RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXX		CASE:  PD-2014-01082
BRANCH OF SERVICE: MARINE CORPS 	SEPARATION DATE:  20081230

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3 (Fiscal/Budgeting Technician) medically separated for diabetes mellitus (DM).  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS). He was placed on limited duty (LIMDU) and referred for a Medical Evaluation Board (MEB).  The “diabetes mellitus without mention of complication, type 1 [juvenile type], not stated as uncontrolled,” was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E.  The Informal PEB adjudicated the type 1 DM condition as unfitting, rated 20%.  The remaining condition was determined to be a Category IV, a condition which does not constitute a physical disability.  The CI made no appeals and was medically separated. 

CI CONTENTION:  The CI contends for his diabetes plus conditions not addressed by either the MEB or the PEB.  The applicant’s 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 20081021	VA* - (~4 Mos. Post-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Type 1 Diabetes Mellitus	7913	20%	Type 1 Diabetes Mellitus	7913	20%	20090403	
Other MEB/PEB Conditions x 1 (Not In Scope)	Other x 0	
RATING:  20%	RATING:  20%	
*Derived from VA Rating Decision (VARD) dated 20090623 (most proximate to date of separation (DOS)).  

ANALYSIS SUMMARY:  

Type 1 Diabetes Mellitus Condition.  The record shows that the CI was evaluated for diabetes in mid-2008 after presentation with a month long history of increased urination and a strong family history.  He was diagnosed with DM and begun on insulin on 31 July 2008.  He was also placed on LIMDU pending PEB.  He denied any sequelae from the DM condition such as visual or neurological complaints.  On examination, there was no evidence of eye, renal, neurological, or cardiac complications.  He was begun on a diabetic diet, but had no regulation of activities.  At the MEB examination on 25 August 2008, the MEB physical examiner noted the presence of tattoos, but an otherwise unremarkable examination.  The narrative summary (NARSUM) was dated 17 September 2008, 3 months prior to separation.  The examiner noted the positive family history including an older brother of the CI.  The CI was noted to be in good control with his current lifestyle and medication regimen.  No complications of DM were documented.  At the VA Compensation and Pension (C&P) examination performed on 3 April 2009, 3 months after separation, the CI reported rare hypoglycemic episodes twice a month.  He self-treated these and had not required hospitalization.  There was no history of diabetic ketoacidosis.  No complications (end organ damage) of the eyes, nerves, renal system, or heart were present.  Regulation of activities was not recorded.  

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).  Absent regulation of activities, the Board found no route to a higher rating.  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 mellitus 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 §4.100, 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 20140221, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 4 Jan 16

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

- XXXXXXXXXXXXXXXXXXXX former USN
- XXXXXXXXXXXXXXXXXXXX former USMC
- XXXXXXXXXXXXXXXXXXXX former USMC  
- XXXXXXXXXXXXXXXXXXXX former USMC
- XXXXXXXXXXXXXXXXXXXX former USN
- XXXXXXXXXXXXXXXXXXXX former USMC 
- XXXXXXXXXXXXXXXXXXXX former USN
- XXXXXXXXXXXXXXXXXXXX former USMC
- XXXXXXXXXXXXXXXXXXXX former USN

						  XXXXXXXXXXXXXXXXXXXX
	     				  Assistant General Counsel
						  (Manpower & Reserve Affairs)