AF | PDBR | CY2013 | PD2013 00132
Chronic Mandible and Neck Pain Condition . 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 chronic mandible pain condition coded 9905. 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 | CY2013 | PD2013 00133
The rating for the unfitting dysthymic disorder, generalized anxiety disorder (GAD) and PTSD conditions is addressed below;no additional conditions are within the DoDI 6040.44 defined purview of the Board. There are no separate mental health records available for review outside the narrative summary (NARSUM) and addendum until the VA records well after separation. As noted, the history upon which the VA based this decision is not consistent with the historical record.The Board directed...
AF | PDBR | CY2013 | PD2013 00141
No other conditions were submitted by the MEB.The PEB adjudicated “chronic left knee and bilateral hip pain…”as unfitting and rated 0% IAWUS Army Physical Disability Agency (USAPDA) pain policy.The CI made no appeals and was medically separated. Left Leg 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...
AF | PDBR | CY2013 | PD2013 00143
Osteoarthritis and Chondromalacia of Both Knees .The PEB combined the right and left knee conditions under a single Service disability rating, coded 5003. If the members judge that separately ratable conditions are justified by performance based fitness criteria and indicated IAW VASRD §4.7 (higher of two evaluations), separate ratings are recommended; with the stipulation that the result may not be lower than the overall combined rating from the PEB. Physical Disability Board of Review
AF | PDBR | CY2013 | PD2013 00145
The back condition, characterized as “chronic low back pain with s/p lumbar fusion with osteoarthritis” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. The Board also acknowledges the CI’s contention for ratings of his sleep apnea condition which was determined by the MEB to meet retention standards. Board members finally debated the application of VASRD §4.45in this case, which allows for the next higher rating if evidence of additional functional loss after repetitive...
AF | PDBR | CY2013 | PD2013 00147
CI CONTENTION : “I had four different surgical procedures done by the Army on both feet which has resulted in continued pain, callouses and deformity of my toes in addition as a result of my military service. The examination was based on her evaluation on 28 October 2003. Physical Disability Board of Review
AF | PDBR | CY2013 | PD2013 00148
RATING COMPARISON : Service IPEB 20040405VA Exam (2 Weeks after Separation)ConditionCodeRatingConditionCodeRatingExam Cholinergic Urticaria78250%Cholinergic Urticaria782510%20040727No Additional MEB/PEB EntriesOther x 720040727 Rating: 0%Combined: 30% Derived from VA Rating Decision (VARD)dated 20041122(most proximate to date of separation [DOS]). His hives and itching were relieved by cold showers and the use of anti-histamine medications. I direct that all the Department of the Army...
AF | PDBR | CY2013 | PD2013 00158
He was psychiatrically hospitalized for a 2-week period following this suicide attempt. Prior to Final Adjudication Date) - Effective 20031003On TDRL - 20031003 CodeRating Condition CodeRatingExam ConditionTDRL Sep.Major Depressive Disorder943430%0%Bipolar Disorder with Depression943230%20040212No Additional MEB/PEB EntriesOther x320040204 Rating: 0%Combined Rating: 50% invalid font number 31502 ANALYSIS SUMMARY :The VA evidence and the service treatment record evidence were not available...
AF | PDBR | CY2013 | PD2013 00159
No other conditions were submitted by the MEB.The PEBadjudicated “Systemic Lupus Erythematosus with Class II Nephritis and Stage I Chronic Kidney Disease, asymptomatic with normal renal function studies”as unfitting, rated 10%,referencing the Department of Defense Instruction (DoDI) 1332.39and Veterans Affairs Schedule for Rating Disabilities (VASRD).The remaining conditions (post-partum cardiomyopathy and hypertension) were determined to be Category II, which can be unfitting, but are...
