RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01495
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040305

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Heavy Construction Equipment Operator, medically separated  for “polyarthralgias” with a disability rating of 10%.

CI CONTENTION:  Other conditions were not considered.  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 - 20040122	VARD - 20041213	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Polyarthralgias	5099-5003	10%	Chronic Polyarthralgia of Unclear Etiology	5099-5003	NSC	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Polyarthralgias.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s polyarthralgia (multiple joint pain) condition began in early 2003.  The CI underwent multiple assessments by primary care and rheumatology which determined a diagnosis of chronic polyarthralgias in November 2003.  The MEB forwarded “multiple chronic joint pain” for PEB adjudication.

During the 10 December 2003 MEB NARSUM examination, 3 months prior to separation, the CI complained of chronic pains of multiple joints.  Physical examination was brief.  The “Extremities” portion of the examinations stated, “The [CI] had different examinations in the office where he would have arthralgias of the proximal and distal interphalangeal digits of his hands and feet.  There were no nodes or nodules of the hands or feet, and no gross joint deformities of his extremities.  He had a somewhat antalgic gait.”  Pain was assessed as slight intensity with frequent occurrence.  Chronic polyarthralgia of unclear etiology was diagnosed.  X-rays reveal bilateral shoulder and foot degenerative changes.  There was no VA examination proximate to separation for this panel to review.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the polyarthralgia condition at 10%, analogously coded 5099-5003 (degenerative arthritis), coded 5099-5003, citing the US Army Physical Disability Agency’s pain policy.  The VA did not service-connect the polyarthralgia condition, also coded 5099-5003, citing a definitive-diagnosed disability for establishing service connection was not shown.

Panel members first agreed that the involvement of multiple symptomatic joints clearly contributed to the overall disability in this case.  The panel concluded that the presumption that multiple joints were reasonably justified as separately unfitting was overturned by the preponderance of STR evidence.  The evidence showed the CI experienced fleeting symptoms coupled with “slight” pain and radiographic evidence of degenerative changes.  The panel determined the PEB’s listed diagnosis and coding scheme were appropriate.  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 polyarthralgia condition.

BOARD FINDINGS:  In the matter of the polyarthralgia condition and IAW VASRD §4.71a, the panel unanimously 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.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161012, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20180004007, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

	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