RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX	CASE:  PD-2014-01946
BRANCH OF SERVICE:  Army	BOARD DATE:  20141002
SEPARATION DATE:  20050712

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty PFC/E-3 (11B/Infantryman) medically separated for diabetes.  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty.  He was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB).  The diabetes mellitus Type II condition was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other conditions were submitted by the MEB.  The Informal PEB adjudicated “diabetes mellitus, Type II” as unfitting, rated 20%, with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.

CI CONTENTION:  “Please consider all conditions.”

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 diabetes 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 20050324	VA - (5 Mos. Pre-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Diabetes Mellitus, Type II	7913	20%	Diabetes Mellitus	7913	20%	20050228	
Other x0 (Not in Scope)	Other x7	20050228	
Combined:  20%	Combined:  50%	
Derived from VA Rating Decision (VARD) dated 20050728 (most proximate to date of separation [DOS])

ANALYSIS SUMMARY:  IAW DoDI 6040.44, the Board’s authority is limited to making recommendations on correcting disability determinations.  The Board’s role is thus confined to the review of medical records and all evidence at hand to assess the fairness of PEB rating determinations, compared to VASRD standards, based on ratable severity at the time of separation.

Diabetes Mellitus, Type II.  The CI reported that in September or August of 2003 during his deployment in Iraq he experienced a 30 pound weight loss that was associated with increased thirst.  Two months later, he noted the onset of blurred vision.  After his initial weight loss, he then gained weight and in January 2004 his weight rose to approximately 300 pounds.  In August of 2004 he again had mild weight loss associated with polyuria (frequent urination), polydipsia (increased thirst), and blurred vision at which time he was diagnosed with diabetes mellitus.  He was tried on numerous medications finally gaining control of his blood sugar on oral medications and insulin.  His activity was never restricted and exercise was encouraged.  It was noted that increased alcohol consumption was highly correlated with lack of blood sugar control.  He did have one hospitalization for uncontrolled diabetes approximately 5 months prior to separation.  The narrative summary prepared 4 months prior to separation noted that his prognosis was good if he continued to modify his diet and severely limit his alcohol intake.  The physical exam was essentially normal.  At the VA Compensation and Pension exam performed 4 months prior to separation, the CI reported that for regular exercise he went to the pool almost every day and biked and did weight training every other day.  He described his health status as fair.  He continued on oral diabetic medications along with daily insulin.  His physical exam showed 73 inches tall and 290 pounds.  His physical exam was essentially normal.

The Board directs attention to its rating recommendation based on the above evidence.  The PEB utilized VASRD code 7913 (diabetes mellitus) and rated it 20% for diabetes mellitus uncontrolled on oral hypoglycemic and restricted diet.  The VA utilized the same code and also rated it 20%.  The VASRD rating criteria for diabetes mellitus requires consideration of diet restrictions, activity regulation, insulin requirement, hospitalizations, frequency of required provider visits for care and complications not compensable if separately evaluated.  In this case, the CI required oral medication and insulin use along with diet restrictions which meets the criteria for a 20% evaluation.  The next higher rating, 40%, requires the addition of activity regulation which was not present in this case.  The CI had one hospitalization over 5 months prior to separation and no complications secondary to diabetes mellitus at the time of separation.  Considering the totality of the evidence and mindful of VASRD §4.3 (reasonable doubt), members agreed that the disability rating of 20% for the diabetes mellitus, Type II condition was appropriately recommended in this case.

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, Type II 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 20140421, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

		
XXXXXXXXXXXXXXXXX
President
Physical Disability Board of Review

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, AR20150006352 (PD201401946)

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						     XXXXXXXXXXXXXXXXX