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AF | PDBR | CY2013 | PD-2013-01893
Original file (PD-2013-01893.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX         CASE: PD-2013-01893
BRANCH OF SERVICE: Army  BOARD DATE: 20141212
SEPARATION DATE: 20040319


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-6 (CID Special Agent) medically separated for Crohn’s disease. The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty. He was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB). Crohn’s disease was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The Informal PEB adjudicated Crohn’s disease as unfitting rated 10%, with likely application of the VA Schedule for Rating Disabilities (VASRD). The CI made no appeals and was medically separated.


CI CONTENTION: 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 when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting. Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military/Naval Records. Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate. The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions. That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws. The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.


RATING COMPARISON :

Service IPEB – Dated 20031230
 VA - Based on Service Treatment Records (STR)
Condition
 Code Rating Condition Code Rating Exam
Crohn’s Disease 7399-7323 10% Crohn’s Disease 7323 NSC* STR
Other x 0 (Not in Scope)
 Other x 0
Rating: 10%
 Combined: 0%
Derived from VA Rating Decision (VARD) dated 20071107 ( most proximate to date of separation [DOS]).
* VARD dated 20080710 indicates a rating of 10% for the Crohn’s Disease based on a C&P exam specific to that condition dated 20080505.




ANALYSIS SUMMARY:

Crohn’s Disease. The CI was diagnosed with Crohn’s disease in April 2003. Seven months prior to separation, he denied having abdominal pain, he was having normal bowel movements, normal labs and was responding well to medications. The narrative summary noted he was having abdominal pain and diarrhea that did awaken him from sleep, but he had no hospitalizations since diagnosis, no planned surgeries and no serious complications from the condition. At the MEB exam, the CI reported no symptoms related to his Crohn’s disease except for a 42-pound loss of weight since diagnosis. This was over 20% from baseline weight; however, the body mass index decreased from 28 [overweight] to 23 [normal weight]. The MEB physical exam noted a normal abdominal exam and the examiner stated “the patient does look fairly well-nourished.” The CI failed to show for his first VA Compensation and Pension exam in 2007 and his claim for service-connection was denied. In 2008, 3 years later, the CI was initially rated at 0% as he denied vomiting, bleeding or incontinence (loss of bowel or bladder contents). After undergoing abdominal surgery in 2008 (3 years remote from separation) for complications from his Crohn’s disease, the CI was briefly given a 100% rating which was subsequently reduced to 10 % 3 months later.

The Board directed attention to its rating recommendation based on the above evidence. The Informal PEB assigned a 10% rating under code 7399-7323 (colitis, ulcerative) per the VASRD. The 10% criteria are “moderate; with infrequent exacerbations.” At the time of separation, the CI was doing well on medications alone. There was insufficient evidence to assign a 30% rating (“moderately severe; with frequent exacerbations”) as he was not having severe or frequent exacerbations. The VA later granted a service-connection in 2008 but gave a 0% (changed to 10%) rating stating that the CI was not having any symptoms related to his disease. The CI’s surgery in 2008 was remote from separation and not indicative of the CI’s disability picture proximate to separation. 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 Crohn’s disease.


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 Crohn’s Disease 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 re-characterization of the CI’s disability and separation determination.


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20130911, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record

                 
XXXXXXXXXXXXXXXXXX
President
DoD Physical Disability Board of Review

SAMR-RB                                                                         


MEMORANDUM FOR Commander, US Army Physical Disability Agency
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557


SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for. XXXXXXXXXXXXXXXXXX, AR20150008345 (PD201301893)


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                       XXXXXXXXXXXXXXXXXX
                           Deputy Assistant Secretary of the Army
                           (Review Boards)
                 
CF:
( ) DoD PDBR
( ) DVA

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