AF | PDBR | CY2012 | PD2012 01698
SEPARATION DATE: 20030612 BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.In the matter of the chronic LBP condition and IAW VASRD §4.71a, the Board unanimously...
AF | PDBR | CY2012 | PD2012 01699
At the MEB exam (also 6 months prior to separation), the CI reported continued constant pain. The Board considered that the MEB exam of decreased pain-limited motion and the PT exam with slight decreased extension and lateral flexion measurements supported application of VASRD §4.7 (higher of two evaluations) for a rating of 10% rather than the 0% evaluation based on the VA exam, which may have been on “a good day” for a condition which is known to vary from day-to-day. Physical Disability...
AF | PDBR | CY2012 | PD2012 01702
The MEB forwarded crushing left hand injury; status post (s/p) surgical treatment of near amputation of left middle, ring and small fingers; arthrofibrosis of the proximal interphalangeal joint of the left middle, ring and small fingers; and decreased left hand grip strength conditions to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E. Arthrofibrosis Proximal and Distal Interphalangeal Joints Left Middle, Ring and Small FingersCondition . Physical Disability Board of Review
AF | PDBR | CY2012 | PD2012 01707
The Physical Evaluation Board (PEB) adjudicated the FM (which considered the LBP and depression to be an integral part of FM and not independently unfitting) as unfitting, rated 20%, with application of the Department of Defense Instruction (DoDI) 1332.39.The remaining condition, OSA, was determined to be not unfitting and therefore not rated. There was normal ROM in all joints with pain.Neurological exam was normal.The Board noted the PEB to combine the depression and LBP conditionsand...
AF | PDBR | CY2012 | PD2012 01714
No other conditions were submitted by the MEB.The PEB adjudicated post-traumatic arthritis of the left index PIP joint as unfitting rated 10%with application of the Veterans Administration Schedule for Rating Disabilities (VASRD).The CI made no appeals, and was medically separatedwith a 10% disability rating. Left Index Finger Condition . BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by...
AF | PDBR | CY2012 | PD2012 01715
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) standards, based on ratable severity at the time of separation. Board members agreed that all evidence considered, the CI’s lower back pain and intermittent right lower extremity radiculopathy did not rise to the level of severe. BOARD FINDINGS : IAW DoDI 6040.44, provisions of...
AF | PDBR | CY2012 | PD2012 01717
CI CONTENTION : “I was rated at I0 percent for service connected snapping hip (Left Hip), I have much less range of motion in my left hip. Physical Disability Board of Review 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 01718
The Board determined that the most appropriate code for the CI’s right ankle condition was 5271, since there was some limitation of ROM.Based on the evidence in the treatment record, and IAW VASRD §4.71a, the Board determined that the CI’s ankle surgery had left his right ankle in good weight-bearing position. RECOMMENDATION : The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows: I have carefully reviewed the...
AF | PDBR | CY2012 | PD2012 01719
5292 Spine, limitation of motion of, lumbar The VA rating under 5292 referenced “slightly limited motion of the lumbar spine”, although the evidence cited full ROM. BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.The Board did not surmise from the record or PEB ruling in this case that...
AF | PDBR | CY2012 | PD2012 01726
CI described the same PTSD symptoms as described in the C&P exam 3 months prior to separation. As regards the permanent rating recommendation, the Board must weigh the evidence in the year post separation VA assessments, the MEB and the VA pre-separation C&P exam in order to extrapolate an estimation of the ratable impairment at 6 months after separation. The CI was reported by his commander to have done exemplary work in a ground job after being removed from flight status and prior to...
AF | PDBR | CY2012 | PD2012 01728
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 Board then considered its rating recommendation for the unfitting right and left shin splint conditions at the time of separation. The MEB forwarded the right foot pain condition as medically acceptable.The right foot condition was reviewed and considered by the Board.
AF | PDBR | CY2012 | PD2012 01729
On a medical assessment dated 7 February 2002, the CI reported complaints as “little finger numb at times, elbow hurts at times.” The commander’s non-medical statement 15 April 2002 noted elbow pain limited the CI’s duty performance.At the VA Compensation and Pension (C&P) examination, 3December 2002, 3 months after separation, the examiner recorded: “Since that time the patient has continued to notice recurrent episodes of tingling and numbness about the left small finger. An X-ray of the...
AF | PDBR | CY2012 | PD2012 01732
Upon InformalReconsideration following the appeal, the PEB adjudicated the cervical spine (subsuming myofascial pain) and lumbar spine conditions as unfitting, rated 10% each, citing criteria of the Veterans Affairs Schedule for Rating Disabilities (VASRD). Since the PEBadjudicated polyneuropathy and iliotibial band syndrome were integral to the VA “findings” cited in the application, members agreed that those conditions were appropriately included in the Board's scope of review; and, are...
