RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00110
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040226

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Reserve CW2, UH-60 Blackhawk Helicopter Pilot, medically separated for “Hashimoto’s Thyroiditis” with a disability rating of 10%.  

CI CONTENTION:  The CI contends for this unfitting condition and several other conditions he states were triggered by his unfitting condition.  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 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 - 20040115	VARD - 20040929	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Hashimoto’s Thyroiditis	7999-7903	10%	No VA Placement	
Depression	Not Unfitting	Depression	9434	0%	STR	
Erectile Dysfunction		Erectile Dysfunction	7522	0%		
History of Low Back Pain with recurrent Lipomas		History of Low Back Pain and Lumbar Disc Disease	5243	0%		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Hashimoto’s Thyroiditis.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was initially treated for hypothyroidism as far back as 1996.  Initially he was adequately controlled with thyroid replacement hormone, but subsequently was unable to achieve adequate control and removed from flight status.  The final performance report in evidence closed out on 1 June 2003, 9 months prior to separation.  It noted that he was the “most outstanding warrant officer in this battalion” and that the CI should be promoted ahead of his peers.  

In October 2003, the CI had been off of flight status for over 1 year and permanently grounded.  In addition, he reported problems with fluctuating weight, depression, and weakness associated with the hypothyroid condition as well as the impact of the poor control on his job (he was not able to remain on flight status).  The commander’s assessment was dated 2 November 2003 and noted that his duty performance had been excellent.  The CI was seen in endocrinology on 13 November 2003, and reported that he still had fatigue and trouble maintaining a stable weight, but that he was improved on his new medication regimen which began the previous January.  His physical examination was unremarkable.  The endocrinologist opined that the thyroid replacement medications had not been adequately titrated and frequent follow up and testing (every 6 weeks) was recommended.  

The panel observed that the weight at accession, on 16 February 1988, was 160 pounds and the CI was 67 inches in height.  Over 15 years later, on the MEB SF 2808 examination dated 31 October 2003, the CI was 68 inches in height and weighed 169 pounds.  This is within a few pounds of the expected gain with the additional inch in height.  

The 8 January 2004 MEB NARSUM examination, 6 weeks prior to separation, and based on the MEB physical examination on 31 October 2003.  It was thought that there was some residual thyroid function which made control difficult.  It noted that the CI had concerns with depression secondary to the alterations in thyroid function and waxing and waning of mood and physical abilities.  The physical examination was normal including the neurological examination.  Thyroid function tests showed suppression of the thyroid stimulating hormone and the thyroid function hormone levels were within the normal range.  

There was no VA Compensation and Pension (C&P) evaluation in evidence, the CI cancelled his scheduled examination in June 2004. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the Hashimoto’s Thyroiditis condition 10%, analogously coded 7903 (hypothyroidism), citing that continuous medications were required.  The VA did not rate the condition or consider it in the 29 September 2004 rating determination.
  
The panel considered the evidence to determine if criteria for a higher rating were met.  For a higher 30% rating, these include fatigability, constipation, and mental sluggishness.  The outstanding performance report and commander’s assessment do not support either fatigability or mental sluggishness.  In fact, they argue against both of these.  Constipation was reported 15 months prior to separation, but the panel found no record of it after December 2002.  The evidence does not support a higher rating than the 10% adjudicated by the PEB.  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 Hashimoto’s Thyroiditis condition.  

Contended PEB Conditions:  Depression, Erectile Dysfunction, and History of Low Back Pain with recurrent Lipomas.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  The depression was profiled, but at an S2.  The other two conditions were not profiled.  None of the conditions were implicated in the commander’s statement which was not specific.  All contended conditions were judged to meet retention standards.  There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded that there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions and so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the Hashimoto’s Thyroiditis condition and IAW VASRD §4.120, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended Depression, Erectile Dysfunction, and History of Low Back Pain with recurrent Lipomas conditions, the panel unanimously recommends no change from the PEB determinations as not unfitting.  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 20160223, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Rating Decision

AR20170013357, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	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,	  				      
						      					
Enclosure