RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-00368
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060220

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E-4, Light Wheeled Vehicle Mechanic, medically separated by the Informal Physical Evaluation Board (PEB) for “Type II diabetes mellitus,” with a disability rating of 20%.  

CI CONTENTION:  The applicant is requesting a medical retirement for his diabetes.  The applicant’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  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 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 PEB - 20060109	VARD - 20061128	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Type II Diabetes Mellitus	7913	20%	Diabetes Mellitus, Type II	7913	NSC	20060517	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  80%	

ANALYSIS SUMMARY:  

Type II Diabetes Mellitus.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s diabetes condition began in September 2005 after experiencing numbness and tingling in his hands and arms.  A trip to the emergency room validated the CI was experiencing elevated blood sugar consistent with the onset of Type II diabetes mellitus. 

At the MEB examination (recorded on DD Forms 2807 and 2808) dated October 2005, 4 months prior to separation, the examiner reported the CI was newly diagnosed with diabetes and taking medication.  The CI was placed on insulin and referred to the Nutrition clinic for diet control.  The NARSUM ocular, cardiovascular, and neurological examinations performed 3 months prior to separation were normal.  At the VA Compensation and Pension (C&P) examination on 17 May 2006, 3 months after separation, the CI reported he experienced hypoglycemia most recently in February of 2006.  He was taking insulin and oral hypoglycemic and required two emergency room visits due to his diabetes.  The physical examination did not reveal any ocular, cardiovascular or neurologic diabetic complications and there was no documentation of prescribed regulation of activities.  

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB assigned a 20% rating under the 7913 code (diabetes mellitus), citing the CI required insulin and a restricted diet.  The VA determined the condition was not service-connected, basing their determination on the VA C&P examination 3 months after separation, noting the condition was unrelated to the CI’s current period of military service.  

The Board noted that although the CI’s condition was managed with a restricted diet, treatment with insulin was also required.  A 20% rating was therefore justified on this basis.  Because there was no evidence of medically prescribed regulation of activities, no rating higher than 20% was supported.  Furthermore, he did not require frequent visits to a diabetic care provider, nor were there episodes of ketoacidosis, hypoglycemic reactions, hospitalizations or diabetic complications that could support higher ratings.  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 diabetes condition.  

BOARD FINDINGS:  In the matter of the Type II 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.  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 20140107, 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 XXXXXXXXXXXXXXXXXX, AR20160005482 (PD201400368)

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:

Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA