RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00721
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20040209

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Personnel Craftsman, medically separated for “fibromyalgia” with a disability rating of 20%.  

CI CONTENTION:  “Review all conditions.”  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 - 20031209	VARD - 20041021	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Fibromyalgia	5025	20%	Fibromyalgia with Mood Disorder	5025	40%	20040512	
Obesity	Category III	No VA Placement	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  60% 	

ANALYSIS SUMMARY:  

Fibromyalgia.  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was evaluated for multiple somatic complaints which began after the birth of her first child in 1988.  On 10 July 2003, she was evaluated in rheumatology for possible fibromyalgia and the diagnosis was confirmed.  She was referred for physical therapy and regular exercise and her medications were adjusted.  On 2 October 2003, she was re-evaluated and reported ongoing symptoms, but there was improvement with treatment.  Benefit from treatment was also reported on follow-up examinations in physical therapy and primary care.  

The 30 October 2003 MEB NARSUM examination, 4 months prior to separation noted complaints of ongoing muscle aches and fatigue.  The CI reported an exacerbation after working 12-hour days for 14 days straight in preparation for a deployment.  It was also noted she had recently (not defined) been placed on 24 hours of quarters twice and on convalescent leave for a “short period of time.”  On examination, multiple trigger points were positive.  She was noted to be world-wide qualified.  

At the 12 May 2004 VA Compensation and Pension (C&P) evaluation, 3 months after separation, the CI reported some benefit from treatment and aggravation from increased activity.  She was again noted to have multiple positive trigger points.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the fibromyalgia condition 20%, coded 5025 (fibromyalgia) IAW DoD and VASRD guidelines.  The VA rated the fibromyalgia condition 40%, also coded 5025, based on the C&P examination 3 months after separation, citing constant symptoms which were refractory to treatment.  The criteria for a 40% rating includes constant or nearly constant symptoms which are refractory to treatment.  While the CI reported persistent symptoms, she also reported benefit from therapy.  Thus, the criteria for a 40% rating was not met.  After due deliberation, considering all of 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 fibromyalgia condition.  

Contended PEB Condition:  Obesity.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  As noted in DoDI 1332.38 E5.1.3.10., obesity does not constitute a physical disability and is therefore not ratable.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the fibromyalgia condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended obesity condition, the panel unanimously recommends no change from the Category III determination.  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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160913, w/atchs
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

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-00721.

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.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have 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.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

Attachment:
Record of Proceedings