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AF | PDBR | CY2013 | PD-2013-02242
Original file (PD-2013-02242.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX     CASE: PD -20 13 - 0 2242
BRANCH OF SERVICE: Army   BOARD DATE: 2014 0801
Separation Date: 20050831


SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SPC/E-4 (63J/Quartermaster and Chemical Repair) medically separated for diabetes mellitus (DM). The condition could not be adequately rehabilitated to meet the physical requirements of her Military Occupational Specialty or satisfy physical fitness standards. She was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB). The diabetes Type I condition characterized as “Diabetes Type I fails retention standards” and was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The Informal PEB adjudicated “diabetes mellitus, Type I” as unfitting, rated at 20%, with likely application of Veterans Affairs Schedule for Rating Disabilities (VASRD). The CI made no appeals and was medically separated.


CI CONTENTION : “I believe my rating is inaccurate because the military discharge me while I was put on insulin and I became diabetic in the Army. I am now on pills and insulin and re-enlisted to stay in the Army. I believe I deserve to have medical on post and dental. I also had to dependents at the time of my discharge who do not get medical or dental with the VA. I believe I should still have rights to go on base and shop since I did not choose to get out.”


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 , T ype I 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.


RATING COMPARISON :
invalid font number 31502
Service IPEB – Dated 20050527
 VA - (16 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Diabetes Mellitus, Type I 7913 20% Type I Diabetes Mellitus 7913 20% 20051206
No Other Items In Scope
Combined: 20%
 Combined: 20%
Derived from VA Rating Decision (VARD) dated 20060130 (most proximate to date of separation )


ANALYSIS SUMMARY :

 Diabetes Mellitus, Type I Condition . The CI was diagnosed with gestational diabetes during her first pregnancy in November 2003 and started on oral medications. Her sugars normalized after child birth. At a routine checkup after child birth ( March 2004) , t he CI was noted to have blood glucose of 161 and was sta rted on an oral hypoglycemic (G lyburide). She was seen by Nutrition ist and started on an 1800 calorie diabetic diet along with meal planning and diet education. Glycosylated hemoglobin ( HgbA1C) was 6.0- nea r normal . The CI had one hospitalization for symptoms of frequent urination, weight loss (15 to 20 pounds ) and a blood glucose greater than 500 ; she was stated on Humulin 70/30 regular insulin with a 2000 calorie diet and activity as desired. The CI was given a P3 p rofile for T ype I DM with regulation of activities noted as no work environment grea ter than 90 degrees of temperature and no operating heavy equipment.

The c ommander’s s tatement indicated that the CI’s condition prevented her from participating in critical field exercises and prevented her from deploying. Due to her condition of having a high occurrence of blurred vision, she was prevented from operating heavy machinery and driving for long distances. The c ommander recommended that the CI be reclassified to accommodate her medical condition and allow her to remain on a ctive d uty.

The MEB narrative summary exam ( performed approximately 5 months prior to separation ) documented that since she was started on insulin, the blood sugars were well controlled. The examiner documen ted that the CI could not do unlimited running, walking, biking or swimming. The examiner further opined that she should not be allowed to operate heavy equipment. The e ndocrinologist noted that the CI had an HgbA1C of 6.9 and adjusted the bedtime and morning insulin dosages.

T he VA Compensation and Pension exam ( approximately 3 months after separation ) documented that the CI continued with insulin medication and that her blood sugar levels elevated if she was under a lot of stress. The HgbA1C was 7.4 and the urinalysis was positive for glucose. At the time of this exam, the diabetes was poorly controlled.

The Board directs attenti on to its rating recommendation based on the above evidence . The PEB and the VA coded the DM Type I condition as 7913 ( DM ) and rated at 20% r equiring insulin and restricted diet; or oral hypoglycemic agent and restricted diet. There was documentation proximate to separation that the CI was taking her insulin and continued on a 2000 calorie diabetic diet. There was ample documentation that the CI was profiled for diabetes with activity regulation of no work environment greater than 90 degrees of temperature and no operating heavy equipment. The c ommander documented that the CI was prevented from operating heavy machinery and driving for long distances. The MEB examiner documented that the CI could not do unlimited running, walking, biking or swimming and further opined that she should not be allowed to operate heavy equipment . The Board considered the 20% rating versus a 40% rating (r equiring insulin, restricted diet and regulation of activities ) . After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 20% 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 diabetes mellitus Type I condition, the Board unanimously recommends a disability rating of 20% coded 7913 IAW VASRD §4. 121 a. 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 20 131001 , w/atchs
Exhib it B. Service Treatment Record
Exhibit C. Department of Veterans ’ Affairs Treatment Record





                                                              
XXXXXXXXXXXXXXX
President
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 XXXXXXXXXXXXXXX, AR20150004775 (PD201302242)


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

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