AF | PDBR | CY2013 | PD2013 00160
RECORD OF PROCEEDINGSPHYSICAL DISABILITY BOARD OF REVIEWNAME: xxxxxxxxxxxxxxxxxxxx CASE: PD1300160 BRANCH OF SERVICE: AIR FORCE BOARD DATE: 20131105 The presence of functional impairment with a direct impact on fitness is the key determinant in the Board’s decision to recommend any condition for rating as additionally unfitting. I have carefully reviewed the evidence of record and the recommendation of the Board.
AF | PDBR | CY2013 | PD2013 00161
The ratings for the unfitting neck and back conditions are addressed below. The PT note on 16March 2007, 3 months prior to separation recorded bubble inclinometer ROM without specification of the method used, or normal values, at flexion 21 degrees, and extension 9 degrees with pain.The MEB NARSUM exam on 23 April 2007, approximately2 months prior to separation, documented that the CI’s LBP symptoms had slowly worsened and that he had undergone rest, activity modification, anti-inflammatory...
AF | PDBR | CY2013 | PD2013 00164
The CI was advised to continue using Advair twice daily.The final narrative summary (NARSUM) in May 2005 notes the CI’s report of shortness of breath and chest tightness 2-3 times a week, mostly with exertion and worse at night; symptoms were reported worsened with fast walking and running, walking up three flights of stairs, or any type of aerobic activity; andby exposure to chemical fumes, hot and cold weather, and dust.Prescribed medications included inhaled Advair twice per day and a...
AF | PDBR | CY2013 | PD2013 00166
The CI was then medically separated. Both the PEB and the VA coded the chronic neck pain condition 5241 for spinal fusion. The presence of functional impairment with a direct impact on fitness is the key determinant in the Board’s decision to recommend any condition for rating as additionally unfitting.
AF | PDBR | CY2013 | PD2013 00168
Flare ups were accompanied by abdominal pain in the right upper and lower quadrants, without identifiable triggers.On examination the CI was noted to be in no distress and the examination of the abdomen was non-tender. The Board undertook a careful review of the treatment records and noted the report of constant abdominal pain in every entry; however, clinical examinations noted no distress during physical exams, and examination of the abdomen was generally reported as normal. Service...
AF | PDBR | CY2013 | PD2013 00178
He was diagnosed with bilateral carpal tunnel syndrome (CTS) and was noted to have normal X-rays. 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...
AF | PDBR | CY2013 | PD2013 00190
Despite being a treatment option, surgery would not likely result in return to MOS duties; discussion with the CI therefore led to non-operative management at that time.At a psychiatric evaluation on 30June 2006, the CI stated that his apparent “stiffness” was due to pain in his legs and residual pain from a history of pilonidal cysts.The commander’s statementnoted that the CI could not perform his MOS duties due to his medical condition.At the VA Compensation and Pension (C&P) examination...
AF | PDBR | CY2013 | PD2013 00191
It, and any other 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.In accordance with DoDI 6040.44, the Board’s authority is limited to making recommendations on correcting disability determinations. Under the authority of Title 10, United States Code, section 1554(a), I approve the enclosed recommendation of the Department of Defense...
AF | PDBR | CY2013 | PD2013 00192
The back and sleep apnea conditions, characterized as “lumbar spine, DDD w/chronic low back pain” and “obstructive sleep apnea (OSA), requiring CPAP” [continuous positive airway pressure], were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.The MEB also identified and forwarded 10 other conditions for PEB adjudication. Should the Board judge that any contested condition was most likely incompatible with military service, a disability rating IAW the VASRD, based on the degree...
AF | PDBR | CY2013 | PD2013 00193
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. Degeneration of the disc was noted, but no evidence of nerve root compression or radiculopathy were presented.Although surgical records were not in evidence, the available service treatment records indicated he underwent L4-S1...
AF | PDBR | CY2013 | PD2013 00194
Initial Board deliberations considered if the associated right leg weakness/numbness and the residual neurogenic bladder condition were separately unfittingwarranting separate coding and rating recommendations. Therefore, the Board cannot recommend an additional disability rating for that 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...
