RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW
NAME: BRANCH OF SERVICE: NAVY
CASE NUMBER: PD0900065 COMPONENT: ACTIVE
BOARD DATE: 20090610 SEPARATION DATE: 20060321
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SUMMARY OF CASE: This covered individual (CI) was a Navy Petty Officer First Class Cryptologic Linguist medically separated in 2006 after eight and a half years of service. After several years of evaluations and treatment for a variety of conditions which caused pain, he was diagnosed with fibromyalgia in 2004. After his diagnosis was confirmed he received treatment with a multitude of different medications, none of which led to the resolution of his condition and he was referred to the Navy Physical Evaluation Board (PEB). He also was diagnosed with an adjustment disorder with depressed mood related to marital issues and chronic pain in April of 2005. A statement from the psychiatric service dated 16 December 2005 included this diagnosis and stated that this condition was considered temporary, would resolve when his underlying circumstances resolved, and did not warrant a medical board. In general this diagnosis is not continued for more than six months because after this time the condition either has resolved or has been determined to be one of the permanent mental health diagnoses such as depression. Although more than six months had passed at the time of separation, no documentation of further diagnosis or evidence of resolution of symptoms was found in the CI’s service treatment record. He also had a history of migraine headaches. No documentation of any medication specific for depression or migraine headaches was noted in his Navy treatment record.
The Navy PEB found him unfit for continued service and he was separated with a 0% disability rating for 5025 Fibromyalgia using the Veterans Affairs Schedule for Ratings Disabilities (VASRD) and applicable Navy regulations. Using an evaluation done two months after separation from the Navy, the Veterans Administration (VA) rated his disability at a combined 70%. This included 40% for 5025 Fibromyalgia, 30% for 8100 Migraine Headaches, 10% for 7319 Irritable Bowel Syndrome, 10% for Depressed Mood/Major Depressive Disorder, 10% for 6260 Bilateral Tinnitus, and 0% for 6513 Chronic Sinusitis. The CI contends that the VA ratings included 40% for fibromyalgia, 10% for irritable bowel syndrome, and 10% for depressed mood and that all of these were considered by the Navy and rated at 0%.
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. After careful consideration of all available information, the Board concluded the CI’s condition met the criteria for a rating of 40% for 5025 fibromyalgia at the time of his separation because he had nearly constant symptoms that were refractory to therapy. While pain and fatigue are the main characteristics of fibromyalgia, migraine headaches, depression, and irritable bowel syndrome are also very commonly present and are considered associated symptoms. The VASRD code 5025 provides the same ratings for fibromyalgia with or without associated symptoms and the PDBR did not rate these symptoms separately.
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RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical separation.
| Unfitting Condition | VASRD Code | Rating |
|---|---|---|
| Fibromyalgia | 5025 | 40% |
| Combined | 40% |
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The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20090123, w/atchs.
Exhibit B. Service Treatment Record.
Exhibit C. Department of Veteran's Affairs Treatment Record.
AF | PDBR | CY2013 | PD2013 00545
STRs noted a consultation with rheumatology on 03 June 2003, six months prior to separation, which described a “constellation of symptoms compatible with fibromyalgia with chronic generalized pain, complications of fatigue, sleep disturbance and chronic depression.” Physical examination noted “typical trigger pointing noted in the cervical, scapular and lumbar regions of the spine.”An outpatient note on 24 July 2003reported “widespread muscle pain and fatigue,” back pain and neck pain, “hip...
AF | PDBR | CY2009 | PD2009-00635
The PEB reconvened on 20080104 and evaluated the CI as 10% disabled due to Fibromyalgia Syndrome (5025) and again considered the CI’s mental health condition. However, the VA included all of the CI’s mental health symptoms in its rating for fibromyalgia. The occupational and social impairment that resulted from the CI’s Depressive Disorder with Anxious Mood is sufficient to warrant a 30% rating separate from the fibromyalgia.
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...
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AF | PDBR | CY2013 | PD-2013-01532
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AF | PDBR | CY2013 | PD-2013-01382
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AF | PDBR | CY2011 | PD2011-00088
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AF | PDBR | CY2009 | PD2009-00493
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AF | PDBR | CY2012 | PD2012 01383
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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. Post-Separation) Fibromyalgia 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 the Board to the extent they were inconsistent with the VASRD in effect at...