AF | PDBR | CY2012 | PD2012 01735
The CI was referred for psychiatric consultation after MEB referral for the knee condition,was diagnosed with posttraumatic stress disorder (PTSD), and was issued a permanentS3 profile. The initial commander’s statement of May 2009 (concurrent with the MEB referral for knee) specifically documented, “Soldier has no mental disorder.” A follow-up commander’s statement of August 2009 documented, “This command was unaware that [CI] was being treated for PTSD, and after contemplating [CI’s]...
AF | PDBR | CY2012 | PD2012 01736
The PEB adjudicated the neurogenic claudication condition as unfitting, rated 20%(specified as a pre-existing condition with 0% deduction), applying criteria ofthe Veterans Affairs Schedule for Rating Disabilities (VASRD). In order to recommend a rating for the separate condition, however, the Board must be satisfied that the separately rated condition is reasonably justified as separately unfitting. BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or...
AF | PDBR | CY2012 | PD2012 01738
The Board deliberated and concluded that the CI’s condition had improved after separation; however, the Board’s recommendation is based on the CI’s psychological status at the time of separation. After due deliberation, the Board determined that based on the evidence and IAW VASRD §4.130 at the time of separation, the most appropriate disability rating recommendation was 30%. XXXXXXXXXXXXXXXXXX President Physical Disability Board of Review
AF | PDBR | CY2012 | PD2012 01746
This evidence supports a determination of moderate disability.After due deliberation in consideration of all of the evidence and mindful of VASRD §4.3 (Reasonable doubt), the Board concluded that left tibial FX with residual weakness of the left ankle requiring an AFO and a cane for ambulation condition was separately unfitting and recommends a disability rating of 20%, coded 5262 IAW VASRD §4.71a. Physical Disability Board of Review Providing a correction to the individual’s separation...
AF | PDBR | CY2012 | PD2012 01747
Wrist ROM In degrees (Normal)MEB/Occ Therapy ~7 Mo. BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.In the matter of the left CTS condition, the Board recommends a...
AF | PDBR | CY2012 | PD2012 01749
However, I was only given a rating on my knees. Should the Board judge that any contested condition was most likely incompatible with specific duty requirements; a disability rating IAW the VASRD, and based on the degree of disability evidenced at separation, will be recommended.The Board further acknowledges the CI’s information regarding the significant impairment with which his service-connected conditions continue to burden him; but, must emphasize that the Disability Evaluation System...
AF | PDBR | CY2012 | PD2012 01750
The VA assigned a40% rating for the back condition rated 5292-5293 citing severe limitation of motion of the lumbar spine. The discussed the C&P examination report that the CI held on a chair and compared that examination with prior examinations and concluded the examination confirmed characteristic pain on motion but did not evidence muscle spasm.The Board also considered if additional disability rating was justified for peripheral nerve impairment due to radiculopathy.Although there was...
AF | PDBR | CY2012 | PD2012 01753
5292 Spine, limitation of motion of, lumbar In the matter of bilateral lower extremity radiculopathies associated with the unfitting lumbar spine condition, the Board unanimously agrees that it cannot recommend additional ratings for peripheral nerve impairment.There were no other conditions within the Board’s scope of review for consideration. RECOMMENDATION : The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:
AF | PDBR | CY2012 | PD2012 01755
Ratings for unfitting conditions will be reviewed in all cases.The rated, unfitting condition of bilateral foot painas well as Raynaud’sphenomenon, low back pain (LBP), left knee retropatellar pain syndrome (RPPS), hemorrhoids, cervical dysplasia, pelvic pain, and bilateral wrist pain conditions as requested for consideration meet the criteria prescribed in DoDI 6040.44 for Board purview.Any conditions or contention not requested in this application, or otherwise outside the Board’s defined...
AF | PDBR | CY2012 | PD2012 01758
Consequently, the Board need not apply a 50% minimum Temporary Disability Retired List rating in this case.The service treatment record(STR) reported the onset of “situational depression” in 2000, related to weight gain secondary to LBP, and duty repercussions; outpatient notes described depressed mood, normal thought process, no psychotic symptoms, and no evidence of dangerousness.At the psychiatric MEB exam in July 2001 (14 months prior to separation), the CI endorsed symptoms of loss of...
AF | PDBR | CY2012 | PD2012 01759
The patient continued with rehabilitation; however, he continued to report episodes of severe back pain. Physical Disability Board of Review SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130010303 (PD201201759)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 01761
The hand condition, characterized as “Complex regional pain syndrome not sympathetically maintained”, was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.The PEB adjudicated the hand conditionas unfitting and rated 20%.The CI made no appeals and was medically separated. Service Treatment Record Exhibit C. Department of Veterans’ Affairs Treatment Record Physical Disability Board of Review
AF | PDBR | CY2012 | PD2012 01762
The PEB adjudicated the “lumbar degenerative disc disease (DDD)” as unfitting, rated 20%with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). The VA coded the DDD lumbar spine with spondylosis as 5242 with 5243intervertebral disc syndrome rated at 20%.The general rating formula for diseases and injuries of the spine considers the CI’s pain symptoms “with or without symptoms such as pain (whether or not it radiates), stiffness or aching in the area of the spine...
