RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02189
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20030103

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty O1, Contract Administrator, medically separated for “ulcerative colitis” with a disability rating of 10%.

CI CONTENTION:  “Review all conditions.”  The CI’s 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 progression or complications of service-connected conditions after separation.  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 - 20021105	VARD - 20040902	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Ulcerative Colitis	7323	10%	Ulcerative Colitis	7323	10%	20040802	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Ulcerative Colitis.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI began having intermittent rectal bleeding, minor chills, and abdominal pain, without fevers in May 2002.  In June 2002, she underwent colonoscopy and biopsies with findings consistent with diagnosis of ulcerative colitis.  Her condition improved with treatment and she achieved remission; however, given the nature of the disease, she was referred to the MEB.  

The 24 August 2002, MEB NARSUM examination, 4 months prior to separation, noted complaints of “belly pain and rectal bleeding.”  The CI provided a history of intermittent rectal bleeding, initially 3-4 times a day with episodes of no blood in her stools.  She experienced no fevers.  The CI also reported that she had normal colonoscopy prior to coming into the military. Physical examination of the abdomen was normal with the exception of diffuse pain.  The examiner noted that radiographic (X-ray) studies on 3 June 2002, showed evidence of ulcerative colitis and was subsequently placed on medication.  The CI reported a 70% improvement of her symptoms after medication was adjusted.  

At the time of the NARSUM, she was no longer taking steroid medication and her symptoms had improved with return to normal function.  The examiner noted that although her symptoms had improved, she should be discharged from the service given the fact that her course will be intermittent and likely be recurring.  

At the 2 August 2004 VA Compensation and Pension (C&P) evaluation, performed 19 months after separation, the CI reported she had been maintained on non-steroidal medication and had done well, and has had no severe exacerbations, but did have a flare in May 2004.  The CI was employed full-time.  Physical examination was unremarkable.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the ulcerative colitis condition 10%, coded 7323 (colitis, ulcerative).  The VA also rated the ulcerative colitis condition 10%, coded 7323, citing infrequent exacerbations.  The 20% rating for “moderately severe; with frequent exacerbations” was not justified since the record recorded one exacerbation of symptoms in the 2 months prior to separation, and one mild flare-up, 1 month after separation, noted in the June 2003 medical evaluation.  The CI had no additional flare-ups in the 8 months following.  The record demonstrated greater remission periods than periods of exacerbation.

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 ulcerative colitis condition.  

BOARD FINDINGS:  In the matter of the ulcerative colitis condition and IAW VASRD §4.71a, 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 20150805, w/attachments
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

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-02189.

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.  The Board recommended no re-characterization or modification of your separation.

I 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.  I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings