RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00644
BRANCH OF SERVICE:  AIR FORCE	SEPARATION DATE:  20041018

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Fire Protection Journeyman, medically separated for “diffuse 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 conditions 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 - 20040624	VARD - 20050201	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Diffuse Ulcerative Colitis	7323	10%	Ulcerative Colitis	7323	30%	20050112	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:

Diffuse Ulcerative Colitis.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s ulcerative colitis condition began in January 2004.  The CI presented with a 1 week history of blood in his stool.  After an initial evaluation which included a colonoscopy on 6 February 2004, the CI was diagnosed with ulcerative colitis and begun on Mesalamine (nonsteroidal anti-inflammatory).  He subsequently did well and met all duty requirements in garrison, but was not deployable and referred for an MEB.

The MEB NARSUM examination was dated 21 March 2004, 7 months prior to separation.  The examiner noted that he was asymptomatic and had a normal physical examination without stigmata of inflammatory bowel disease.  His weight was 163.  The gastroenterologist recommended consideration of retention in a non-deployable status.  He had one relapse in August which was treated with a 5 day steroid burst.

The CI was medically separated on 18 October 2004.  One month after separation, the CI was evaluated in a VA gastroenterology clinic and noted to have been asymptomatic since the flare in August and his weight was stable at 168 (an increase from 8 months earlier).  His examination was unremarkable.  At the VA Compensation and Pension (C&P) general evaluation performed on 12 January 2005, 3 months after separation, the CI reported flares of lower left quadrant pain 1-2 times a year with some abdominal pain 3 times a month.  He reported loose stools 3 times a day without blood other than in flares.  He denied weight loss.  The physical examination was unremarkable and his weight had again increased to 171 pounds.

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), citing the CI’s medical condition is not compatible with the rigors of military service.  The VA rated the ulcerative colitis condition 30%, also coded 7323, based on the C&P examination 3 months after separation, citing frequent exacerbations.

The panel directed attention to its rating recommendation based on the above evidence.  While the VA rated the CI for frequent exacerbations, these were not documented in the record and the records proximate to separation both before and after noted that the CI was asymptomatic.  The criteria for a 30% rating are “moderately severe with frequent exacerbations.”  The panel also noted that the CI’s weight increased over the course of the illness which is not consistent with a moderately severe condition.  The panel determined that the evidence does not support a higher 30% rating at separation.  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 diffuse ulcerative colitis condition.

BOARD FINDINGS:  In the matter of the diffuse ulcerative colitis condition and IAW VASRD §4.114, 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 20160915, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-00644.

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,

Attachment:
Record of Proceedings