RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00679
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20070306

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Basic Trainee, medically separated for “post cholecystectomy syndrome,” with a disability rating of 10%.

CI CONTENTION:  “Review 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 based on 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 - 20070223	VA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Post Cholecystectomy Syndrome	7399-7318	10%	No VA Disability Claim Filed	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:

Cholecystectomy Syndrome.  According to service treatment records (STR), the CI abdominal pain began in November 2006, 8 days into basic training, when she presented to the emergency room.  Inflammation of the gallbladder (cholecystitis) was found on CT scan and ultrasound examination.  Pain symptoms did not resolve with medications and dietary changes.  A cholecystectomy (removal of the gallbladder) was accomplished on 9 December 2006.  Post-operative abdominal pain continued.  During a gastroenterology follow up on 20 December 2006, the CI requested a Medical Evaluation Board (MEB) and separation.  Physical examination was unremarkable.  At the final general surgery follow-up prior to separation, dated 4 January 2007, 2 months prior to separation, the CI reported less abdominal pain, nausea, and a better appetite with regular bowel movements.  Physical examination was normal.  The final gastroenterology examination on 22 January 2007, noted complaints of intermittent diarrhea after breakfast (approximately every third day) after consuming greasy foods or tomato products.  She reported increased activity with the ability to walk to and from the clinic and utilize stairs.  The physical examination revealed a normal abdomen.  Her weight increased 15 pounds since the beginning basic training 9 months earlier, and 11 pounds since her emergency room visit in December 2006, 6 weeks earlier.  She was prescribed Colestid for occasional diarrhea thought to be from bile salt malabsorption.  The MEB forwarded “post cholecystectomy syndrome” for PEB adjudication.  No additional clinical records were in evidence.  

The CI did not file a VA disability claim; and therefore, there was no VA Compensation and Pension evaluation for Board review.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the post cholecystectomy syndrome at 10%, analogously coded 7399-7318 (gallbladder removal with mild symptoms).  There was no VA rating.  Board members agreed the STR evidence did not support “severe” post gallbladder removal symptoms for a 30% rating at separation.  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 post cholecystectomy syndrome condition.

BOARD FINDINGS:  In the matter of the post cholecystectomy syndrome 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 20150602, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MR
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

Dear XXXXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-00679.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

Attachment:
Record of Proceedings