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AF | PDBR | CY2014 | PD-2014-01778
Original file (PD-2014-01778.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXX       CASE: PD-2014-01778
BRANCH OF SERVICE: AIR FORCE     BOARD DATE: 20141212
SEPARATION DATE: 20051012


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4 (Morse Operator) medically separated for diabetes. The condition could not be adequately rehabilitated to meet the requirements of his Air Force Specialty. He was issued a temporary P4 profile and referred for a Medical Evaluation Board (MEB). Type I diabetes mellitus (DM) was forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123. No other condition was submitted by the MEB. The Informal PEB adjudicated “Diabetes Mellitus, Type I” as unfitting, rated 20%, citing application of the VA Schedule for Rating Disabilities (VASRD). The CI made no appeals and was medically separated.


CI CONTENTION: “Please consider all conditions. Have had difficulty maintaining/obtaining employment in civilian workforce since discharge; would have continued my military service if not for the injuries. Lost my car as a result of the incident”


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 20050818
 VA* - (~3 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Diabetes Mellitus, Type I 7913 20% Diabetes Mellitus, Type I 7913 20% 20060104
Other x 0 (Not In Scope)
 Other x 0
RATING: 20%
 RATING: 20%


ANALYSIS SUMMARY:

Diabetes Mellitus, Type I. The narrative summary (NARSUM) noted the CI’s DM condition first manifested itself in February 2001 when he developed diabetic ketoacidosis with extreme blood sugar levels requiring admission to the intensive care unit of a hospital for emergent intravenous insulin therapy. Following discharge from the hospital, the condition was stabilized with a treatment program of daily insulin injections, monitoring of blood sugars three times daily, dietary regulation and regular exercise. A permanent profile on 1 August 2005, placed no activity restrictions on the CI, allowing him to walk, run and swim at his own pace, to take the routine physical fitness test and to participate in all military functional activities and body building exercises without restriction. At the MEB/NARSUM examination the CI reported no symptoms of uncontrolled DM (polyuria/nocturia/polydipsia). There were no documentations of visits to the emergency department or hospitalizations for emergent treatment of the DM condition or any of its complications. The physical examination was normal with no evidence of any complication of diabetes. The VA Compensation and Pension exam, scheduled for 4 January 2006, was not performed because the CI failed to appear.

The Board directed its attention to its rating recommendation based on the above evidence. The PEB and VA both rated the DM condition at 20%, coded 7913 (diabetes mellitus), IAW VASRD §4.119. This rating requires use of insulin and dietary restriction. A higher rating of 40% requires insulin use, dietary restriction and regulation of activity. The Board undertook to determine if the 40% rating was indicated for “regulation of activity.” The Board noted that VASRD §4.119, defines regulation of activity for a diabetic condition as “avoidance of strenuous occupational or recreational activities.” The Board noted the permanent profile of 1 August 2005 with no restrictions as noted above. The Board found no other prescriptions for restriction of activity by any health care provider in the record in evidence. The Board noted no episodes of recurrent hypoglycemia/hyperglycemia or other diabetic complications related to physical activity prior to separation. The Board unanimously agreed the record in evidence reflected no impairment in ordinary conditions of daily life and no medically prescribed avoidance of strenuous activities due to the diabetic condition and thus could not recommend the 40% rating. The Board found no other appropriate codes for rating consideration. 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 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 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 20140, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record








                                   
XXXXXXXXXXXXXXXXXXXX
President
DoD Physical Disability Board of Review

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762
Dear XXXXXXXXXXXXXXXXXXXX :

 Reference your application submitted under the provisions of DoDI 6040.44 (Title 10 U.S.C. § 1554a), PDBR Case Number PD-2014-01778.
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,
XXXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency
Attachment:
Record of Proceedings

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