RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE: NAVY 

 
NAME: XXXX 
CASE NUMBER:  PD1200250                                                              SEPARATION DATE:  20040611 
BOARD DATE:  20121031 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty Naval Officer, LCDR/0-4 (9640, Op Intel), medically 
separated  for  Factor  II  Mutation.    The  CI  developed  a  blood  clot  in  his  right  calf  after  a 
prolonged  air  flight  and  was  determined  to  have  a  congenital  blood  disorder  (Factor  II 
Mutation)  which  can  cause  excessive  blood  clotting.    He  was  treated  with  long  term 
anticoagulation  (Coumadin)  and  referred  for  a  Medical  Evaluation  Board  (MEB).    The  MEB 
forwarded Factor II Mutation as medically unacceptable IAW SECNAVIST 1850.4E citing risks of 
hemorrhage  while  anticoagulated  during  military  service.    The  MEB  forwarded  no  other 
conditions for Informal Physical Evaluation Board (IPEB) adjudication.  The IPEB adjudicated the 
condition as unfitting, rated 0%, with application of the Veteran’s Affairs Schedule for Rating 
Disabilities (VASRD).  The CI appealed to the Formal PEB (FPEB), but withdrew his appeal, when 
the disability rating was adjusted to 10% by an interim reconsideration PEB.  The CI made no 
further appeals and was medically separated with a 10% disability rating. 
 
 
CI CONTENTION: The CI states: “The 10% rate was based on the assumptions that: 1.) onetime 
localized event, 2.) due to aggravating circumstance, 3.) not requiring lifelong meds.  All three 
assumptions  were  proved  false  in  July  2010  when  I  was  admitted  to  ICU  with  multiple 
pulmonary  emboli  (illegible)  aggravating  reason  &  requiring  lifelong  meds.    A  full  review 
package  with  12  enclosures  was  submitted  to  the  Veterans  Administration  in  Seattle  on  6 
March.  The case review is under my social sn. [sic] All assumptions of Med Review Board, and 
review by hematol/oncol [sic] clinic Bethesda 8 April 2004 proved false by medical events of 
July/August 2010.  3 days in ICU, easily could have died, lifelong medication.”  
 
 
SCOPE OF REVIEW:  The Board wishes to clarify that the scope of its review as defined in the 
Department of Defense Instruction (DoDI) 6040.44 (Enclosure 3, paragraph 5.e.(2) 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  condition(s)  “identified  but  not 
determined to be unfitting by the PEB.”  The ratings for unfitting conditions will be reviewed in 
all cases.  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 Naval Records.   
 
 
RATING COMPARISON:  
 

VA (3 Mos. Post-Separation) – All Effective Date 20040612 

Condition 

Code 

Rating 

Deep Venous Thrombosis 
w/Associated Factor II Mutation  
S/P  Ventral  Hernia Repair…..   

7121 

7338 

10%* 

0%** 

0% X 0 / Not Service-Connected x 0 

Exam 

20040909

& 

20040922 
20080327 
20040909 

Service Recon PEB – Dated 20031104 
Condition 

Code 

Rating 

Factor II Mutation 

7121 

10% 

↓No Additional MEB/PEB Entries↓ 

 

 

Combined: 10% 
      * Continued on VARD 20080919         

**Added by VARD of 20080919 effective the day after separation. 

Combined:  10% 

 
ANALYSIS SUMMARY:  The Disability Evaluation System (DES) is responsible for maintaining a fit 
and  vital  fighting  force.    While  the  DES  considers  all  of  the  member's  medical  conditions, 
compensation  can  only  be  offered  for  those  medical  conditions  that  cut  short  a  member’s 
career, and then only to the degree of severity present at the time of final disposition.  The DES 
has neither the role nor the authority to compensate members for anticipated future severity 
or  potential  complications  of  conditions  resulting  in  medical  separation  nor  for  conditions 
determined  to  be  service-connected  by  the  Department  of  Veteran  Affairs  (DVA)  but,  not 
determined to be unfitting by the PEB.  However the DVA, operating under a different set of 
laws  (Title  38,  United  States  Code),  is  empowered  to  compensate  all  service-connected 
conditions  and  to  periodically  re-evaluate  said  conditions  for  the  purpose  of  adjusting  the 
Veteran’s disability rating should the degree of impairment vary over time.  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  VASRD  standards,  based  on  severity  at  the  time  of 
separation.  The Board has neither the jurisdiction nor authority to scrutinize or render opinions 
in reference to the CI’s statements in the application regarding suspected DES improprieties in 
the processing of his case or quality of medical care rendered.  
  
