RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	   CASE:  PD-2014-04008
BRANCH OF SERVICE:  Army 	separation DATE:  20060626

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E-4, Cable Systems Installer-Maintainer, medically separated by the Informal (IPEB) for abdominal pain, with a disability rating of 10%.

CI CONTENTION:  He was not evaluated for his post-traumatic stress disorder, right shoulder, abdominal and left temporal scars, and tinnitus conditions.  He was also given a higher rating by the VA.  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 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 - 20060601	VARD - 20071002	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Abdominal Pain …. s/p Laparotomy and Partial Resection of Large and Small Bowel	7301	10%	Status Post Laparotomy and Partial Resection of Large and Small Bowel	7301	10%	20061215	
			Abdominal Scars with Tenderness	7804	10%		
Migraine Headaches	Not Unfitting	Migraine Headaches	8100	0%		
		Left Temporal Area of Skull Scar, Tender	5296-7804	10%		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:

Chronic Abdominal Pain.  In October 2005, the CI was the victim of domestic violence whereby he received multiple GSWs to include abdominal trauma with bowel perforation.  He underwent emergent surgery resulting in an intestinal resection.  Postoperatively, he did well with recovery and rehabilitation, but persistent abdominal pain continued.  He was permanently profiled in February 2006 with a diagnosis of chronic abdominal pain s/p GSW and was referred to a Medical Evaluation Board (MEB).  At the MEB narrative summary (NARSUM) examination on 8 May 2006 (6 weeks pre-separation) the CI reported constant abdominal pain worsened with walking, running, standing, or performing exercise.  Specifically, “this pain causing tightness of the whole stomach area [and] may last from one hour to the entire day.”  His abdominal-focused physical examination was normal with the exception of diffuse tenderness without guarding.  His diagnosis remained unchanged.  The commander’s statement included the CI’s duty limitations and noted the inability to perform his required MOS duties.  At the 15 December 2006 VA Compensation and Pension (C&P) examination; 6 months post-separation, the CI reported daily intermittent mid-to-low abdominal pain.  The CI noted the ability to do routine daily activities and the usual duties of his occupation.  The PE revealed ‘vague tenderness’ over the mid- and lower abdomen.

The Board directed attention to its rating recommendation based on the above evidence.  Both the PEB and VA rated the abdominal pain condition at 10%, utilizing VASRD code 7301 (peritoneum [abdomen] adhesions) and citing pulling pain upon movements.  Board members first considered the probative value of the examinations in evidence and agreed that the MEB examination be apportioned exclusive probative value due to its close time reference to separation.  Members then agreed that the VASRD code of 7301 appropriately reflected the underlying pathology in this case.  Absent evidence of ongoing partial intestinal obstruction or interference of intestinal motility, there was no evidentiary support greater than 10% impairment.  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’s adjudication for the chronic abdominal pain condition. 

BOARD FINDINGS:  In the matter of the abdominal pain condition and IAW VASRD §4.114, 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, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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 AR20160005171 (PD201404008)

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