RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01608
BRANCH OF SERVICE:  AIF FORCE	SEPARATION DATE:  20071116

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E1, Trainee, medically separated for “residual right lower quadrant pain after appendectomy” with a disability rating of 10%.   

CI CONTENTION:  “Review 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 review of disability ratings assigned 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 or non-compensable.  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 determination 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(s) 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 - 20071105	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Residual Right Lower Quadrant Pain After Appendectomy	7399-7301	10%	No VA Examination in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Residual Right Lower Quadrant Pain after Appendectomy.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent a laparoscopic appendectomy on 17 July 2007.  On pathological evaluation the appendix was ruptured.  Following surgery further treatment did not result in improvement sufficient to allow unrestricted duty.  

The 19 October 2007 MEB NARSUM examination, 1 month prior to separation, noted complaints of sharp lower abdominal pain around the surgical incision that felt like “bad gas.”  Running and sit-ups made the pain worse.  
Physical examination showed the abdomen to be non-tender and flexion of the torso did not cause abdominal pain.  There was no VA examination in evidence proximate to separation. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right lower quadrant abdominal pain 10%, coded 7399-7301 (peritoneum, adhesions of).  The panel did not find evidence of intestinal obstruction required for a higher rating using VASRD code 7301.  There was no evidence of post-operative inguinal or ventral hernia to rate using codes 7338 or 7339.  The panel considered if it would be appropriate to rate the CI’s post-operative pain using code 8530 (ilioinguinal nerve paralysis) but noted that 10% is the highest rating and provides no advantage to the CI.  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 right lower quadrant abdominal pain condition.  

BOARD FINDINGS:  In the matter of the right lower quadrant abdominal pain condition and IAW VASRD §4.114, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.    

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150629, with attachments
Exhibit B.  Service Treatment Record

SAF/MRB
XXXXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-01608.

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,

XXXXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings