AF | PDBR | CY2013 | PD-2013-02821
The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation. In assigning probative value to these somewhat conflicting examinations,it was noted from the C&P exam thatpainful motion occurred at the end-ROM with no evidence of attempts to proceed further; reduced flexion to 45 degrees seemed inconsistent with the normal to...
AF | PDBR | CY2013 | PD-2013-02822
SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (42A20/Human Resources Sergeant) medically separated for obstructive sleep apnea (OSA) with nocturnal hypoxia, treated with bi-level positive airway pressure (BIPAP). 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 | CY2013 | PD-2013-02823
Post-Separation)ConditionCodeRatingConditionCodeRatingExam Right Ankle Pain…527120%Post-Operative Residuals of Right Ankle Fracture with Degenerative Joint Disease5010-527120%20061118Other x 0 Other x 3 RATING: 20%RATING: 50% *Derived from VA Rating Decision (VARD)dated 20061221(most proximate to date of separation [DOS]). NOTE: VASRD dated 20070828 noted the VA rated the CI’s ankle scar at 10% coded 7804, based on the 20061118 exam. The Board considered that there was not a preponderance...
AF | PDBR | CY2013 | PD-2013-02825
The Informal PEB (IPEB) adjudicated the history of left (non-dominant) radial nerve injury as unfitting, rated 10% with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation. The neurological studies of the left arm were recorded as “essentially...
AF | PDBR | CY2013 | PD-2013-02826
No other conditions were submitted by the MEB.The Informal PEB adjudicated “right chronic testalgia”as unfitting, rated 10%, with likely application of VA Schedule for Rating Disabilities (VASRD).The CI made no appeals and was medically separated. Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate. BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department...
AF | PDBR | CY2013 | PD-2013-02829
The non-medical assessmentnoted that the CI lost 10 hours per week due to her condition, including time atmedical appointments.At the VA Compensation and Pension (C&P) examination(performed 3 months prior to separation), the CI reported that her migraine headaches started when she went on a ship and continued since then, but with decreased frequency on continuous preventive medication. The Board first considered if the “migraine associated dizziness” was a separately unfitting condition at...
AF | PDBR | CY2013 | PD2013 00001
In March 2003, approximately 11 months prior to separation, the CI was evaluated by orthopedic physician who indicated a normal right leg with normal range-of-motion (ROM); diagnosis of periotitis of right lower extremity was made.All treatment entries indicated full ROM, normal gait, and tenderness to palpation of the right leg. The PEB rated right leg pain condition at0% under code 5022(periostitis) for pain, while the VA rated the right leg condition at 10% as 5262 (impairment of tibia)...
AF | PDBR | CY2013 | PD2013 00003
The Board considered whether an additional rating could be recommended under a peripheral nerve code for cervical radiculopathy. Examination revealed slow and guarded ambulation, normal posture and gait with slight increase in lumbar lordosis, there was paraspinal muscle tenderness and spasm, positive straight leg raising test, pain throughout the thoracolumbar ROM, normal lower extremity motor and sensory examination. SUBJECT: Department of Defense Physical Disability Board of Review...
AF | PDBR | CY2013 | PD2013 00005
After two periods of limited duty(LIMDU) the case sent to a Medical Evaluation Board (MEB) that found the bilateral CTS to be medically unacceptable and as forwarded it to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E.The MEB also forwarded a right shoulder condition for PEB adjudication. Neurological exam was normal. After a thorough review of the treatment record, the Board determined that the CI’s left and right wrist conditionswere essentially non-compensable based solely...
AF | PDBR | CY2013 | PD2013 00009
SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active dutySGT/E-5 (71L/Administrative Specialist)medically separated for chronic low back and chronic right ankle conditions.The CI initially reported low back pain (LBP) in 1992. The chronic low back and right ankle conditions, characterized as “lumbar spondylosis, chronic low back pain” and “ankle arthritis after fracture” were forwarded to the Physical Evaluation...
