RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01975
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040311

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a activated National Guard E5, Chemical Operations Specialist, medically separated for “diabetes mellitus type 2” with disability rating of 20%.

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 panel 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 - 20040126	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Diabetes Mellitus Type 2	7913	20%	No VA Examination in Evidence	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:  

Diabetes Mellitus Type 2.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI developed diabetes mellitus type 2 (DM2), which is characterized by hyperglycemia (high blood glucose) and variable degrees of insulin (hormone that regulates blood glucose) resistance/deficiency, in 2000-2001.  He ultimately required treatment with the oral hypoglycemic medications of Avandia and Glucophage, and dietary restriction.  

At the 26 November 2003 MEB examination (recorded on DD Forms 2807 and 2808), 3 months prior to separation, the examiner noted that the CI was taking oral hypoglycemic medications (Avandia and Glucophage).  The examiner did not indicate that avoidance of strenuous occupational and recreational activities was medically necessary.  The permanent profile dated 2 December 2003 did not restrict activities.  

The 5 December 2003 MEB NARSUM examination also noted that the CI was on the same oral hypoglycemic medications (Avandia and Glucophage).  The examiner did not indicate that avoidance of strenuous occupational and recreational activities was medically necessary.  There was no evidence of hospitalizations for treatment of ketoacidosis (life threatening elevation of serum acids [ketones], hyperglycemia, electrolyte disturbances, and dehydration) or hypoglycemia (low blood glucose).  There was also no examination/lab evidence of diabetic complications or twice monthly visits to a diabetic care provider.  There was no VA Compensation and Pension (C&P) examination in evidence proximate to separation. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the diabetes condition 20%, coded 7913 (diabetes mellitus), citing the requirement of oral hypoglycemic medication and restricted diet.  The panel agreed that the requirement for an oral hypoglycemic agent and restricted diet justified a 20% rating.  Because there was no evidence of insulin use and medically prescribed regulation of activities, the next higher 40% rating was not justified.  Furthermore, the CI did not require frequent visits to a diabetic care provider, nor were there episodes of ketoacidosis, hypoglycemic reactions, hospitalizations or diabetic complications that could support higher ratings.  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 DM2 condition. 

BOARD FINDINGS:  In the matter of the DM2 and IAW VASRD §4.120, 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 modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150715, w/attachments
Exhibit B.  Service Treatment Record

AR20170010105, XXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:  

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,