RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00980
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070124

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Cavalry Scout, medically separated for “left lateral abdominal pain” with a disability rating of 10%.  

CI CONTENTION:  “I was only awarded 10% for shrapnel after being shot in an ambush.  After I entered the Denver VA system I was found to have PTSD, TBI, neck injury, and ear damage.”  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 - 20061108	VARD - 20070703	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Lateral Abdominal Pain	5099-5003	10%	S/P Shrapnel Wound Left Abdominal Area	5314	10%	20070430	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Chronic Left Lateral Abdominal Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s abdominal condition was the result of a shrapnel injury that occurred on 18 May 2003.  He was sent back to the states for recuperation.  One piece of shrapnel was removed, but others remained in the body cavity.  The CI healed and deployed again from November 2003 to April 2004 and from August 2005 to February 2006.  He continued to have pain and expressed difficulty doing his job as a cavalry scout and wearing his load bearing equipment.  While on his last deployment, sharp, deep flank pain began to limit functioning.  
The 28 August 2006 MEB physical examination showed no tenderness to the left flank.  At the 17 October 2006 MEB NARSUM examination, 3 months prior to separation, the CI reported 1-2/10 pain when completely at rest.  He noted that any twisting or heavy lifting caused the pain to increase to a 5-7/10.  He could no longer run for pleasure, practice martial arts, do yard work, or roughhouse with his children due to his left flank pain.  At the 30 April 2007 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI made no specific complaints and the physical examination of the abdomen was normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left flank condition 10%, coded 5099-5003 (analogous to arthritis, degenerative), citing moderate, occasional deep pain.  The VA also rated the left flank condition 10%, coded 5314 (group XIV function), based on the C&P examination, citing continued abdominal pain with retained shell fragments.  

The panel, in accordance with VASRD §4.56, notes the left flank condition is best characterized as moderate muscle disability and rated at 10% under code 5319 (group XIX, muscles of the abdominal wall) with deep penetrating shrapnel fragments without explosive effect of high velocity missile, residuals of debridement, or prolonged infection.  The next higher 30% rating under this code requires evidence of a moderately severe injury with palpation of loss of deep fascia, loss of muscle substance, or loss of normal firm resistance, which were not present.  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 left flank condition.  

BOARD FINDINGS:  In the matter of the left flank condition and IAW VASRD §4.73, 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 20170212, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180005734, 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