AF | PDBR | CY2013 | PD2013 00011
The MEB also identified and forwarded three other conditions that met retention standards (urinary tract flow difficulties; paresthesias to both right thighs; and some vague minor discomfort in the abdominal wall when lying down) for Physical Evaluation Board (PEB) adjudication.The PEB adjudicated “ shrapnel wound from an IED blast (10 A/C), penetrating the abdomen and causing a non-displaced fracture of the right acetabular dome, right hip joint” as unfitting, rated 10%, with likely...
AF | PDBR | CY2013 | PD2013 00020
The only rating greater than 20% using this criteria is 40% for “daytime voiding interval less than one hour, or awakening to void five or more times per night.” The 20% rating conferred by the IPEB at final separation is clearly consistent with the evidence as documented by all four periodic TDRL examiners, specifically the “averages one pad per day, occasionally requires two pads per day” cited in the final exam. In his Petition for Relief, the CI emphasized that TDRL examiners focused on...
AF | PDBR | CY2013 | PD2013 00022
Multiple entries in the STR document normal gait, normal lower extremity neurological findings, grossly normal or modestly impaired range-of-motion (ROM); and, there is no documentationof any periods of incapacitation. Service Treatment Record Exhibit C. Department of Veterans’ Affairs Treatment Record 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...
AF | PDBR | CY2013 | PD2013 00029
Service treatment records (STR) indicated that the CI was seen and treated for symptoms due to KS continuously from mid-August 2003 with hospitalization for a week due to pneumonia; followed by outpatient treatment for a month with antibiotics and breathing medications; medications were stopped 20 October 2003. The Board considered that the sinus and lung dysfunction each contributed to the co-mingled disability of the KS condition and agreed that a combined rating approachbetter...
AF | PDBR | CY2013 | PD2013 00032
Physical examination showed joint swelling of the right knee, but not of the left knee. The record was otherwise silent about ankle symptoms until the MEB separation exam in April 2001, at which time the CI noted "arthritis" of the ankle.Because of right foot pain and normal foot X-rays, a nuclear medicine study was performed in April 2001 and revealed mild right ankle findings consistent with stress or degenerative changes.The commander's statement was silent regarding the occupational...
AF | PDBR | CY2013 | PD2013 00034
The back condition, identified by the MEB as “chronic mechanical low back pain”was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. The NARSUM completed 6 months prior to separation documented that the CI could not do sit-ups or pass physical fitness testing due to LBP. Physical Disability Board of Review
AF | PDBR | CY2013 | PD2013 00035
Low back pain (LBP) . 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.Based on a thorough review of the evidence in the service treatment record (STR), the Board determined that IAW VASRD §4.71a, the CI’s LBP condition was best described as “slight.” There was insufficient evidence to support classifying the condition as “moderate” or “severe.”After due deliberation, the Board determined that a...
AF | PDBR | CY2013 | PD2013 00036
Back Pain post L5/S1 Interbody Fusion for Pars Defect and Spondylolysis Right Lower Extremity .The FPEB combined the back pain and peripheral neuropathy (right leg weakness) conditions under a single disability rating, “Back pain post L5/S1 interbody fusion” (noting weakness, paresthesias and disthesias) at 20%, assigning codes 5327, 5099, and 5003.Although the VASRD permits some combined ratings of two or more joints or conditions, it allows separate ratings for separately compensable...
AF | PDBR | CY2013 | PD2013 00037
Chronic Right Leg Pain Condition .The CI first presented for pain in both lower extremities (BLE) in May 1999, 3 months after accession. Physical Disability Board of Review SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130016373 (PD201300037)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 | CY2013 | PD2013 00040
Thoracolumbar ROM MEB ~ 8 mos . Physical Disability Board of Review SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130010296 (PD201300040)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 | CY2013 | PD2013 00041
5003Right Knee Pain5299-500310%20031016 Right Knee Pain . Specifically, the left knee condition was less severe than the right, and the Board determined that the left knee was not separately unfitting at the time of separation from service.