AF | PDBR | CY2012 | PD2012 01769
RECOMMENDATION : The Board recommends that the CI’s prior determination be modified as follows; and, that the discharge with severance pay be recharacterized to reflect permanent disability retirement, effective as of the date of his prior medical separation: Physical Disability Board of Review Providing orders showing that the individual was retired with permanent disability effective the date of the original medical separation for disability with severance pay.
AF | PDBR | CY2012 | PD2012 01771
The VA determined the condition was not serviced-connected and provided no rating.In accordance with DoDI 6040.44, the Board is required to recommend a rating IAW the Veterans Affairs Schedule for Rating Disabilities (VASRD) in effect at the time of separation. The record in evidence did not record the presence of back spasms.The Board opined that the sciatica condition was an integral part of the back pain pathology and could not be recommended for an additional rating IAW VASRD 4.14...
AF | PDBR | CY2012 | PD2012 01773
BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.In the matter of the VCD, and IAW VASRD §4.97, the Board unanimously recommends no change in the PEB...
AF | PDBR | CY2012 | PD2012 01781
The right knee pain, characterized as “right knee pain secondary to chondromalacia of the lateral tibial plateau and patella, status post arthroscopic debridement of medial and lateral meniscus tears,”was forwarded to the Physical Evaluation Board (PEB) as medically unacceptable IAW AR 40-501.Essential hypertension and overweight conditions were addressed by the MEB, and forwarded as medically acceptable.The PEB adjudicated the right knee pain as unfitting, rated 0%, with likely application...
AF | PDBR | CY2012 | PD2012 01782
Any conditions or contention not requested in this application, or otherwise outside the Board’s defined scope of review, remain eligible for future consideration by the Board for Correction of Military Records. The diagnosis was the same as at the MEB exam with the C&P examiner noting “GAF of 45- “indicating major symptoms of depression along with evidence of impairment of reality with visual hallucinations and problems with sleep and concentration, which would interfere with her ability...
AF | PDBR | CY2012 | PD2012 01787
Left Leg and Right Knee Conditions. The Board opined that the totality of the available evidence supports that the CI’s left leg condition of healed fractures of the femur and tibia resulting in valgus deformity with painful, limited ROM and mild to moderate instability most nearly met the 30% disability rating at the time of permanent separation.After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of...
AF | PDBR | CY2012 | PD2012 01788
The Board must apply separate codes and ratings in its recommendations if compensable ratings for each condition are achieved IAW VASRD rating guidelines. Strength and sensation was normal.MEB/PT ROM evaluation17 September 2003appears to document reduced left shoulder abduction of possibly 15 degrees but is illegible; the NARSUM noted the PT consultation as abduction 110 degrees.At the C&P exam the CI reported pain, decreased ROM, and difficulty with overhead motion. Service treatment...
AF | PDBR | CY2012 | PD2012 01789
The PEB adjudicated “chronic bilateral knee pain secondary to bilateral patella-femoral arthrosis, s/p bilateral lateral retinacular release”as unfitting, rated 0% with application of the VA Schedule for Rating Disabilities (VASRD).The sixremaining conditions were determined to be not unfitting. Pre-SepLeftRightLeftRightFlexion (140 Normal)140135> 105>105Extension (0 Normal)00CommentStable kneeStable kneePainful motion noted at MEB§4.71a Rating10%10%10%10%*The MEB ROM numbers are from the...
AF | PDBR | CY2012 | PD2012 01790
[The CI] suffers from back pain. Additionally, under the current general rating formula for diseases and injuries of the spine, which uses ROM measurements for rating, the CI’s back pain would also be rated at 10% based on the ROM measurements documented in the NARSUM. Since no evidence of functional impairment exists in this case, the Board would not have supported a recommendation for additional rating based on peripheral nerve impairment (as opposed to the PEB’s adjudication).
AF | PDBR | CY2012 | PD2012 01793
The CIs back pain condition did not improve adequately with treatment to meet the physical requirements of her Military Occupational Specialty (MOS)or satisfy physical fitness standards.Shewas issued a permanent L4 profile andreferred for a Medical Evaluation Board (MEB).The MEB forwarded no other conditions for Physical Evaluation Board (PEB) adjudication.The PEB adjudicated her low back condition as unfitting, rated 10%, with application of the Veterans Affairs Schedule for Rating...
