RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00849
BRANCH OF SERVICE:  Navy	SEPARATION DATE:  20080612

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, CH/MH-53E Systems Organization Maintenance Technician and E2C Systems Organization Initial Maintenance Technician, medically separated for “type I diabetes” with a rating of 20%.

CI CONTENTION:  Contends his diabetes was due to stress.  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 - 20071205	VARD	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Diabetes Mellitus…	7913	20%	No VA Examination in Evidence	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  N/A%	

ANALYSIS SUMMARY:

Diabetes Mellitus.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s Type I diabetes condition initially manifested as blurred vision in December 2005 and November 2006.  During a hospitalization on 24 November 2006, 19 months before separation, he was found to have profound hyperglycemia with blood sugar of 616, diagnosed with Type I diabetes and placed on insulin.  The MEB forwarded diabetes mellitus Type I for PEB adjudication.  

A diabetic clinic visit on 23 August 2007, 10 months before separation, revealed the CI utilized an insulin pump and received nutrition counseling to restrict his diet.  During the MEB NARUSM on 16 November 2007, 7 months before separation, the examination documented the CI utilizing an insulin pump, was carbohydrate counting (restricted diet) and monitored his blood sugar several times a day.  The CI reported “good exercise habits and works out at least three times per week for thirty minutes.” A regulation of activities was not indicated.  The CI received two limited duty medical board reports and a non-medical assessment, from December 2006 through December 2007, which did not prescribe a regulation of activities.  

There was no VA Compensation and Pension examination for this Board’s review since the CI did file a VA disability claim.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the diabetes 20%, coded 7913 (diabetes mellitus).  The VA did not rate the diabetes condition because the CI did not file a VA disability claim.  The Board agreed that the CI’s requirement for insulin and restricted diet justified a 20% rating.  Because there was no evidence of medically prescribed regulation of activities, the next higher 40% rating was not justified.  The CI also did not have evidence of episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice a month visits to a diabetic care provider, plus complications that would not be compensable if separately evaluated to justify a 60% 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 type I diabetes condition.  

BOARD FINDINGS:  In the matter of the type I diabetes condition and IAW VASRD §4.121, 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

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 13 Dec 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:

		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USMC 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN 

						  XXXXXXXXXXXXXXXXXX	     				  			  		  Assistant General Counsel
						  (Manpower & Reserve Affairs)