AF | PDBR | CY2013 | PD2013 00045
The VA rated the condition 30% coded 6205, Meniere’s syndrome, hearing impairment with vertigo less than once a month.The Board noted the final PEB diagnosis was recurrent vestibulopathy and not Meniere’s disease, however STRs indicated some diagnostic uncertainty regarding whether the CI’s vestibulopathy was Meniere’s disease or not. Migraine Headaches . XXXXXXXXXXXXXXXXXX President Physical Disability Board of Review
AF | PDBR | CY2013 | PD2013 00046
Despitenon-operativetreatmentwith non-steroidalanti-inflammatorydrugs,periods oflimited duty(LIMDU) andlightduty, physicaltherapy(PT),andepiduralsteroidinjections (ESI),theCI’s conditioncouldnotbeadequatelyrehabilitated tocontinuetomeet thephysicalrequirements ofhisMilitary OccupationalSpecialty(MOS)orsatisfy physicalfitnessstandards. SignificantBack Pain/LumbagoandDiskDegeneration Condition . ROM limited by pain; Gait-normal; Pos.
AF | PDBR | CY2013 | PD2013 00053
The VA coded each knee individually and used the analogous code 5999-5014 asosteomalachia and rated at each one at 10%.The service treatment record (STR) contained an equal amount of documentation relative to the left or right knee with the majority of documentation pertaining to the bilateral knee pain with activities. The left ankle physical exam findings of dorsiflexion limited to 10degrees (normal 20 degrees).The C&P examiner documented that the CI had daily pain with activities in all...
AF | PDBR | CY2013 | PD2013 00056
No other conditions were submitted by the MEB.The PEBadjudicated “chronic right shoulder pain, status post distal clavicle excision, and pain rated as slight, not requiring daily narcotic therapy and frequent” as unfitting, rated 10%, citing criteria of the US Army Physical Disability Agency (USAPDA) pain policy. 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...
AF | PDBR | CY2013 | PD2013 00058
Her back pain began in October 2004 with additional right leg pain. The PEB assigned a disability rating of 20% and the VA a rating of 10%. In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their respective forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating...
AF | PDBR | CY2013 | PD2013 00064
The PEB adjudicated “anterior knee pain after left anterior cruciate ligament (ACL) reconstruction” as unfitting, rated 10%, with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). There was no instability and examination of ligaments of the left knee was symmetrical compared to the uninjured left knee. Both the PEB and the VA rated the condition as 10% for painful motion of a major joint with similar coding (5010-5003 and 5257-5010 respectively).
AF | PDBR | CY2013 | PD2013 00066
No other conditions were submitted by the MEB.The PEB found the bilateral ankle condition unfitting, and rated each ankle10% for a combined disability rating of 20%, with likely application of the VeteransAffairs Schedule for Rating Disabilities (VASRD).Three other conditions (listed in the rating comparison chart below) were adjudicated as Category III (not separately unfitting, and not contributing to the unfitting condition).The CI made no appeals, and was medically separated. The VA...
AF | PDBR | CY2013 | PD2013 00073
Conversion Disorder/PTSD Condition .The CI injured her right arm 27 August 2000 when she fell aboard her ship during at-sea ship to ship refueling operations when the two ships collided. The VA combined the two mental health conditions, PTSD with conversion disorder manifested with limited functioning of the right arm and hand condition and rated at 10% based on her level of functioning at the time of the C&P examination in 2006. While the PEB separated the PTSD from the conversion...
AF | PDBR | CY2013 | PD2013 00074
The CI was medically separated. 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-Sep (20060327)Flexion (90 is Normal) 100 8 5 Combined (240 is Normal ) 230 210 Comment Pain with motion Pain with motion §4.71a Rating 10% 10 %The Board carefully reviewed all evidentiary information available, and directs attention to its rating recommendation based...