AF | PDBR | CY2012 | PD2012 01798
Pain was elicited on straight leg raise (SLR) without pain radiation, and no other objective evidence of radiculopathy.During the MEB/NARSUM on 4 August 2002,the evaluation noted normal neuromuscular examination, normal gait (heel toe walk and tandem walk), and no evidence ofradiculopathy.Upon MEB/NARSUM evaluation on 7 November 2002, approximately 4 months prior to separation, the CI reported chronic back pain. BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department...
AF | PDBR | CY2012 | PD2012 01802
The PEB adjudicated asthma and chronic LBPconditionsas unfitting, rated10% and 0%, with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) and AR 635-50 respectively.The remaining conditions (OSA, benign prostatic hypertrophy, patellofemoral syndrome (PFS), posttraumatic stress disorder(PTSD) and congestive heart failure) were determined to be not unfitting.The CI made no appeals and was medically separatedwith a 10% combined disability rating. The PEB designated...
AF | PDBR | CY2012 | PD2012 01806
No other conditions were submitted by the MEB.The Informal PEB adjudicated “L5-S1 radiculopathy with EMG evidence of active denervation and mild abnormality of the right peroneal nerve”as unfitting, rated 20%, citing criteria of the VA Schedule for Rating Disabilities (VASRD).The CI made no appeals and was medically separated. The MEB NARSUM diagnosis was L5-S1 radiculopathy with active denervation (on EMG) due to degenerative disc and joint disease of the lumbar spine.The neurology...
AF | PDBR | CY2012 | PD2012 01808
ANALYSIS SUMMARY : The Board evaluates VA evidence proximate to separation in arriving at its recommendations, but its authority resides in evaluating the fairness of fitness decisions and rating determinations for disability at the time of separation.DoDI 6040.44 specifies a 12-month interval for special consideration to VA findings.Post-separation evidence, however, is probative only to the extent that it reasonably reflects the disability at the time of separation from military...
AF | PDBR | CY2012 | PD2012 01818
The CI since has had recurrent back pain. BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.In the matter of the back pain condition, the Board by split decision of...
AF | PDBR | CY2012 | PD2012 01819
After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the bilateral foot pain condition, but does recommend a change in the diagnostic descriptor to chronic right foot pain.The Board’s main charge is to assess the fairness of the PEB’s determination that left foot condition as not unfitting. The Board noted only one evaluation in the record...
AF | PDBR | CY2012 | PD2012 01821
After the disc decompression procedure performed 8 months prior to separation, the CI did experience relief from the radicular symptoms while his back pain persisted. 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 DoDI 1332.39 for rating chronic back...
AF | PDBR | CY2012 | PD2012 01824
(2).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 fibromyalgiacondition is addressed below; and, no additional conditions are within the DoDI 6040.44 defined purview of the Board. The Board reviews medical records and other available evidence to assess the fairness of PEB rating...
AF | PDBR | CY2012 | PD2012 01825
Post-SepFlexion (45⁰ Normal)45⁰‘Within functional limits’30⁰30⁰Combined (340⁰)340⁰215⁰215⁰§4.71a Rating10%*10%20%20%* Conceding §4.59 (painful motion).The Board directs attention to its rating recommendation based on the above evidence. A provider entry during that period noted left knee pain with various motions, but “right knee only ‘sore’ if stands up for prolonged periods.” Nearly all outpatient entries in the STR documented left knee dominance of symptomatology, with several mentioning...
AF | PDBR | CY2012 | PD2012 01827
The CI was then medically separated. IAW DoDI 6040.44, the Board must use the VASRD coding and rating standards which were in effect at the time of the CI’s separation from service. BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.The Board did not surmise from the record or PEB ruling...
AF | PDBR | CY2012 | PD2012 01833
The left ankle condition, characterized as “left ankle pain status post fracture repair” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.The Informal PEB (IPEB)adjudicatedleft ankle pain as unfitting, rated 10%, citing criteria of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD).The CI made no appeals, and was medically separatedwith a 10%disability rating. Post-Separation)...
AF | PDBR | CY2012 | PD2012 01838
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 CI had additional spine surgery in 2006 and subsequent left lower extremity peripheral nerve rating in 2008 and additional spine surgery in 2009. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2012 | PD2012 01839
The commander’s statement corroborated that the condition limited him in his duties and physical fitness, and further documented the CI was unable to pull, push, bend, run and lift without making his back condition worse, was unable to wear load bearing equipment, and was still working in his MOS within his limitations.At the MEB exam, the CI reported constant, slight pain which awoke him at night, worsened with prolonged sitting or standing, and bending or heavy lifting. Therefore, based...
AF | PDBR | CY2012 | PD2012 01841
RECORD OF PROCEEDINGSPHYSICAL DISABILITY BOARD OF REVIEWNAME: CASE: PD1201841 BRANCH OF SERVICE: Army BOARD DATE: 20130619 BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were...