RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW
NAME: BRANCH OF SERVICE: AIR FORCE
CASE NUMBER: PD0900097 COMPONENT: ACTIVE
BOARD DATE: 20090617 SEPARATION DATE: 20050201
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SUMMARY OF CASE: This covered individual (CI) was an Air Force SSgt Health Services Management Craftsman medically separated in 2005 after eight years of active service and five years in the reserves. She was diagnosed with fibromyalgia in 2002 and over time her symptoms gradually increased in intensity and frequency. These symptoms include widespread pain with trigger points, fatigue, sleep disturbance, depression, and anxiety. Her condition had progressed to the point of preventing her from reasonably performing the duties of her office, grade, rank, and rating. The Air Force Physical Evaluation Board (PEB) found her unfit for continued service and she was separated with a 20% disability rating for 5025 Fibromyalgia using the Veterans Affairs Schedule for Ratings Disabilities (VASRD) and applicable Air Force regulations. Using an evaluation done three months after separation from the Air Force, the Veterans Administration (VA) rated her disability at a combined 90%. This included 40% for 5025 Fibromyalgia, 50% for 6847 Sleep apnea, 30% for 9400 Generalized anxiety disorder, 20% for 5299-5257 right knee strain and meniscal tear, 10% for 5299-5284 right foot bunionectomy, 10% for 7805-8515 residuals ganglion cyst and 0% each for 5019 Right shoulder subacromial bursitis, 5020-5276 Left plantar fasciitis, and 5020-5276 Right plantar fasciitis. The CI contends the Air Force did not consider all of her conditions and intentionally kept her rating at a level that precluded retirement.
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 that the CI’s condition is appropriately rated at 40% under VASRD 5025 Fibromyalgia. This rating is based on the presence of symptoms of widespread musculoskeletal pain and tender points with associated fatigue, sleep disturbance, depression, and anxiety that were constant, or nearly so, and refractory to therapy. The CI did have some relief of her symptoms with therapy but her daily pain level was never rated at less than 3 out of 10, averaged 5 out of 10, and sometimes was 8 out of 10.
The Board examined all the other conditions that were rated by the VA and did not find any to be separately unfitting.
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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 20090202, w/atchs.
Exhibit B. Service Treatment Record.
Exhibit C. Department of Veteran's Affairs Treatment Record.
PDBR PD-2009-00097
MEMORANDUM FOR THE CHIEF OF STAFF
Having received and considered the recommendation of the Physical Disability Board of Review and under the authority of Section 1554, Title 10, United States Code (122 Stat. 466) and Section 1552, Title 10, United States Code (70A Stat. 116) it is directed that:
The pertinent military records of the Department of the Air Force relating to XXXXX be corrected to show that:
a. The diagnosis in her finding of unfitness for fibromyalgia, VASRD code 5025, was rated at 40% rather than 10%.
b. On 1 February 2005, she elected children-only coverage under the Survivor Benefit Plan (SBP) based on full retired pay and her spouse concurred with her election.
c. She was not discharged on 2 February 2005 with entitlement to disability severance pay; rather, on that date she was released from active duty and on 3 February 2005 her name was placed on the Permanent Disability Retired List.
JOE G. LINEBERGER
Director
Air Force Review Boards Agency
AF | PDBR | CY2011 | PD2011-00213
The VA exam, two months pre-separation, documented a normal knee exam, and the VA adjudicated the condition as not Service connected (NSC). The CI’s unfitting fibromyalgia considered the impact of all musculoskeletal pain symptoms and conditions associated with fibromyalgia as noted above. The CI’s unfitting fibromyalgia considered the impact of all musculoskeletal pain symptoms and conditions associated with fibromyalgia as noted above.
AF | PDBR | CY2013 | PD2013 00935
The PEB combined the MEB referred conditions of FM and bilateral plantar fasciitis and pes cavus and rated them as one unfitting condition of FM coded at 5025, specified by the VASRD as “with widespread musculoskeletal pain and tender points, with or without associated fatigue, sleep disturbance, stiffness, paresthesia, headaches, irritable bowel symptoms, depression, anxiety, or Raynaud’s-like symptoms.” The PEB cited avoidance of pyramiding IAW VASRD §4.14 for not rating the plantar...
AF | PDBR | CY2011 | PD2011-00993
The CI was medically separated with a 10% disability rating. Post-Separation) – All Effective Date 20070801 Service Recon PEB – Dated 20070702 Condition Code Rating No Separate VA Entry (see 9434 below and 5025 above) Code 5025 8100 5010-5237 5024-5284 5024-5284 6847 9434 7101 6260 5201-5024 Rating 10%* 30% 10% 10% 10% 50% 50% 0% 10% 10% Exam 20080219 20080219 20080219 20080219 20080219 20080212 20080201 20080219 20080219 20080206 Not Service Connected 7399-7346 6820 5010-5237 7899-7806 No...
AF | PDBR | CY2012 | PD2012-00177
Neck Pain Condition . Fibromyalgia Condition . In the matter of the rotator cuff tear condition, the Board by a vote of 2:1 recommends a disability rating of 10%, coded 5099-5003 IAW VASRD §4.71a.
AF | PDBR | CY2011 | PD2011-00088
The Formal PEB (FPEB) adjudicated “Fibromyalgia Associated with Depression and Fatigue” as unfitting and rated 20% with application of DoDI and Veterans Administration Schedule for Rating Disabilities (VASRD). The CI was then medically separated with a 20% disability. At the time of the MEB examination and the VA C&P examination, the CI had constant symptoms of joint pain, depression, fatigue, headache, and sleep disturbance that responded poorly to therapy.
AF | PDBR | CY2012 | PD2012-00347
RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW BRANCH OF SERVICE: NAVY NAME: CASE NUMBER: PD1200347 SEPARATION DATE: 20060501 BOARD DATE: 20130102 SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty PH3/E-4 (Photographer’s Mate) medically separated for fibromyalgia. The examiner opined, “Tenderness throughout the back and at all joints is not considered significant in this claimant, particularly the...
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 | CY2013 | PD2013 00583
No other conditions were submitted by the MEB.The InformalPEB adjudicated fibromyalgia as unfitting rated 10%with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).The CI appealed to the Formal PEB (FPEB) whoupon review increased the rating to 20%. Fibromyalgia Condition . The Board directs attention to its rating recommendation based on the above and considered whether the evidence of the service treatment records (STR) supported a higher 40% rating at...
AF | PDBR | CY2009 | PD2009-00718
In considering the rating, the Board readily agreed that the MEB, VA examinations, and the service treatment record all indicated that the CI’s symptoms were not controlled by medications, and that the pain was present daily. Other PEB Conditions. Exhibit C. Department of Veterans' Affairs Treatment Record.
AF | PDBR | CY2013 | PD-2013-01382
If the Board judges that two or more conditions are reasonably justified as separately unfitting, then each separate condition must be rated IAW the VASRD §4.71a. Accordingly, the Board does not recommend a separate disability rating for the functional bowel symptoms. Right Hip Pain .