Factor II Mutation. The CI developed swelling in his right lower leg after a 13 hour airline flight. 
Doppler ultrasound study (US) obtained 12 January 2003 documented a venous clot (DVT) in 
the veins of his right lower leg.  The CI was treated with an initial course of anticoagulation with 
subcutaneous heparin followed by oral anticoagulation with Coumadin without complication.  
Extremity swelling had resolved by 16 January 2003 and subsequent US, obtained 17 April 2004 
demonstrated  complete  resolution  of  the  DVT.    Coagulation  studies  identified  the  Factor  II 
Mutation condition, and Coumadin therapy was continued with a plan for indefinite treatment.  
CI was instructed to wear prescribed compression stockings when on airline flights.  At the MEB 
exam performed 10 July 2003, approximately a year before separation, the patient was taking 
Coumadin  without  complication.    Examination  of  the  lower  extremities  was  recorded  as 
normal.  Three VA Compensation and Pension (C&P) exams were performed, all approximately 
3 months after separation.  C&P exam, performed on 9 September 2004, the CI reported taking 
Coumadin  without  complication.    Examination  of  the  lower  extremities  revealed  no  edema, 
ulceration or skin changes.  Motor and sensory functions and gait were normal.  The examiner 
noted ‘no conditions which would impact the veteran ability to perform normal daily routine or 
work  related  activities.’    At  the  C&P  hematology  examination  performed  on  22  September 
2004,  a  slight  firmness  of  the  right  leg,  without  any  evidence  of  serious  overt  post  phlebitis 
syndrome  was  reported.    The  C&P  vascular  exam,  performed  on  25  September  2004,  the  CI 
reported  some  aching  and  swelling  in  both  calves  at  the  end  of  the  day  relieved  by  leg 
elevation.    He  noted  exercising  and  running  3  miles  at  a  time  a  few  times  a  week  without 
sequelae.    On  examination  of  the  lower  extremity,  no  varicosities,  skin  ulcers,  edema,  stasis 
pigmentation  or  eczematous  changes  were  noted.    The  Board  directs  attention  to  its  rating 
recommendation  based  on  the  above  evidence.    Both  the  PEB  and  VA  rated  the  left  leg 
condition  10%  code  7121,  post  phlebitis  syndrome.    The  10%  rating  requires  intermittent 
edema  or  aching  and  fatigue  in  the  leg  after  prolonged  standing  or  walking  and  symptoms 
relieved  by  elevation  or  compression  therapy.    A  higher  rating  0f  20%  requires  persistent 
edema  with  or  without  stasis  changes,  pigmentation  or  eczema.    The  Board  unanimously 
agreed  that  there  were  no  findings  in  the  record  in  evidence  which  would  support  the  20% 
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 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 

   2                                                           PD1200250 
 

surmise  from  the  record  or  PEB  ruling  in  this  case  that  any  prerogatives  outside  the  VASRD 
were exercised.  In the matter of the Factor II Mutation condition and IAW VASRD §4.104, 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 

7121 

COMBINED 

10% 
10% 

Factor II Mutation  

 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120307, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

             
           President 
           Physical Disability Board of Review 

   3                                                           PD1200250 
 

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 7 Nov 12 

 

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

 

 
 
 
 
 
 
 
 
 

     

 

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  
  Assistant General Counsel 
  (Manpower & Reserve Affairs) 

   4                                                           PD1200250