RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02508
BRANCH OF SERVICE:  Coast Guard 	SEPARATION DATE:  20080430

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Machinery Technician, medically separated for “beta thalassemia intermedia…” with a disability rating of 0%.

CI CONTENTION:  “Beta Thalassemia Intermedia.”  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 - 20071119	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Beta Thalassemia Intermedia…	7799-7714	0%	No VA Examination In Evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Beta Thalassemia Intermedia.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s beta thalassemia intermedia (condition of intermediate symptom severity between beta thalassemia trait and beta thalassemia major) condition was a genetic condition.  There was no mention of the beta thalassemia condition on the CI’s enlistment physical or history forms dated July and August 2002.  The CI’s symptoms due to the beta thalassemia condition began in October 2003 with complaints of jaundice, nausea, and abdominal pain.  During active duty the CI underwent removal of his gall bladder in 2003 due to gall stones and following repeated hemolytic episodes (fragmentation of red blood cells) he underwent removal of his spleen in June 2006.  There was no documentation of additional symptoms related to the thalassemia condition in record following the splenectomy to the date of separation.  

At the 8 November 2006 MEB NARSUM examination, 18 months prior to separation, the physical examination was normal.  The MEB NARSUM examiner indicated that the CI was not fit for continued duty due to his inability to be worldwide deployed due to possible future complications or required treatment.  In a letter dated the same day the CI indicated he felt well in all regards and his only restrictions were quarterly hematology follow up visits and avoidance of exposure to infectious diseases due to the removal of his spleen.  Two commanders’ statements in record supported that the CI should be retained and he was able to perform all the physical duties expected of his Rate.  

The record showed that the CI did not attend a VA Compensation and Pension (C&P) evaluation proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the beta thalassemia intermedia condition 10%, coded analogously to 7714 (sickle cell anemia), and applied a 10% reduction, judging the condition existed prior to service (EPTS) and was not aggravated by service for a combined rating of 0%.  The PEB cited the CI was asymptomatic, but with identifiable organ impairment.  There is no evidence of a VA rating for the beta thalassemia intermedia condition in record.  

The panel agrees with the PEB determinations that the thalassemia intermedia condition, a genetic condition, existed prior to service.  However there was no evidence in record to support that at the time of enlistment there was identifiable organ impairment due to the beta thalassemia condition.  Therefore the panel does not recommend a 10% EPTS deduction.  Following the splenectomy, there was no evidence of repeated hemolytic episodes for higher rating under 7714.  CI underwent a splenectomy for worsening symptoms of the genetic condition during active duty and the splenectomy was a residual of the unfitting condition.  However, there was no evidence that, absent the underlying beta thalassemia condition, the splenectomy would have been unfitting for continued military service and it therefore it cannot be recommended for Service rating.  There was therefore no higher rating than the 10% rating adjudicated by the PEB under any applicable VASRD code.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends that the beta thalassemia condition was EPTS and a rating of 10% as adjudicated by the PEB with no EPTS deduction recommended, coded 7799-7714.  

BOARD FINDINGS:  In the matter of the beta thalassemia intermedia condition, the panel unanimously recommends the condition was EPTS and recommends a disability rating of 10%, coded 7799-7714 IAW VASRD §4.117.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Beta Thalassemia Intermedia	7799-7714	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20151101, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX,

I am the Designated Decision Authority for the Coast Guard on applications submitted to the Department of Defense Physical Disability Board of Review (PDBR).  Under the authority of Title 10, United States Code, section 1554a, I accept the PDBR’s recommendation in your case (Case Number PD-2015-02508) and accept the recommendation to change your combined rating from 0% to 10% but with no re-characterization of seperation. 

Enclosed for your information are a copy of the PDBR’s recommendation and a copy of the record of proceedings. 

A copy of this decision has also been provided to Coast Guard Enlisted Personnel Management Branch, the PDBR, and the Department of Veterans Affairs. 

If you have any further questions, please contact the Coast Guard Personnel Service Center at XXXXXXXXXXXXXXXXXXX. 
	Sincerely,

XXXXXXXXXXXXXXXXXXX
Rear Admiral, U. S. Coast Guard
Assistant Commandant for Human Resources

2 Enclosures	

Copy:

CG Personnel Service Center (EPM-1)
DoD Physical Disability Board of Review
Department of Veterans Affairs