AF | PDBR | CY2013 | PD2013 00196
His first complaint of back pain in the (Army) Service treatment records (STRs) was 2 months after enlistment. The VA physical exam noted “normal posture and gait and normal curvature of the spine,” although there was a subsequent comment on scoliosis; and “no objective evidence of spasms, weakness or tenderness.” The VA ROM measurements were flexion to 80 degrees and a combined ROM of 230 degrees. BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or...
AF | PDBR | CY2013 | PD2013 00197
SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active dutySGT/E-5 (68X20 / Mental Health) medically separated for anxiety disorder condition.During a previous deployment to Iraq from September 2004 to September 2005, while on convoy, CI reported that he experienced improvised explosive blasts and saw a gunner shot by a sniper and served on body details. The anxiety disorder condition, characterized as anxiety...
AF | PDBR | CY2013 | PD2013 00199
The Board carefully reviewed all available evidence and directs attention to its rating recommendation.The VA Schedule for Rating Disabilities (VASRD) coding and rating standards for the spine, which were in effect at the time of the CI’s separation, were changed in September 2003. After a thorough review of the evidence in the service treatment record (STR) and based primarily on the November 2002 MEB exam, the Board determined that IAW VASRD §4.71a, the CI’s back condition was best...
AF | PDBR | CY2013 | PD2013 00210
The PEB adjudicated the “ lumbar degenerative disc disease without motor neurologic deficit” as unfitting, rated 10% and the “major depressive disorder with associated generalized anxiety disorder” as unfitting, rated 10% with application of Veterans Affairs Schedule for Rating Disabilities (VASRD) standards. The VA applied code 9400, generalized anxiety disorder, and increased the rating to 50% from the 30% rating he received 21 months earlier. Additionally, the Board considered the PEB’s...
AF | PDBR | CY2013 | PD2013 00212
The C&P joints exam noted a hip strength of 1/5 due to pain; the C&P general examination a week later noted no muscle atrophy and a normal motor examination.The various examination findings suggest that the CI’s abnormal gaitwas due to pain from the hip, rather than muscle weakness or motor nerve injury. On exam there was tenderness of the anterior, lateral and posterior left thigh and the examiner noted the CI’s paresthesias to have hyper-esthetic and “pins and needles” components.The...
AF | PDBR | CY2013 | PD2013 00216
The Board directs attention to its TDRL entry rating recommendationbased on the above evidence.The IPEB applied Veterans Affairs Schedule for Rating Disabilities (VASRD) code 9411, PTSD, and rated the condition at 30% disabling and placed the CI on TDRL. 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...
AF | PDBR | CY2013 | PD2013 00219
The PEB and the VA adjudicated the chronic incisional abdominal pain condition as a painful scar with a service rating of 10%. 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 her prior medical separation: Providing orders showing that the individual was retired with permanent disability effective the date of...
AF | PDBR | CY2013 | PD2013 00224
Separation Date: 20040223 The rating for the unfitting low back condition is addressed below; no additional conditions are within the DoDI 6040.44 defined purview of the Board. Physical Disability Board of Review
AF | PDBR | CY2013 | PD2013 00225
There were no clinical records or VA C&P examinations proximate to TDRL exit in evidence. The CI was not tender on examination and subsequent neurological examinations were normal and also documented normal gait and posture. Again, there was no proximate C&P examination to TDRL exit, but the gait and posture were noted as normal on a 2010 neurology examination.
AF | PDBR | CY2013 | PD2013 00227
SEPARATION DATE: 20031216 The eye and neurological evaluations were normal.The Board directs attention to its rating recommendationbased on the above evidence.The PEB and VA both coded the condition as 7913, DM, and rated it at 20% for the use of Insulin without regulation of activities. RECOMMENDATION : The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.
AF | PDBR | CY2013 | PD2013 00234
The MEB also identified and forwarded one other condition (shrapnel wound to the right upper arm, which met retention standards) to the PEB.The PEBadjudicated “asthma…” rated at 30%and placed the CI on the Temporary Retired Disability List (TDRL) in order for the condition to be stabilized by treatment.The remaining condition was determined to be not unfitting.The CI made no appeals and was placed on the TDRL in November, 2004, where he continued to receive medical treatment. The Board’s...
AF | PDBR | CY2013 | PD2013 00235
In a 15 September 2004 mental health (MH)note, most proximate to the date of separation, the examiner noted “the patient’s mental status exam is very reassuring.” A service treatment record (STR) MSE entry noteda mildly constricted affect and depressed mood but an otherwise normal exam. The Board next considered the permanent disability rating of the right knee condition.As noted there are no post-separation records available regarding the right knee condition. Notes in the STR indicated...
AF | PDBR | CY2013 | PD2013 00246
No other conditions were submitted by the MEB.The PEBadjudicated “right hind foot reconstruction following posterior tibial tendon rupture with flexor hallux longus augmentation” as unfitting, rated 10%, citing criteria of the Veterans Affairs Schedule for Rating Disabilities (VASRD). Right Foot Condition . The VA’s 10% rating under an analogous 5271 code (ankle, limited motion of) was based on a “moderate” degree of motion impairment.Board members agreed that there was sufficient evidence...
AF | PDBR | CY2013 | PD2013 00254
X-rays performed at the time of the C&P examination were normal. The VA rated the back condition under code 5243 (intervertebral disc syndrome) 40% and cited lumbar spine degenerative disc disease L3-S1 and painful motion and limited flexion of 10 degrees from the C&P examination.The Board considered the ROM examination from the C&P examination and noted that it was dramatically inconsistent with the MEB examination in flexion but was essentially the same in all other directions.Therefore,...
AF | PDBR | CY2013 | PD2013 00255
A post-deployment examination noted only complaint of hearing loss. No specific injury was indicated.The CI reported he was unable to perform his duties as a mortar soldier due to back pain. The determination was continued at the time of the 5 September 2008 rating decision.The PEB rated the back condition 10%, coded 5237 (lumbosacral strain) for motion limited by pain (with likely application of service regulations) noting the absence of traumatic injury and normal X-rays.The limitation...
AF | PDBR | CY2013 | PD2013 00264
In addition, the CI’s commanding officer, via his commander’s performance statement, documented the CI”s “weekly treatments for depression.”The CI’s right shoulder condition, characterized as “chronic right shoulder pain, status post right shoulder impingement and subacromial decompression” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.The PEB adjudicated “chronic right shoulder pain” as unfitting, rated 0%with likely...
AF | PDBR | CY2013 | PD2013 00267
The Board noted no mental health (MH) conditions were referred to the MEB or PEB for adjudication. After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a determination of unfit for a mental health condition; and, therefore, no additional disability ratings can be recommended. SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130016483 (PD201300267)I have...
AF | PDBR | CY2013 | PD2013 00270
The PEB adjudicated “right knee, other impairment of”as unfitting, rated 20%with likely application of Veterans Affairs Schedule for Rating Disabilities (VASRD).The chronic LBP condition was determined to be not unfitting and not ratable. 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.In addition, the CI was notified by the Army...
AF | PDBR | CY2013 | PD2013 00272
The PEB adjudicated the condition as right knee pain rated from arthritis, due to trauma while in Iraq; soldier had undergone a right knee arthroscopic medial meniscal repair and microfracture of the medial femoral condyle, and a right knee HemiCap procedure,as unfitting, rated 10% with likely application of Veterans Affairs Schedule for Rating Disabilities (VASRD).The CI made no appeals and was medically separated. RECOMMENDATION : The Board, therefore, recommends that there be no...
