RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00505
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20060516

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Aerospace Medical Service Craftsman, medically separated for “diabetes mellitus type I” with a disability rating of 20%.  

CI CONTENTION:  “Review all conditions.  Length of service (16 years 10 months) should afford retirement.”  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 - 20060310	VARD - 20081224	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Diabetes Mellitus, Type I	7913	20%	Type I Diabetes Mellitus	7913	20%	STR	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Diabetes Mellitus, Type I.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s diabetes mellitus type I condition was initially diagnosed in May 2005 following an acute viral illness.  He was evaluated by endocrinology, referred to MEB, and was returned to duty by the PEB in October 2005.  He was doing well, but his fluctuating blood sugars caused extreme anxiety and required frequent medication dose adjustments to his regimen.  The P4 profile 5 months before separation restricted the CI from formal physical training when his blood glucose was greater than 250. 

The 4 February 2006 MEB NARSUM examination, 3 months prior to separation, noted the complaint of type I diabetes.  The CI was doing very well with monitoring and maintaining his medication regime; however, diet restrictions or regulation of activities were not addressed.   Physical examination was unremarkable.  The 13 February 2006 MEB endocrinology addendum noted the CI required quarterly visits to the physician and diet restriction, and was restricted from PT or carrying/firing weapon at range when blood glucose was more than 250 or less than 70mg/dl.  The physician noted the CI’s condition was very well controlled, and that he had no diabetes-related complications.  The commander noted the CI had continued working in his AFS, but due to his condition he was unable to fulfill the duty requirement of deployment.  The STR demonstrated the absence of hospitalization for control of ketoacidosis or hyperglycemic reactions; absence of any evidence of peripheral neuropathy, diabetic neuropathy, or nephropathy; and there was no indication of regulation of activities.  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 diabetes 20%, coded 7913 (diabetes mellitus).  The VA also rated the diabetes condition 20%, coded 7913, based on the STR.  The panel agreed that the CI’s requirement for insulin and restricted diet justified a 20% rating.  Because there was no evidence of medically prescribed regulation of activities, the next higher 40% rating was not justified.  Furthermore, there were no documented episodes of ketoacidosis, hypoglycemic reactions, hospitalizations or diabetic complications that could support higher ratings.  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 type I diabetes condition.

BOARD FINDINGS:  In the matter of the diabetes type I condition and IAW VASRD §4.120, 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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170213, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs 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-2017-00505.

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,

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings