RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX	CASE:  PD-2013-01487
BRANCH OF SERVICE:  Army	BOARD DATE:  20141003
SEPARATION DATE:  20040227

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SPC/E-4 (56M/Chaplain Assistant) medically separated for diabetes mellitus (DM) Type II condition.  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards.  He was issued a permanent P3 profile, could perform alternate aerobic conditioning exercises and subsequently referred for a Medical Evaluation Board (MEB).  The diabetes condition, characterized as “type II diabetes mellitus,” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other conditions were  submitted by the MEB.  The PEB adjudicated “diabetes mellitus, type II, poor control, requiring insulin and restricted diet” as unfitting, rated 20%, referencing the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.

CI CONTENTION:  “After being discharged it was discussed that I am a Type I diabetic and not a type II Diabetic.  I have included a copy of my progress notes from my care provider with the statement that I am a Type I…” (sic)

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 Type II DM condition is addressed below; 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:

Service IPEB – Dated 20031210	VA - (5 Mos. Post-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Diabetes Mellitus, Type II	7913	20%	Diabetes Mellitus Type II	7913	20%	20040722	
Other x 0  (Not in Scope)	Other 7  (Not in Scope)	20040722	
Combined:  20%	Combined:  30%	
Derived from VA Rating Decision (VARD) dated 20040916 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:  The Board utilizes VA evidence proximal to separation in arriving at its recommendations; and, DoDI 6040.44 defines a 12-month interval for special consideration to post-separation evidence.  The Board’s authority as defined in DoDI 6044.40, however, resides in evaluating the fairness of the Disability Evaluation System fitness determinations and rating decisions for disability at the time of separation.  Post-separation evidence therefore is probative only to the extent that it reasonably reflects the disability and fitness implications at the time of separation.

Diabetes Mellitus Condition.  The service treatment record contained a scant amount of source documents regarding this condition and most historical information was obtained from MEB related summary reports.  During the 13-month period from the initial diagnosis to the CI’s separation, the DM condition was initially managed with a varied dose of an oral hypoglycemic agent, as well as dietary education and restrictions of activities with poor results.  Daily insulin was added to his medication regime.  The records did not reveal any history of significant complications of DM nor of any hospitalizations for the same.  The CI was issued a permanent profile that restricted his duty assignments so as to assure access to medications and appropriate medical care.  Notably, the profile provided for no activity restriction whatsoever.  The commander’s statement reiterated the CI’s restriction from world-wide deployment, but emphasized the CI’s ability to perform many other aspects of his MOS duties, to include the Army’s fitness test.  Neither the MEB (24 October 2003…4 months prior to separation) nor VA (22 July 2004…3 months after separation) examiner noted findings on the physical examination that pertain to the VASRD rating of the diabetes condition.  The clinical evidence at the time of separation was consistent with a 20% rating IAW VASRD §4.120 as determined by the PEB.  There was no laboratory evidence that ketoacidosis or hypoglycemia were manifested at any time since the original diagnosis.  Neither the physical profile nor commander’s statement, as presented above, provided evidence that any regulation of routine activities was imposed by the DM condition.  Upon deliberation Board members agreed that the 40% rating criteria under 7913 were not reasonably supported by the evidence at hand and there is not reasonable doubt in the CI’s favor, therefore, to justify a Board recommendation for other than the 20% rating assigned by the PEB for the diabetes 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 condition and IAW VASRD §4.120, 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 20130916, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

		

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 XXXXXXXXXXXXXXXXX, AR20150002990 (PD201301487)

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						 
CF: 
(  ) DoD PDBR
(  ) DVA