RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00893
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20050314

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Air National Guard E7, Helicopter Flight Engineer, medically separated for “Factor V Leiden mutation status post pulmonary emboli, requiring life-long Coumadin therapy” with a disability rating of 10%.

CI CONTENTION:  Unfitting condition occurred while on active duty National Guard service.  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 - 20050106	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Factor V Leiden Mutation s/p Pulmonary Emboli, requiring life-long Coumadin Therapy	7799-7705	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:

Factor V Leiden Mutation, status post Pulmonary Emboli.  According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI developed spontaneous symptoms of respiratory distress on 20 May 2004.  X-rays revealed the presence of numerous blood clots within the lungs (pulmonary emboli).   The CI was hospitalized for 3 days and became stable on oral anticoagulant medication.  The MEB forwarded thrombophilia secondary to heterozygous Factor V Leiden mutation for PEB adjudication.  Factor V Leiden is a mutated form of blood clotting factor which increases the chance of developing abnormal blood clots.

At the 27 August 2004 MEB NARSUM examination, 7 months prior to separation, the CI’s reported “shortness of breath.”  Physical examination was normal except for a mild elevation in blood pressure.  The CI’s diagnosis remained unchanged and the examiner’s recommendation was lifetime anticoagulation with Coumadin (oral medication). There was no VA examination proximate to separation for the panel to review.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the Factor V Leiden Mutation (blood clotting) condition 10%, analogously coded 7799-7705 (thrombocytopenia; primary, idiopathic, or immune).  The CI’s mutated blood clotting factor was clearly demonstrated by the acute formation of numerous pulmonary emboli.  The VASRD addresses this condition under nontuberculous lung diseases; specifically, code 6817 (pulmonary vascular disease).  All panel members agreed that VASRD code 6817 was specifically accurate in describing the CI’s lung embolic condition.  The difference between a 0% and 30% rating under code 6817 requires continued symptoms (symptomatic) following resolution of acute pulmonary embolism (blood clot in the lung).  After an extensive review of the STR, panel members agreed the CI was not symptomatic at the time of separation as documented by the MEB NARSUM and multiple visits to the anticoagulation clinic.  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’s adjudication for the Factor V Leiden Mutation condition.

BOARD FINDINGS:  In the matter of the Factor V Leiden Mutation condition and IAW VASRD §4.97 the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends 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 20160913, w/atchs
Exhibit B.  Service Treatment Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-00893.

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,

XXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings