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AF | PDBR | CY2013 | PD 2013 01175
Original file (PD 2013 01175.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXX     CASE: PD-2013-01175
BRANCH OF SERVICE: AIR FORCE     BOARD DATE: 20140326
SEPARATION DATE: 20050912


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty MAJ/O-4 (43H3/Public Health Officer) medically separated for diabetes mellitus (DM) Type I associated with metabolic syndrome. The CI was diagnosed with DM in 2004 based on lab work obtained for a hernia repair . The DM could not be adequately rehabilitated to meet the physical requirements of his Air Force Specialty . He was issued a 4T non-worldwide, non-mobility qualified profile and referred for a Medical Evaluation Board (MEB). DM Type I and m etabolic s yndrome were forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123. No other conditions were submitted by the MEB. The I nformal PEB adjudicated DM Type I associated with metabolic syndrome as unfitting, rated 20 % , with likely application of the VA Schedule for Rating Disabilities (VASRD) . H ypertriglyceridemia was determined to be a C ategory III condition (conditions that are not separately unfitting and not compensable or ratable). The CI made no appeals and was medically separated .


CI CONTENTION: “I was never really given my disability rating. I assume it was 20%. My concern is no one ever discussed my guard time when I was being removed from active duty. I have a large amount of guard service and feel I may be eligible for a guard medical retirement.” The CI elaborated no specific contention in his application.


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 DM 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 Board for Correction of Military Records (BCMR).


RATING COMPARISON :

Service IPEB – Dated 20050718
 VA - (10.5 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Diabetes Mellitus Type I 7913 20% Diabetes Mellitus Type I 7913 20% 20060801
Hypertriglyceridemia Category III No VA Entry
No Additional MEB/PEB Entries
 Other x 5 20060801
Rating: 20%
 Combined: 60%
Derived from VA Rating Decision (VA RD ) dated 200 60816 ( most proximate to date of separation [ DOS ] ).


ANALYSIS SUMMARY: The Board acknowledges the CI’s contention regarding eligibility for a guard retirement. The Board does not have the jurisdiction to offer remedy in reference to decisions of this nature. That authority resides with the BCMR.

Diabetes Mellitus Type I. The CI was first noted to have elevated blood glucose levels in February 2004 which was initially controlled by diet. He was given a diagnosis of glucose intolerance with continued glucose monitoring. In February 2005, the CI was diagnosed with DM and started on medications and diet restrictions. Antibody testing performed on 20 April 2005 evidenced an autoimmune etiology (Type I) to the CI’s persistently elevated blood glucose level and he was started on Insulin. The narrative summary, 4 months prior to separation, notes that the CI continued to have elevated blood glucose levels and was on two antihyperglycemic medications. The physical examination was normal with no evidence of cardiovascular or neurologic abnormalities. At the VA Compensation and Pension examination performed 10 months after separation, the CI reported intermittent fatigue. He denied the presence of heart disease, numbness or tingling of his extremities and bowel or bladder impairment (evidence of neurologic involvement). The examiner noted that he was on Insulin; Lantus in the morning and Humalog twice a day. The physical examination was normal except for bilateral shoulder pain.

The Board directs attention to its rating recommendation based on the above evidence. The PEB adjudicated the Type I DM as unfitting. The PEB and VA conferred a 20% disability rating for Insulin use and diet restriction, coded 7913, DM, Type I. There was no evidence of regulation of activities; episodes of ketoacidosis or hypoglycemic reactions requiring hospitalizations or diabetic care visits; or cardiovascular, renal or neurologic impairments for a higher 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 DM Type I 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 DM Type I 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 re-characterization of the CI’s disability and separation determination.


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20130826, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record






                 
XXXXXXXXXXXXXX
President
Physical Disability Board of Review
SAF/MRB
Dear XXXXXXXXXXXXXX:

         Reference your application submitted under the provisions of DoDI 6040.44 (Title 10 U.S.C. § 1554a), PDBR Case Number PD-2013-01175.

         After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate. Accordingly, the Board recommended no re-characterization or modification of your separation.

         I have carefully reviewed the evidence of record and the recommendation of the Board. I concur with that finding and their conclusion that re-characterization of your separation is not warranted. Accordingly, I accept their recommendation that your application be denied.

                                                               Sincerely,
XXXXXXXXXXXXXX
Director
Air Force Review Boards Agency
Attachment:
Record of Proceedings

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