AF | PDBR | CY2013 | PD2013 00275
Plain film X-rays did not demonstrate any fractures; however, multiple boney fragments were seen that represented either old injury or a normal variant finding. At the MEB NARSUM exam, approximately 6months prior to separation, the CI reported significant pain and recurrent episodes of instability of the right ankle. The VA applied VASRD code 5010-5271, limited motion of the ankle, and rated it 10% disabling consistent with a “moderate” limitation of motion.
AF | PDBR | CY2013 | PD2013 00278
The chronic right knee pain/right knee arthritis was the only condition forwarded by the MEB to the Physical Evaluation Board (PEB) IAW AR 40-501 in December 2004. ** VA Exam was ~ 13 mos after Release From Active Duty; ~ 14 mos before final Date of Separation from reserve status ANALYSIS SUMMARY : Chronic Right Knee Pain Condition . RECOMMENDATION : The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical separation:
AF | PDBR | CY2013 | PD2013 00281
The CI had a P3 (for idiopathic hypersomnolence, U2 (chest pain), L1, H1, E1, S2 (major depressive disorder).A sleep study performed on 27 Mar 2003, the CI reported he would fall asleep in the middle of conversations, sleepiness, hypnagogic hallucinations on occasion, occasional cataplectic symptoms, no sleep paralysis and no depressive symptoms. Depressive disorder not otherwise specified (NOS): The Board considered the appropriateness of changes in mental health (MH) diagnoses, PEB...
AF | PDBR | CY2013 | PD2013 00289
Chronic Right Groin and Testicular Pain Condition . The physical examination noted no testicular masses or tenderness.The examiner diagnosed chronic right groin pain and right testicular painand stated that there was no clear explanation for the pain.Removal of the right testicle was discussed as a “last ditch effort.”The CI was given an L3 profile for chronic right groin and testicular pain with specific restrictions towards limiting physical activities.The commander’s statement indicated...
AF | PDBR | CY2013 | PD2013 00299
At the MEB/NARSUM evaluation11 July 2007, seven months before separation, the CI reported neck pain and stiffness with prolonged standing and sitting.On examination flexion of the cervical spine was reduced to 20 degrees with pain. Contended MH Conditions .The Board’s main charge is toreview the record and assess whether any MH condition was unfitting and should be considered for disability rating. The Board concluded that the preponderance of evidence in record did not support an...
AF | PDBR | CY2013 | PD2013 00306
CI CONTENTION : The CI writes:“Conditions were disabling and have been found unemployable due to injury sustained on active duty. No pain was noted by the examiner. The examiner noted that the CI experienced occasion radiation of pain down the right lateral thigh “but he denies any true radiculopathy.” The examiner also noted “subjective leg weakness” in the right LE and toe numbness on the left.
AF | PDBR | CY2013 | PD2013 00322
Other x220030320 Combined: 10%Derived from VA Rating Decision (VARD)dated 20030619(most proximate to date of separation [DOS]) ANALYSIS SUMMARY :The Board acknowledges the CI’s information regarding the significant impairment with which his service-connected condition continues to burden him; but, must emphasize that the military Disability Evaluation System has neither the role nor the authority to compensate service members for anticipated future severity or potential complications of...
AF | PDBR | CY2013 | PD2013 00327
VA, on original rating decision date of 20070730,was given initial ratings of 10% for right hip DJD/acetabular tear, and a 30% rating for PTSD ( claimed asadjustment disorder). Right Hip 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...
AF | PDBR | CY2013 | PD2013 00334
In response to said notification, it is presumed that the CI has elected review by this Board for the MH condition(s) diagnosed after separation. 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 memorandum.
AF | PDBR | CY2013 | PD2013 00338
Post-Sep.Flexion (90 Normal)152035Combined (240)7010090Comments (Date of Surgery was 20040713)ROMs obtained 3.5 months prior to surgery; Pos. There were three service treatment notes related to the CI’s MH condition present for review. Physical Disability Board of Review