RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01017
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070801

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Information Manager, medically separated for “ulcerative colitis,” with a disability rating of 10%.

CI CONTENTION:  The CI requests the board consider all conditions.  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’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 panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’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 panel 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 panel 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 - 20070612	VARD - 20080125	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Ulcerative Colitis	7323	10%	Ulcerative Colitis	7323	10%	20070905	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Ulcerative Colitis (UC).  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s UC condition began in June 2002 after experiencing blood in the stool.  The CI was initially diagnosed with UC by flexible sigmoidoscopy with biopsies in July 2002.  The diagnosis was questioned after a colonoscopy in August 2002 was normal with only internal hemorrhoids noted.  However, the CI’s symptoms of bloody diarrhea waxed and waned and she was treated symptomatically as for UC.  She was seen in the emergency room in January 2006 for four to five bloody stools per day with back pain and the exam showed blood in the stool.  A repeat colonoscopy in February 2006 showed colitis of the rectum and distal colon.  The CI was evaluated by a second gastroenterologist in August 2006 and a CT scan of the abdomen and pelvis was normal and another colonoscopy in August 2006 confirmed the previous findings.  At two follow-up visits in March and June 2007, the CI reported one to two bowel movements per day without blood or abdominal pain.  Her weight was stable and blood work showed the CI was not anemic.  The MEB forwarded “UC” for PEB adjudication.  

The MEB NARSUM examination on 3 May 2007, 3 months prior to separation, noted the CI was on daily medication for UC.  Physical examination showed the abdomen was soft and non-tender with normal bowel sounds.  She was taking daily medications for the UC.  

At the 5 September 2007 VA Compensation and Pension (C&P) evaluation, performed a month after separation, the CI reported daily use of medication for the UC.  She reported two formed bowel movements per day without blood, urgency, or incontinence and the condition had been stable for several months.  Physical exam showed the abdomen was soft, non-tender, and bowel sounds were normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB and VA both rated the UC condition 10%, coded 7323 (colitis, ulcerative).  The VA cited “mild symptoms controlled by medication.”  The panel reviewed to see if there was support for a higher evaluation than the 10% assigned by the PEB.  However, at the time of separation there was no evidence of frequent exacerbations to characterize the UC as moderately severe for the next higher rating of 30%.  There was also no evidence of malnutrition, anemia, “only fair health during remissions,” general debility, or serious complications to warrant one of the higher 60% or 100% ratings.  There was therefore no higher rating available than 10% as adjudicated by the PEB.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the UC condition.  

BOARD FINDINGS:  In the matter of the ulcerative colitis condition and IAW VASRD §4.114, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, 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 20150606, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-01017.

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,

XXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings