RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-00543
BRANCH OF SERVICE:  Army	BOARD DATE:  20150728
SEPARATION DATE:  20040430

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4 (Wire System Installer) medically separated for diabetes mellitus (DM).  The DM could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty.  The CI’s profile did allow for the CI’s participation in the standard aerobic events to satisfy physical fitness standards.  He was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB).  “Diabetes mellitus type II” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  The MEB also identified and forwarded microcytic anemia for PEB adjudication.  The Informal PEB (IPEB) adjudicated DM as unfitting and rated the condition 10%, with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The micro anemia was not specifically adjudicated by the PEB, but the Board judged this was likely an erroneous omission and should be assumed to constitute a de facto PEB determination that the condition was not unfitting.  The CI appealed to the Formal PEB but later withdrew his appeal, concurred with the IPEB findings and recommendations and was medically separated.  

CI CONTENTION:  He was given a higher rating for his condition by the VA.  His complete submission is at Exhibit A.

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 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:

IPEB - Dated 20031022	VA* - (~8 Mos. Pre-Separation) 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Diabetes Mellitus	7913	10%	Diabetes Mellitus Type II 	7913	20%	20030903	
Other MEB/PEB Conditions x 1 (Not In Scope)	Other x 4	
RATING:  10%	COMBINED RATING:  30%	
*Derived from VA Rating Decision (VARD) dated 20031120 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:

Diabetes Mellitus.  The CI developed Type II DM in 2000 which required treatment with oral hypoglycemic medication and dietary instruction.  The narrative summary on 5 August 2003 (9 months prior to separation) reported that the CI was not engaged in exercise and was taking two oral medications for diabetes.  The examiner noted that there was no end-organ complication from the diabetes.  At the VA Compensation and Pension exam on 3 September 2003 (8 months prior to separation), the CI reported that he engaged in weightlifting and playing basketball frequently.  He was taking two oral medications for diabetes.  The examiner opined that the CI could participate in most sports and all activities of daily living.  The permanent profile on 21 October 2003 (6 months prior to separation) allowed for performance of all elements of a physical fitness test.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating under the 7913 code (diabetes mellitus) while the VA rated the condition at 20% using the same code.  The Board agreed that the requirement for an oral hypoglycemic agent and restricted diet justified a 20% rating.  Because there was no evidence of insulin use and medically prescribed regulation of activities, no higher rating was supported.  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 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, the Board unanimously recommends a disability rating of 20%, coded 7913 IAW VASRD §4.119.  There were no other conditions within the Board’s scope of review for consideration.

RECOMMENDATION:  The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical separation:

CONDITION	VASRD CODE	RATING	
Diabetes Mellitus 	7913	20%	
RATING	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140121, 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 XXXXXXXXXXXXXXXXXXXXXXXXXXX, AR20160000248 (PD201400543)

1.  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 to modify the individual’s disability rating to 20% without recharacterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

BY ORDER OF THE SECRETARY OF THE ARMY:

CF: 
(  ) DoD PDBR
(  ) DVA