RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02234
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20080620

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Air Force Academy Cadet, medically separated for “nephropathy” with a disability rating of 0%.

CI CONTENTION:  “Review all conditions.”  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 upon a 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 - 20080304	VARD - 20100315	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Nephropathy	7599-7502	0%	IGA Nephropathy, with Well-Controlled Blood Pressure	7599-7502	0%	20090901	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Nephropathy.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s was diagnosed with IGA nephropathy renal biopsy (kidney disease) on 16 February 2007 after it was discovered he had asymptomatic proteinuria (abnormal quantities of protein in the urine) during the commissioning physical examination (PE).  The MEB forwarded “IGA Nephropathy” for PEB adjudication.  

During the MEB NARSUM examination on 25 February 2008, 4 months prior to separation, physical examination was within normal limits.  During the 1 September 2009 VA Compensation and Pension (C&P) evaluation, performed 15 months after separation, the CI reported IgA nephropathy and hypertension that he found out about during a routine physical.  Physical examination showed the CI’s vital signs, in particular blood pressure was within the normal range.  He took Lisinopril (antihypertensive medication), to control his blood pressure.  Additionally, the laboratory diagnostic studies, specifically urinalysis, blood urea nitrogen and creatinine levels were within normal value.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the nephropathy 0%, coded 7502 (nephritis, chronic), citing biopsy proven and the risk for renal failure is low.  The VA also rated the nephropathy 0%, also coded 7502 code based on the VA C&P examination 15 months after separation, citing no current evidence of albumin and urine casts (cylindrical structures produced by diseased kidney(s)).

The Board agreed the CI had an instance of proteinuria with urine casts.  The Board considered code 7502 which is rated under code 7101 (renal dysfunction).  The CI’s albumin and casts with history of acute nephritis, or hypertension are rated 0%.  A 10% rating requires transient or slight edema or hypertension.  The Board noted the STR did not indicate the CI having edema or being diagnosed with hypertension.  The 30% rating is not warranted because the CI’s albumin was not constant or recurring with hyaline and granular casts or red blood cells.  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 nephropathy condition.

BOARD FINDINGS:  In the matter of the nephropathy condition and IAW VASRD §4.115, 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 20150601, with 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-2015-02234.

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