coded 9434; and listed pseudoseizures and malingering as related conditions.The VA assigned a 100% rating for partial onset seizures under an analogous 8910 code (epilepsy, grand mal); and a 10% rating for adjustment disorder with anxiety citing treatment for an adjustment disorder in 2001.The C&P examiner and VA neurology consultant both expressed uncertainty about the neurologic vs. psychiatric...
AF | PDBR | CY2012 | PD2012 01602
(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. Hearing Loss (bilateral) . The VASRD rates speech discrimination measured by the Maryland CNC which is not directly comparable with the more contemporary SPRINT speech discrimination...
AF | PDBR | CY2012 | PD2012 01603
RECORD OF PROCEEDINGSPHYSICAL DISABILITY BOARD OF REVIEWNAME: XXXXXXXXXXXXXXXXXXXX CASE: PD1201603BRANCH OF SERVICE: AIR FORCEBOARD DATE: 20131016 Contended PEB Conditions .The Board’s main charge is to assess the fairness of the PEB’s determination that contended back pain,cold induced urticaria and hypertension conditions were not unfitting. In the matter of the contended back pain, cold induced uticariaand hypertension conditions the Board unanimously recommends no change from the PEB...
AF | PDBR | CY2012 | PD2012 01605
Post-SepFlexion (90⁰ Normal)90⁰50⁰20⁰Combined (240⁰)215⁰145⁰Extension 10⁰CommentsAntalgic gait.Antalgic gait.Antalgic gait.§4.71a Rating20%20%40%The Board directs attention to its rating recommendationbased on the above evidence.The PEB’s DA Form 199 referenced the ROM values charted above (from physical therapy) which would achieve only a 10% rating; but, noted the presence of an abnormal gait on a “recent exam” (presumably an STR entry, not the NARSUM), which was the basis for the PEB’s...
AF | PDBR | CY2012 | PD2012 01606
The Physical Evaluation Board (PEB) adjudicated the chronic LBP condition as unfitting, rated 10% with application of Veteran’s Affairs Schedule for Rating Disabilities (VASRD).The remaining conditions were determined to be not unfitting.The CI made no appeals, and was medically separated. ROM measurements are reflected in the table; rotation was not performed, and the examiner stated that normal extension was 15 degrees and lateral flexion was 25 degrees.The examiner diagnosed lumbar spine...
AF | PDBR | CY2012 | PD2012 01615
Therefore, the Board cannot support a recommendation for additional rating based on peripheral nerve impairment.After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 20% for the LBP condition coded as 5299-5295. Physical Disability Board of Review 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...
AF | PDBR | CY2012 | PD2012 01618
The PEBadjudicated anxiety disorderas unfitting rated 10%, citing criteria of the Veterans Affairs Schedule for Rating Disabilities (VASRD).There was also an entry on the PEB’s DA Form 199 stating, “condition is complicated by Axis II personality disorder which cannot beincluded in this evaluation for disability rating purposes per DoDI 1332.38.” The CI made no appeals, and was medically separated with a 10% disability rating. Regarding occupational functioning, the examiner noted “his...
AF | PDBR | CY2012 | PD2012 01620
The PEB adjudicated bilateral RPS as unfitting, rated 0%,citing criteria of the Veterans Affairs Schedule for Rating Disabilities (VASRD).The CI made no appeals, and was medically separated. Until the narrative summary (NARSUM), there are no Service or civilian entries documenting left knee or bilateral knee pain. In the matter of the Service-combined bilateral knee condition, the Board unanimously recommends a rating of 10% for an unfitting right knee condition coded 5024 IAW VASRD...
AF | PDBR | CY2012 | PD2012 01622
It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI. The rating for the unfitting back, neck and bilateral foot pain conditions are addressed below;no additional conditions are within the DoDI 6040.44 defined purview of the Board. In the matter of the bilateral foot pain condition and IAW VASRD §4.71a, the Board unanimously...
AF | PDBR | CY2012 | PD2012 01628
He was issued a permanent U3 profile andreferred for a Medical Evaluation Board (MEB).The MEB forwarded no other conditions for Physical Evaluation Board (PEB) adjudication.The PEB adjudicated the left shoulder and left cubital tunnel conditions as unfitting, rated 10% and 10%, with application of the US Army Physical Disability Agency (USAPDA) pain policy.The CI made no appeals and was medically separated with a combined 20% disability rating. The ROM was noted as painful. The examiner...
AF | PDBR | CY2012 | PD2012 01630
He was issued a permanent U3/L3 profile andreferred for a Medical Evaluation Board (MEB).The MEB forwarded “bilateral tibial pain without stress fracture”, “bilateral anterior knee pain” and “low back pain without radiculopathy” for PEB adjudication IAW AR 40-501.No other conditions were submitted. The PEB adjudicated the bilateral tibia/knee pain as a single unfitting condition, rated 10%, referencing the US Army Physical Disability Agency (USAPDA) pain policy;and adjudicated the low back...
AF | PDBR | CY2012 | PD2012 01632
CI CONTENTION : “Upon separation they rated me for a shoulder condition, but told me that the V.A. Right Shoulder ROM MEB ~ 4 mos . RECOMMENDATION : The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:
AF | PDBR | CY2012 | PD2012 01636
” The exam was otherwise silent regarding lumbar spine ROM, tenderness or spasm.X-rays of the lumbar spine were reportedly normal except for the L4-5 disc fusion.The Board directs attention to its rating recommendation based on the above evidence.The PEB and VA applied the same analogous 5295 code (lumbosacral strain), but assigned different ratings for the condition at the time of placement on the TDRL. The PEB elected to use the old spine standards for the permanent adjudication, but IAW...
AF | PDBR | CY2012 | PD2012 01638
The Informal PEB adjudicated chronic right hip painas unfitting, rated 10%, with likely application of the US Army Physical Disability Agency (USAPDA) pain policy.The remaining conditions were determined to be not unfitting.The CI made no appeals, and was medically separatedwith a10%disability rating. 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...
AF | PDBR | CY2012 | PD2012 01640
The CI continued to complain of neck pain and could not perform the full range of activities required by her MOS so she was referred to the MEB.The commander’s letter, 22April 2002, stated that the CI was unable to perform her duties as a supply specialist due to neck and low back pain including wear of the Kevlar helmet.The Board considered whether the cervical spine pain condition,when considered alone separate from the lumbar spine pain syndrome, was unfitting for continued military...
AF | PDBR | CY2012 | PD2012 01643
The next record in evidence is from 23 October 2006 when he was seen for persistent right shoulder blade/back pain despite duty limitations, medications and a sling. The VA also coded the back pain as 5237 and rated it at 10%. In addition, a VA C&P examination 18 months after separation showed no muscle atrophy.
AF | PDBR | CY2012 | PD2012 01644
The Physical Evaluation Board (PEB) adjudicated the recurrent DVT hypercoagulation syndrome, necessitating life-long anticoagulant therapycondition as an impairment that was EPTS, but subsequently PSA, unfitting, rated 0%, with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).The PEB also determined the CI’s deafness to be not unfitting and not ratable.The CI made no appeals, and although he was eligible for transfer to the retired reserve he elected to be...
AF | PDBR | CY2012 | PD2012 01645
Persistent Anterior Knee Pain Condition .The CI originally had a sport-related injury to his right knee in September 2001.A torn anterior cruciate ligament (ACL) was addressed arthroscopically in November 2001,followed by rehabilitative treatment.The CI re-injured his right knee (buckled and popped) while stepping from an aircraft in January 2002, and required a right ACLallograft reconstruction in March 2002.He did well post-operatively with progressive physical therapy (PT) until another...
AF | PDBR | CY2012 | PD2012 01647
invalid font number 31502 Service FPEB – Dated 20030917VA (# Mo. The PEB used these rules to rate the chronic LBP condition, coded 5295 lumbosacral strain, and initially rated at 10% (with characteristic pain on motion). The Board notes that although they did not change the VASRD code, verbiage contained on the FPEB’s findings and recommendations document suggeststhe FPEB may have utilized VASRD code 5293, intervertebral disc syndrome (also in effect at the time of separation) to arrive at...
AF | PDBR | CY2012 | PD2012 01649
invalid font number 31502 invalid font number 31502 The Board directs attention to its rating recommendationbased on the above evidence.For a rating recommendation IAW DoDI 6040.44, the Board must apply the 2002 VASRD coding and rating standards for the spine. BOARD FINDINGS : 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 chronic mid and upper back pain condition and IAW VASRD §4.71a, the...
AF | PDBR | CY2012 | PD2012 01650
The CI experienced idiopathic low back pain (LBP) in 2000. The low back condition, characterized as “status post (S/P) right L4/S1 microdiscectomy” was forwarded to the Physical Evaluation Board (PEB).No other conditions were submitted by the MEB.The PEB adjudicated “status post right L4/S1 microdiscectomy” as unfitting, rated 20%with likely application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD).The CI made no appeals, and was medically separatedwith 20% disability...
AF | PDBR | CY2012 | PD2012 01655
The CI was then medically separated. In reference to medications, the examiner simply stated “Now for asthma, she uses inhalers.” The VA PFT evidence cited an FEV1 of 103% predicted, and did not document an FVC. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2012 | PD2012 01656
The back condition characterized as “ multi-level DDD from L3-S1 with left lower extremity radiculopathy at the L5-S1 nerve root” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.The PEB adjudicated the chronic back pain with a history of pain starting after lifting canisters while stationed in Afghanistanas unfitting, rated 10%. The Board considered whether additional Service rating could be recommended under a peripheral...
AF | PDBR | CY2012 | PD2012 01658
Left testalgia associated and varicocele, status post (s/p)varicocele ligation was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E.No other conditions were submitted by the MEB.The Informal PEB (IPEB)adjudicated left testalgia associated as unfitting rated 10% withapplication of theVeteran’s Affairs Schedule for Rating Disabilities (VASRD).The remaining condition, varicocele, s/p varicocele ligation was adjudicated to by a Category II condition, a condition that...
AF | PDBR | CY2012 | PD2012 01659
He continued to report snapping and popping of shoulder, and loss of strength in left hand, but no pain or numbness below the elbow, and stated he could not use his left hand at all due to pain and weakness.On examination, gait was normal; flexion was recorded at 170 degrees, abduction of 180. The Board noted this to be inconsistent with the service treatment records (STRs) which recorded no limitation of motion.After discussion, the Board agreed the probative value of the NARSUM was...
AF | PDBR | CY2012 | PD2012 01663
Her condition was determined to be stable and heart function was within normal limits. There was no cardiac hypertrophy by direct measurement on the last echocardiogram prior to separation and the ejection fraction was within normal limits. SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130010959 (PD201201663)I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings...
AF | PDBR | CY2012 | PD2012 01664
The conditions characterized as MEB diagnoses 1)“irritable bowel syndrome”, 2)“stress fracture left tibia and fibular stress reactions with pain”, and 3)“lower abdominal pain and low back pain”, were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.ThePEB adjudicatedthe IBS, subsuming the 3rd MEB diagnosis,as unfitting, rated 10% and adjudicated tibial and fibular stress fractures, as unfitting, rated 0%with likely application of...
AF | PDBR | CY2012 | PD2012 01665
Chronic bilateral knee pain was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.ThePEBadjudicated chronic bilateral knee pain as unfitting, rated 0%, referencing the US Army Physical Disability Agency (USAPDA) pain policy.The CI made no appeals, and was medically separatedwith a 0%disability rating. The CI submitted a claim to the VA for status post bilateral meniscal tears; based on an examination performed over 5 years after...
AF | PDBR | CY2012 | PD2012 01674
He continued to have pain in his ankle joint, and on 11 April 2000 the CI underwent a right ankle talar surgical procedure(bone graft from knee) with some improvement; however, he was unable to run. Radiographs of the right ankle in May 2003, a year after separation demonstrated surgical hardware devices were in place, and no fractures or acute abnormality noted.At the MEB narrative summary (NARSUM) evaluation on 12December 2001, 3 months prior to separation, physical examination revealed a...
AF | PDBR | CY2012 | PD2012 01675
It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB, when specifically requested by the CI. Back pain, along with foot pain, was mentioned in a sick call note in 1999, although the entry elaborated only the foot complaint. An individual with a complaint of chronic low back pain, a normal objective examination, and normal objective testing is normally not referred...
AF | PDBR | CY2012 | PD2012 01677
No other conditions were submitted by the MEB.The PEBadjudicated “left ankle trimalleolar fracture”as unfitting, rated 20%.The CI made no appeals, and was medically separated. 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 Veterans Affairs Schedule for Rating Disabilities (VASRD) standards, based on severity at the time of separation. All members agreed that the C&P examination...
AF | PDBR | CY2012 | PD2012 01680
There were no spasms or neurological deficits noted.At the MEB/narrative summary (NARSUM) evaluation, 13 June 2003, performed approximately 3 months prior to separation, the CI reported pain on motion of his neck without numbness or tingling. Physical examination revealed normal strength and reflexes, decreased sensation from the shoulder to the tip of finger and ROM of 40 degree flexion, 50 on extension, and bilateral bending to 30 with bilateral rotation of 60. BOARD FINDINGS : IAW DoDI...
AF | PDBR | CY2012 | PD2012 01686
The Board’s role is thus confined to the review of medical records and all evidence at hand to assess the fairness of PEB rating determinations, compared to Veterans Affairs Schedule for Rating Disabilities (VASRD) and, to review those fitness determinations within its scope (as elaborated above) consistent with performance-based criteria in evidence at separation. IAW DoDI 6040.44, this Board must consider the appropriate rating for the CI’s back condition at separation based on the VASRD...
AF | PDBR | CY2012 | PD2012 01687
No other conditions were submitted by the MEB.The PEBadjudicated the chronic pain of right shoulder status-post arthroscopic surgery condition as unfitting, rated 0% (referencing the US Army Physical Disability Agency pain policy), and adjudicated the chronic back pain due to scoliosis condition as existed prior to service (EPTS). At the C&P exam of 9 December 2004, 2 months after separation, the history indicated the CI “had referred low back pain and scoliosis since she was in high...
AF | PDBR | CY2012 | PD2012 01689
The back and bilateral knee conditions, characterized as “chronic non-radicular low back pain”and“chronic bilateral knee pain”were forwarded as not meeting retention standards, to the Physical Evaluation Board (PEB) IAW AR 40-501.A symptomatic pes planus condition was identified by the MEB and also forwarded as failing retention standards.The informal PEB adjudicated the chronic low back and bilateral knee pain conditions as unfitting, rated 10% and 0%.The remaining condition was determined...
AF | PDBR | CY2012 | PD2012 01692
Two physical examinations document the presence of “crepitus” during examination.The final orthopedic surgeon’s impression (a month prior to separation) was that the CI had “right knee pain, early DJD, negative McMurry’s (a test for meniscal pathology) and MRI showed no meniscal pathology.” The only VA rating decision document prepared 3 years after separation utilized STRs to arrive at its rating decision as there was no VA Compensation and Pension exam performed. Because the PEB...
AF | PDBR | CY2012 | PD2012 01694
The MEB NARSUM physical exam findings are summarized in the chart below. RECOMMENDATION : The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows: Physical Disability Board of Review
AF | PDBR | CY2012 | PD2012 01695
The MEB forwarded “esophageal reflux, nonulcerative dyspepsia (NUD), IBS, generalized anxiety disorder, and social phobia” to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E.The PEB adjudicated the IBS (visceral hyperalgesia) condition as unfitting, rated 10% with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). After due deliberation, the Board consensus was that the preponderance of the evidence with regard to the functional impairment of...
AF | PDBR | CY2012 | PD2012 01696
The chronic right shoulder condition(s), characterized as right shoulder bicipital tendinitis/impingement syndrome was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. 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.As discussed above, PEB reliance on the USAPDA pain...