RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03632
BRANCH OF SERVICE:  Navy	SEPARATION DATE:  20070120

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Religious Programs Specialist, medically separated for “thrombophlebitis of the left iliac vein with residual edema” with a disability rating of 20%.

CI CONTENTION:  “Please Consider All Conditions.”  The CI’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 Physical Evaluation Board (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 - 20061002	VARD - 20070712	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Thrombophlebitis of the Left Iliac Vein with Residual Edema	7121	20%	May-Thurner’s Syndrome	7121	10%	20061201	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:

Thrombophlebitis of the Left Iliac Vein with Residual Edema.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s thrombophlebitis condition began in March 2006 after undergoing surgery (cholecystectomy).  A stent was placed in the internal iliac vein to prevent further complications and medications were started.  Despite treatment, the thrombophlebitis condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for MEB.  The MEB forwarded “thrombophlebitis of the left iliac vein with residual edema” for PEB adjudication.

The MEB NARSUM examination was performed on 25 July 2006 (7 months pre-separation).  The physical examination showed normal skin and normal gait, and did not address the lower extremity.  At the MEB examination (recorded on DD Forms 2807 and 2808) performed in August 2006 (6 months pre-separation), the CI reported pain and swelling, difficulty with prolonged sitting and standing.  Physical examination showed lower extremity edema and normal skin.  There was no STR documentation that described stasis pigmentation, eczema, or intermittent ulceration.  There was documentation of persistent edema requiring compression stockings.

At the VA Compensation and Pension (C&P) examination in December 2006 (2 months pre-separation), the CI reported daily wear of compression stockings and persistent edema when not wearing them.  Physical examination showed no edema after removal of the compression stockings, and no evidence of skin changes attributable to chronic venous insufficiency.

The Board directed attention to the rating recommendation based on the above evidence.  The PEB rated the left iliac vein condition 20% coded 7121 (post-phlebitic syndrome).  The VA also rated the left iliac vein condition 10% also coded 7121 based on the VA C&P examination 2 months before separation, citing no evidence of edema upon removal of compression stockings and no evidence of chronic venous insufficiency.

There was no evidence of persistent edema and stasis pigmentation or eczema, with or without intermittent ulceration in support of a higher 40% rating.  Therefore there was no evidence for a higher rating than that adjudicated by the PEB.  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 thrombophlebitis condition.

BOARD FINDINGS:  In the matter of the thrombophlebitis of the left iliac vein condition and IAW VASRD §4.104, 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 20140728, 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 21 Sep 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 USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN