RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXX CASE: PD1100970 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130313 

SEPARATION DATE: 20050606 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (19K10/M1A1 Armor Crewman) medically 
separated for chronic abdominal pain. The CI went in for a laparascopic appendectomy in early 
2004 and experienced a small bowel perforation. Multiple surgeries, a medical coma for 19 
days and an incisional hernia repair followed. In December 2004, a surgical consult revealed no 
surgical pathology only chronic pain. The condition could not be adequately rehabilitated to 
meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical 
fitness standards. He was issued a permanent P3 profile and referred for a Medical Evaluation 
Board (MEB). The abdominal pain condition was forwarded to the Physical Evaluation Board 
(PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The PEB adjudicated 
chronic abdominal pain, rated 10%. The CI made no appeals and was medically separated with 
a 10% disability rating. 

 

 

CI CONTENTION: “I have since been found to have PTSD as a result of the coma which was a 
result of the abdominal condition for which I was discharged, and the reason given for my 
discharge was: pain. I had one ventral hernia repair will on active duty, and have had two more 
since.” 

 

 

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, 
paragraph 5.e.(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 chronic abdominal 
pain condition is addressed below and no additional conditions are within the DoDI 6040.44 
defined purview of the Board. 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 Army Board for Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20050331 

VA - 4 Mos. Pre –Separation 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Abdominal Pain 

7399-7301 

10% 

Abdominal Pain & Digestive 
Problems s/p Small Bowel 
Perforation & Peritonitis 

7399-7301 

10% 

20050215 

No Additional MEB/PEB Entries 

Other x 7 

20050215 

Combined: 10% 

Combined: 20% 



Derived from VA Rating Decision (VARD) dated 20050726 (most proximate to date of separation [DOS]). 

 

 


ANALYSIS SUMMARY: 

 

Chronic Abdominal Pain. The MEB narrative summary (NARSUM) dated 12 January 2005 noted 
the CI had a history of multiple abdominal surgical procedures starting with laparoscopic 
appendectomy performed on 30 January 2004. The CI developed postoperative complications 
including a small bowel tear, peritonitis and subphrenic abscess which required additional 
procedures including medically induced coma and exploratory laparotomies. The CI was 
released from the hospital on 5 March 2004 and returned to active duty on 1 May 2004. On 
21 July 2004 the CI had surgery for an uncomplicated incisional hernia repair. However, the CI 
continued to complain of abdominal pain and was seen on several occasions in the emergency 
department though no surgical pathology for the pain was identified. Computer tomography 
(CT) scan performed 15 December 2004 disclosed post-surgical changes but no evidence of 
obstruction or abnormality requiring treatment or explaining the pain. The CI reported 
persistent severe pain when bending or lifting heavy loads preventing performance of duties 
and he was referred for MEB. At the VA Compensation and Pension (C&P) exam performed on 
15 February 2005, 4 months prior to separation and 3 weeks prior to the MEB, the CI reported 
frequent abdominal pain episodes located in the left lower quadrant associated with abdominal 
distension, nausea, constipation alternating with diarrhea. The examiner considered the 
functional impairment secondary to small bowel perforation, peritonitis and incisional hernia 
separately. Subsequently, the difficulties bending and lifting were noted as a consequence of 
the incisional hernia only. The physical exam indicated a well developed, well nourished male 
in no acute distress. Height was 75 inches and weight was 225 pounds. Examination of the 
abdomen noted surgical scars without tenderness, disfigurement, ulceration, adherence, 
instability, tissue loss, keloid formation, hyperpigmentation, abnormal texture or limitation of 
motion. Laboratory work did not evidence anemia. At the MEB exam performed on 5 March 
2005, 3 months prior to separation, the CI reported continuous pain that started on 14 January 
2005 and persisted to the evaluation time. He described the pain as sharp, radiating into the 
back and kidney area and rated it 4/10 (10 being the maximum level of pain experienced). The 
CI stated the pain increased to 8/10 before and during bowel movements. The general physical 
exam was normal, and noted the presence of healed surgical scars. The focal exam of the 
abdomen elicited severe lower quadrant and pelvic brim tenderness. Laboratory testing was 
normal (no anemia or results reflecting any gastrointestinal abnormality). 

 

The Board directs attention to its rating recommendation based on the above evidence. Both 
the PEB and VA rated the CI condition 10% analogously to code 7301 (adhesions of peritoneum) 
based on evidence of residual pulling pain during movements of the body, occasional episodes 
of colic, nausea, constipation alternating with diarrhea and abdominal distension. The Board 
could not assign a higher evaluation as there was not demonstrated partial bowel obstruction 
required for a 30% rating. There was no identified weight loss or anemia which would also 
warrant an increase in the rating. The Board also considered additional rating warranted by the 
presence of multiple abdominal scars secondary to surgeries however there was no direct 
functional limitation related to the scars that rendered the CI unfit. The Board concluded 
therefore that the scarring could not be recommended for additional disability rating. 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 chronic abdominal pain 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 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 abdominal pain condition and IAW VASRD §4.114, 


the Board unanimously recommends no change in the PEB adjudication. 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: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Chronic Abdominal Pain 

7399-7301 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20111019, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxx, AR20130006205 (PD201100970) 

 

 

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. Under 
the authority of Title 10, United States Code, section 1554a, I accept the Board’s 
recommendation and hereby deny the individual’s application. 

This decision is final. The individual concerned, counsel (if any), and any Members of Congress 
who have shown interest in this application have been notified of this decision by mail. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)