RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  NAVY 
DATE OF PLACEMENT ON TDRL:  20041216 
DATE OF PERMANENT SEPARATION:  20091014 

 
NAME:  XX 
CASE NUMBER:  PD1100624 
BOARD DATE: 20130206 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty HM1/E-6 (Hospital Corpsman) medically separated 
for  diabetes  mellitus  (DM)  Type  1.    He  was  treated, but  did  not  improve  adequately  to fully 
perform his military duties or meet physical fitness standards.  He was placed on limited duty 
(LIMDU) and underwent a Medical Evaluation Board (MEB).  The MEB found his Type 1 diabetes 
medically  unacceptable,  and  referred  him  to  a  Physical  Evaluation  Board  (PEB).    No  other 
conditions were listed on the NAVMED Form 6100/1.  The PEB found the diabetes condition 
unfitting, but not sufficiently stable for final, permanent adjudication.  The CI was placed on the 
Temporary  Disability  Retired  List  (TDRL)  with  a  40%  disability  rating.    In  September  2009,  a 
second  Navy  PEB  was  convened.    He  was  found  unfit  due  to  DM,  and  separation  was 
recommended  at  20%  IAW  the  Veterans’  Administration  Schedule  for  Rating  Disabilities 
(VASRD).    The  CI  accepted  the  PEB  findings  and  was  medically  separated  with  20%  disability 
rating.   
 
 
CI CONTENTION:  “My condition was severely worse than the rating I received at the time of my 
final decision.  The VA has increased my rating due to the decline in my health.  I have a letter in 
my record dated 14 September 2004 that I am a brittle diabetic limited by a very restricted diet 
and modification of daily activities and needed an insulin pump.  This was not reviewed during 
my initial rating.  The need for an insulin pump is documented throughout my health records at 
the time of my final decision the board of review was not aware of this and the military health 
system did not assist me in obtaining needed health equipment.  Through the diligence of my 
civilian providers I was able to get the insulin pump by spending an incredible amount of my 
own money.  In 2006 I was diagnosed with left and right leg diabetic neuropathy in May 2011 
the VA increased my rating due to neuropathy secondary to Type 1 Diabetes.”  
 
 
SCOPE OF REVIEW:  The Board’s scope of review as defined in DoDI 6040.44, is limited to those 
conditions which were determined by the PEB to be specifically unfitting for continued military 
service; or, when requested by the CI, those conditions “identified but not determined to be 
unfitting by the PEB.”  The unfitting Type 1 diabetes condition meets the criteria prescribed in 
DoDI 6040.44, and is accordingly addressed below.  No other conditions are within the Board’s 
purview.  Any condition outside the Board’s defined scope of review may be eligible for future 
consideration by the Board for Correction of Naval Records.   
 
 
 
 
 
 
 
 
 
 
 

 
RATING COMPARISON: 
 

Final Navy PEB – dated 20090928 

VA – Effective Date 20041216 

Condition 

Code 

 

Type 1 Diabetes 

 

7913 
 

Rating 

TDRL 
40% 

Sep. 
20% 

↓No Additional MEB/PEB Entries↓ 

Condition 

Diabetes Mellitus, Type 1 
Left Shoulder Pain  
Left Knee Pain 
Neuropathy, Left Leg*  
Neuropathy, Right Leg* 
Tinea Versicolor 

Code 
7913 
5024 
5257 

8599-8520* 
8599-8524* 
7813-7806 

0% x 2 / Not Service Connected x 3 

Rating 
20% 
10% 
10% 
10%* 
10%* 
10% 

Exam 

20110415 
20101204 
20101204 
20110415 
20110415 
20101204 
20101204 

Combined:  20% 

Combined:  60% 

* VA ratings for Neuropathy were not in the original VA Rating Decision (VARD), but were added by a subsequent VARD dated 20110914 
 
 
ANALYSIS SUMMARY:  The Board acknowledges the CI’s assertion that the Navy may not have 
considered all the information in his record, and may not have assisted him in obtaining needed 
health  equipment.    For  the  record,  the  Board  has  neither  the  jurisdiction  nor  authority  to 
scrutinize or render opinions in reference to asserted improprieties.  Furthermore, the Board 
wishes  to  clarify  that  its  relevant  recommendations  are  assigned  in  assessment  of  the 
permanent  separation  and  rating  determination,  and  the  TDRL  rating  assignment  is  not 
considered a benchmark.  It is recognized, in fact, that PEB’s sometimes may apply an overly 
generous initial rating in order to meet the DoD requirement of 30% disability for placement on 
TDRL.  This is in the member’s best interest at the time and does not mean that a final lower 
rating is unfair, even if perceived as incongruent with subjective severity from one rating to the 
next.    The  sole  basis  for  the  Board’s  permanent  disability  recommendation  is  the  optimal 
VASRD rating for disability at the time the CI is permanently separated from service.  In cases 
encompassing a period of TDRL, although the Board’s review of fitness adjudications is relevant 
to  the  time  of  temporary  retirement,  the  Board’s  rating  recommendations  are  based  on 
severity evidenced at the time of permanent separation.   
 
Diabetes Mellitus (DM) Type 1.  In July 2003, the CI presented with a history of weight loss, 
polyuria,  and  polydipsia.    He  was  diagnosed  with  DM  and  was  started  on  Insulin  &  dietary 
restriction.  Control of his blood sugar was achieved.  A Navy PEB was convened in August 2004. 
The  CI  was  placed  on  TDRL  with  a  disability  rating  of  40%.    The  Board  considered  all  the 
evidence, and determined that a 40% rating at that time was appropriate.  A higher rating of 
60%  would  require  “insulin,  restricted  diet,  and  regulation  of  activities  with  episodes  of 
ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice a 
month visits to a diabetic care provider, plus complications that would not be compensable if 
separately evaluated.”  Since the treatment record does not show sufficient evidence of these 
findings, the Board has no basis to recommend a rating higher than 40%, at the time of initial 
placement on TDRL.   
 
In January 2008, the CI had a periodic clinical re-evaluation.  Blood sugar was being controlled 
with  insulin  and  restricted  diet.    The  physical  examination  (PE)  was  normal.    Medically 
prescribed regulation of activities was not mentioned.  Nineteen months later, on  12 August 
2009, another clinical re-evaluation was conducted.  The hemoglobin A1C was 6.4, indicating 
good control of blood sugar (BS).  The CI reported that sometimes his BS would go over 300, but 
this was usually associated with dietary indiscretion.  The PE was normal.  Medically prescribed 
regulation of activities was not mentioned.  In December 2010, the CI had a VA Compensation 
and  Pension  (C&P)  exam.    At  that  time,  BS  was  being  controlled  with  an  Insulin  pump  and 
restricted diet.  The CI had no active complaints or symptoms related to his DM.  He denied any 

2                                                           PD1100624 
 

episodes  of  ketoacidosis  or  hospitalization.    He  reported  that  his  hypoglycemic  trouble  had 
largely resolved since he had begun therapy with the insulin pump.  He was seeing his diabetic 
care providers every 3 to 6 months, and they had not restricted his activities.  He was working 
as an entomologist.  The CI reported that his activities of daily living and employability were not 
limited by his DM, except when he had difficulty finding food. 
 
The Board carefully reviewed all evidentiary information available, and directs attention to its 
rating recommendation based on the above evidence.  The CI required insulin and restricted 
diet, but did not require medically prescribed regulation of activities.  Regulation of activities is 
when a licensed healthcare provider prescribes or recommends that a diabetic patient avoid 
strenuous occupational or recreational activities.  In the CI’s treatment record, there was not 
sufficient  evidence  that  this  was  the  case.    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 diabetes 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  Type  1  diabetes  and  IAW  VASRD  §4.119,  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 

7913 

COMBINED 

RATING 

 

20% 
20% 

Type 1 Diabetes Mellitus 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20110810, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

           xx 
           Acting Director 
           Physical Disability Board of Review 

3                                                           PD1100624 
 

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW  
                                        BOARDS  

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 

Ref:   (a) DoDI 6040.44 

             (b) CORB ltr dtd 26 Feb 13 
 

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for 
the reasons provided in their forwarding memorandum, 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 previously assigned by the Department of the Navy’s 
Physical Evaluation Board: 
 
 

 

 

 

     
 
 
 
 

-   former USMC 
-   former USN  
-   former USMC 
-   former USMC 
-   former USN  
-   former USMC 
  
 

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  xx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

4                                                           PD1100624