AF | PDBR | CY2013 | PD2013 00078
The CI was evaluated for reported symptoms of paresthesias of the right upper extremity, but cervical magnetic resonance imaging (MRI) on 9 January 2001 did not show spinal canal stenosis or nerve encroachment and nerve conduction studies on 13 April 2001 did not show any evidence of radicuolpathy.The CI was involved in another MVA on 26 June 2001 and was seen in the ER for “right shoulder, neck and low back pain;” the exam noted only right trapezius muscle tenderness, no spinal tenderness,...
AF | PDBR | CY2013 | PD2013 00079
Approximately a year prior to separation, 23 March 2001,orthopedic consult recorded a normal gait, normal reflexes, and normal motor exam; the CI indicated his pain and sensory symptoms had not significantly improved with treatment and requested surgery. The MEB narrative summary (NARSUM) evaluation, 20 June 2001, approximately 8 months prior to separationand 2 months status post (s/p) back surgery, indicated the CI was attending physical therapy and continued to report back pain. ...
AF | PDBR | CY2013 | PD2013 00080
Separation Date: 20011225 SUMMARY OF CASE :Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty Specialist/E4 (52C10/Utilities Equipment Repairer) medically separated for “ chronic lower back pain(LBP) secondary to L5-S1 herniated nucleus pulposus(HNP)without neurologic abnormality or documented chronic paravertebral muscle spasms.” Despite neurology and neurosurgery evaluations, extensive physical therapy, and medications, the...
AF | PDBR | CY2013 | PD2013 00084
5292 Spine, limitation of motion of, lumbar The VA rating decision cited “mild symptoms associated with intervertebral disc syndrome” for its 10% rating under 5293. SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130011457 (PD201300084)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 | CY2013 | PD2013 00092
The left knee condition, characterized as left knee severe degenerative joint disease (DJD), left knee anterior cruciate ligament insufficiency, left knee lateral meniscus tear and medial meniscus tear, was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E. He had further knee re-injuries after the first two surgeries. The operative report described severe chondromalacial changes in the lateral compartment with osteophytic ridging in the patellofemoral joint, medial,...
AF | PDBR | CY2013 | PD2013 00096
The back condition, characterized as lumbar spine, degenerative disc disease was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.The MEB also identified and forwarded four other conditions, see rating chart below, that do not fall below retention standards for PEB adjudication.The PEB adjudicated chronic radiating low back pain (LBP) as unfitting, rated 10% with likely application of US Army Physical Disability Agency (USAPDA) pain policy and the Veterans Affairs Schedule for...
AF | PDBR | CY2013 | PD2013 00097
At the MEB exam and FPEB appearance, the CI reported pain in his shoulder and inability to do pull-ups. The only exam documenting motion limited to the shoulder level (~90 degrees for 20% rating) was the separation exam. 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...
AF | PDBR | CY2013 | PD2013 00106
The MEB forwarded the left humerus fracture (surgical residuals) and osteopetrosis as separate conditions to the Physical Evaluation Board (PEB) IAW AR 40-501. The Board directs attention to its rating recommendation based on the above evidence.Members first agreed that any separate disability intrinsic to the osteopetrosis condition is appropriately subsumed in a single disability rating for the left upper extremity impairment in evidence as was determined by both the PEB and VA. Physical...
AF | PDBR | CY2013 | PD2013 00108
The back condition, characterized as “herniated nucleus pulposus [HNP]” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501 as medically unacceptable.The MEB also identified and forwarded tinnitus as medically acceptable.The PEB adjudicated “chronic low back pain, with L4-5 herniated nucleus pulposus”as unfitting, rated 10%, using the Department of Defense Instruction (DoDI) 1332.39, and theVeterans Affairs Schedule for Rating Disabilities (VASRD). CI CONTENTION : The CI...
AF | PDBR | CY2013 | PD2013 00110
Bilateral Leg Pain . After due deliberation, the Board determined that the evidence did not support a conclusion that the right leg pain, separately, would have rendered the CI incapable of performing his required military duties; and, accordingly cannot recommend a separate disability rating for right leg pain. Physical Disability Board of Review
AF | PDBR | CY2013 | PD2013 00113
The rating for the unfitting left hip condition(with consideration for the possibly associated degenerative arthritis and“radiating nerve pain down my left leg” as referenced in the contention)is addressed below. The service treatment record (STR) documented significant activity limitations and a limp with the use of a cane. 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...
