RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04312
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20041120

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E-4, Wheeled Vehicle Mechanic, medically separated for “Crohn’s Disease,” with a disability rating of 10%.  

CI CONTENTION:  The decision was made within 6 months of the diagnosis and complications were not taken into consideration.  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 – 20040819	VARD -20050524	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Crohn’s Disease	7399-7323	10%	Crohn’s Disease	7399-7323	10%	20050211	
			Scars, Residuals of Anal Mass Excision 	7805	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Crohn’s Disease.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s Crohn’s disease condition began in January 2002 with a painful rectal mass.  At a gastroenterology examination dated 22 April 2004 the examiner noted mild Crohn’s colitis and good control with medication (Asacol).  Despite treatment, the Crohn’s 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 Crohn’s disease for PEB adjudication.  At the MEB NARSUM examination on 14 May 2004 (6 months prior to separation) the CI noted complaints of daily rectal bleeding with bowel movements, an increased number of bowel movements (2-5 per day), and abdominal pain.  Physical examination showed a normal abdominal evaluation.  A colonoscopy performed 08 March 2004 (8 months prior to separation) showed increased nodularity, superficial ulcers, and some areas of redness consistent with inflammatory bowel disease.  The pathology result from that procedure showed granulomatous proctitis.  At the 11 February 2005 VA Compensation and Pension (C&P) evaluation (performed 3 months after separation) the CI reported daily abdominal cramping and bleeding with bowel movements.  Physical examination showed a normal abdominal evaluation.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the Crohn’s disease condition 10%, analogously coded 7399-7323 (Colitis, ulcerative), citing moderate disease and infrequent exacerbations.  The VA also rated the Crohn’s disease condition 10% analogously coded 7399-7323, based on the VA C&P examination citing infrequent exacerbations.  The CI’s complaints began as a painful anal mass that was removed.  The pathology report from that lesion favored a foreign body reaction so medical evaluation board for Crohn’s disease was not pursued at that time.  She initially did well; however, over the next 2 years she developed increased stool frequency with rectal bleeding and some cramping so further work-up was initiated.  The CI had not had any admissions to the hospital or operations on her GI tract with the exception of the initial biopsy of the rectal mass which classifies her symptoms as moderate in character justifying a 10% rating.  She had not had frequent exacerbations or malnutrition to justify 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 Crohn’s disease condition.  

BOARD FINDINGS:  In the matter of the Crohn’s disease 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 20141125, 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

08 DEC 2016

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20160018401 (PD201404312)

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