RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02313
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20041103

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Communications-Computer Systems Operator, medically separated for “Crohn's disease with pancolitis” with a disability rating of 10%.   

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 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 - 20040805	VARD - 20050516	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Crohn's Disease with Pancolitis	7323-7399	10%	Crohn's Disease	7399-7323	10%	20050301	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:  

Crohn's Disease with Pancolitis.  According to the service treatment record and MEB narrative summary (NARSUM), the CI presented with anorexia, nausea, abdominal pain, diarrhea and weight loss in September 2003.  In March 2004, a colonoscopy revealed pancolitis.  The 15 June 2004 MEB NARSUM examination, 5 months prior to separation, noted his symptoms had stabilized, with no diarrhea, blood in the stool, or fever, and an increase in energy and appetite with a return to baseline weight.  The CI reported occasional mild abdominal pain associated with gas and fatigue on busy or stressful days.  Medications included daily prednisone and pantasa.  Physical examination showed a weight increase from 152 pounds (2 months earlier) to 170 pounds.  The 9 July 2004 commander’s statement, 4 months before separation, indicated the CI was working full shifts, performing more than his full measure of duty, and should be returned to full duty status.  At a 14 February 2005 gastroenterology appointment, 3 months after separation, the CI reported a recent flare-up which was treated with increased prednisone.  There was no blood in the stool, diarrhea, fevers or chills, and his weight was 170 pounds.  

The 1 March 2005 VA Compensation and Pension (C&P) evaluation, 4 months after separation, noted complaints of low energy, daily abdominal pain, nausea and fatigue.  The CI reported flare-ups occurring once or twice a month lasting several days.  Physical examination showed mild tenderness in the right lower quadrant, no evidence of bleeding during a rectal examination, and a weight of 176 pounds.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the Crohn's Disease 10%, coded analogously to 7323, (colitis, ulcerative), citing DoD and VASRD guidelines.  The VA also rated the Crohn's Disease 10%, coded analogously to 7323, based on the C&P evaluation, citing infrequent exacerbations.  The panel noted that at the time of separation, the CI was doing well, had no signs of malnutrition and was experiencing infrequent attacks.  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’s adjudication for the Crohn's Disease.  

BOARD FINDINGS:  In the matter of the Crohn's disease and IAW VASRD §4.114, 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 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 20170121, 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-2017-02313.

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