AF | PDBR | CY2013 | PD2013 00114
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 (BCMR). The service treatment record documented no thrombosis problems following the start of anticoagulant therapy in July 2001 through the MEB exam; and the MEB and C&P examiners reported no objective findings related to abnormal clotting or bleeding, or of any daily functional...
AF | PDBR | CY2013 | PD2013 00117
Spine surgery evaluation concluded there was no indication for surgery.The MEB physical examination on29January 2002 (DD Form 2808) recorded “ROM 45 degrees anterior flexion” but did not specify whether this was lumbar spine or trunk motion.The orthopedic MEB narrative summary addendum examination on30March 2002, recorded back flexion with fingers reaching to mid shin (approximately 70 degrees), similar to the physical therapy examination the year previously.There was tenderness to palpation...
AF | PDBR | CY2013 | PD2013 00120
The bipolar disorder II and the meniscus tear conditions, characterized as “bipolar type II disorder” and “non-displaced tear, lateral meniscus, right knee,” were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.The MEB also identified and forwarded three other conditions (see rating chart below) for PEB adjudication.The PEB adjudicated “bipolar disorder type II”and “non-displaced meniscus tear, lateral, right knee”as unfitting, rated 10% and 0%.The remaining conditions were...
AF | PDBR | CY2013 | PD2013 00125
ThePEB found the pulmonary condition unfitting and rated it 10%with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).The other conditions were determined to be not unfitting, except for the adjustment disorder, which the PEB considered as not compensable. Prior to enlistment, the CI had two episodes of spontaneous PTX of the left chest. Accordingly, the Board does not recommend a separate disability rating for pleurisy.
AF | PDBR | CY2013 | PD2013 00126
CI CONTENTION :“When medically discharged I received a twenty percent (20%) disability rating from the Army Medical Review Board. The requested knee, ankle, ligament, depression, anxiety and insomnia conditions were not mentioned by the MEB or PEB and are therefore not within the purview of the Board. Spider Bite Left Foot with RSD Condition .The CI’s condition is well documented in the numerous notes in the service treatment record (STR).
AF | PDBR | CY2013 | PD2013 00127
The right knee condition, characterized as right knee pain was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.The PEB adjudicated patellofemoral pain syndrome (PFPS), right kneeas unfitting, rated 0%with likely application of the US Army Physical Disability Agency (USAPDA) pain policy.The CI made no appeals and was medically separated. At the MEB narrative summary evaluation on 18 September 2006, 2 months prior to separation, the...
AF | PDBR | CY2013 | PD2013 00128
The VA, in its rating decision of 7 October 2003, utilized code 5242, degenerative arthritis of the spine, as per the current VASRD rating guidelines in effect at that time.The VA rating decision dated 29 July 2003, 2 months proximate to the date of separation, rated the CI’s condition at 0%, based upon an examination that revealed neither painful nor limited motion. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a...
AF | PDBR | CY2013 | PD2013 00129
The PEB adjudicated “chronic bilateral lower extremity pain…”as unfitting and rated 10% per the US Army Physical Disability Agency (USAPDA) pain policy.The CI made no appeals and was medically separated. The Board must apply separate codes and ratings in its recommendations if compensable ratings for each condition are achieved IAW applicable VASRD sections. Examination of both right and left tibia/fibula were normal.
AF | PDBR | CY2013 | PD2013 00131
The MEB forwarded right shoulder pain s/p arthroscopic subacromial decompression and distal clavicle excision to the Physical Evaluation Board (PEB) IAW AR 40-501.The MEB also identified and forwarded left ankle pain as medically acceptable.The PEBadjudicated the chronic right shoulder pain as unfitting, rated 0%with specified application of the US Army Physical Disability Agency (USAPDA) pain policy.The left ankle pain condition was determined to meet retention standards and thereforewas...