RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:   ARMY  
SEPARATION DATE:  20030515 

 
NAME:  XXXXXXXXXXXXXXXX 
CASE NUMBER:  PD1201573 
BOARD DATE:  20130201 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  2LT/0-1  (11A/Infantry),  medically  separated  for 
diabetes mellitus (DM) Type I.  The condition was diagnosed in October 2002 and treatment 
with Insulin initiated.  Treatment with Insulin was disqualifying and he was issued a permanent 
P3  profile  and  referred  for  a  Medical  Evaluation  Board  (MEB).    The  left  shoulder  instability 
condition, identified in the rating chart below, was also forwarded by the MEB.  The Physical 
Evaluation  Board  (PEB)  adjudicated  the  DM  Type  I  condition  as  unfitting,  rated  20%,  with 
application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD).  The left shoulder 
instability condition was determined to be not unfitting and therefore not rated. The CI made 
no appeals, and was medically separated with a 20% disability rating.   
 
 
CI CONTENTION:  The CI reports his diabetes control “has generally been good up until last past 
year”,  despite  diet  and  lot’s  of  exercise,  and  is  now  on  an  insulin  pump.    He  elaborates  no 
specific contention in his application.  
 
 
SCOPE OF REVIEW:  The Board wishes to clarify that the scope of its review as defined in 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 Army Board for Correction of Military Records.   
 
 
RATING COMPARISON:   
 

 
 
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  Veterans  Affairs  (DVA)  but  not 

Service PEB – Dated 20030305 
Condition 

Diabetes Mellitus Type I 
Left Shoulder Instability 

Combined:  20% 

Rating 
Code 
7913 
20% 
Not Unfitting 

Condition 
Diabetes Mellitus Type I 
L Shoulder s/p Arthroscopic Surgery 

Code 
7913 

5299-5201 

Rating 
20% 
0% 

Exam 

20030104 
20030104 

VA (4mos Pre-Separation) – All Effective Date 200516 

Combined:  20% 

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.   
 
Diabetes Mellitus Type I Condition.   The CI was hospitalized 10 October 2002 and diagnosed 
with  Type  I  DM,  stabilized  over  2  days,  and  discharged  from  the  hospital  on  Insulin.    The 
hospital  discharge  summary/instruction  sheet,  dated  12  October  2002,  reported  the  CI’s 
condition as “stable” and reported activities/limitations as “unrestricted.”  The MEB narrative 
summary (NARSUM), 15 January 2003, reported that the CI was followed by an endocrinologist 
and maintained fairly good control of his diabetes.  The CI was able to continue physical training 
at his own pace and distance.  He had no complaints of illness or weakness at that time.  After 
stabilization on treatment, there was no evidence of ketoacidosis or hypoglycemia, requiring 
hospitalizations.  The MEB examination performed on 20 December 2002 described the CI as a 
thin white male in no acute distress.  The CI’s physical examination was absent any abnormal 
findings.    The  MEB  recommendation  to  the  PEB  states  that  the  CI  did  not  meet  medical 
standards  for  retention  in  the  military.    At  the  VA  Compensation  and  Pension  (C&P) 
examination, 4 January 2003, 4 months prior to separation, the CI reported that his diabetes 
had caused restriction in terms of his ability to continue his military training.  He reported he 
had a 25 pound weight loss but he had regained 20 pounds since his initial diagnosis of DM.  
The CI was capable of performing activities of daily living.  The examiner reported that the CI 
was able to walk, climb stairs, shop, vacuum, garden, drive a car, take out trash, and mow the 
lawn.  The CI was performing sedentary duties at work but the VA examiner felt the CI should 
be as active as possible.  The examiner noted that the CI had no restrictions of his activities.  
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  and  VA  chose  the  same  coding  options  for  the  condition  and  both  were  IAW  §4.119 
(Schedule  of  ratings-endocrine  system).    The  PEB  coded  7913  rated  at  20%  and  this  criteria 
requires  Insulin  and  restricted  diet,  or;  oral  hypoglycemic  agent  and  restricted  diet.    The  VA 
coded  7913  rated  at  20%  based  on  the  same  criteria.    The  review  of  the  service  treatment 
records  indicate  that  the  CI  had  was  responding  well  to  his  treatment  following  his  initial 
hospitalization in which he was diagnosed.  There were no subsequent episodes of ketoacidosis, 
hypoglycemic reactions, or hospitalizations documented proximate to the time of separation to 
meet the  criteria  of  one  of the  higher  ratings under the  code  7913.    The  determining  factor 
between the 20% and 40% rating is the presence of regulation of activities which is defined as 
avoidance  of  strenuous  occupational  or  recreational  activities  by  the  VASRD.    There  was  no 
evidence that the CI was advised by a physician to avoid strenuous occupational or recreational 
activities due to his DM diagnosis.  Both the MEB and PEB physician examiners recommended 
that the CI have no restriction of physical activities.  Board members agreed that there was no 
evidence  to  support  that  a  physician  had  indicated  that  the  CI’s  condition  was  unstable  and 
required  regulation  of  activities.    The  Board  agreed  with  both  the  PEB  and  VA  that  the  DM 
condition  was  properly  rated  at  20%.    After  due  deliberation  in  consideration  of  the 
preponderance  of  the  evidence,  the  Board  concluded  that  there  was  insufficient  cause  to 
recommend a change in the PEB fitness determination for the DM 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.  In the matter of the DM 
condition 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  RATING 

7913 

COMBINED 

20% 
20% 

Diabetes Mellitus Condition 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120806, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXXXXX, DAF 
           Acting Director 
           Physical Disability Board of Review 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / XXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation 
for XXXXXXXXXXXXXXXXX, AR20130003018 (PD201201573) 
 
 
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 
 
 
 

     XXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)