RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2016-00520
BRANCH OF SERVICE:  Marine Corps	SEPARATION DATE:  20031215

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Field Radio Operator, medically separated for “seronegative rheumatoid arthritis” with a disability rating of 20%.  

CI CONTENTION:  “The condition that I was rendered unfit for service had several underlying conditions that were not properly diagnosed at the time of discharge and has aggravated the situation.”  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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20031106	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Seronegative Rheumatoid Arthritis	5002	20%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Seronegative Rheumatoid Arthritis.  According to the service treatment record and MEB narrative summary (NARSUM), the right-handed CI began to experience bilateral hand and foot pain, swelling, and morning joint stiffness in September 2001.  Evaluation led to a rheumatologist’s diagnosis of seronegative rheumatoid arthritis with resolution of symptoms on systemic steroids and a transition to methotrexate (immunosuppressive agent).  At an internal medicine visit on 5 June 2003, the CI related improved symptoms on methotrexate and medication included “Prednisone PRN” indicating the CI could take a burst of systemic steroids as needed.  
The 11 June 2003 MEB NARSUM examination, 6 months prior to separation, noted complaints of hand and foot swelling and pain with an inability to lose weight due to the use of steroids for flares.  Physical examination was not detailed, and the 25 September 2003 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months before separation, showed “normal” checked marked for upper and lower extremities to include foot evaluation.  There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the rheumatoid arthritis condition 20%, coded 5002 (rheumatoid arthritis (atrophic) as an active process).  Although the STR documented several flares of pain with required steroid tapers, it did not support multiple episodes of incapacitation or total incapacitation.  There was no objective evidence or examination findings of definite impairment of health, weight loss, or anemia, for any rating higher than that adjudicated by the PEB.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the rheumatoid arthritis condition.  

BOARD FINDINGS:  In the matter of the rheumatoid arthritis condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.  

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS Ref: (a) DoDI 6040.44
In accordance with reference (a), I have reviewed the cases listed below and approve the recommendations of the PDBR that the following individual's records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy's Physical Evaluation Board: