RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-02927
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060216

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E7, Cable Systems Installer/ Maintainer, medically separated for “diabetes insipidus” with a disability rating of 0%.  

CI CONTENTION:  In addition to the diabetes, the CI requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20060123	VARD - 20071109	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Diabetes Insipidus	7909	0%	Diabetes Insipidus	7909	20%	20070505	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Diabetes Insipidus.  According to the service treatment record and MEB narrative summary (NARSUM), the CI began to reveal physical symptoms of dry mouth, extreme thirst and frequent urination in April 2005.  After an extensive medical work-up, the condition was diagnosed as diabetes insipidus (a condition that may cause frequent episodes of dehydration if not properly treated).  At the 9 December 2005 MEB NARSUM examination, 2 months prior to separation, the CI complained of “always feel[ing] thirsty and frequent urination.”  The examiner recorded that the CI “continues with frequent headaches, polydipsia, thirst and polyuria (frequent urination).  The general physical examination (PE) was normal and the CI was maintained on Desmopressin nasal spray twice a day.  During the 5 May 2007 VA Compensation and Pension (C&P) examination, 15 months after separation, the examiner stated there were “no episodes of dehydration since being on medication.”  The PE was unremarkable.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the diabetes insipidus condition 0%, coded 7909 (diabetes insipidus), citing the condition was controlled while on medication and no episodes of dehydration since being on medication.  The VA rated the condition 20%, coded 7909, based on the C&P examination, citing polyuria with near-continuous thirst.  VASRD code 7909 is specific for this condition and has four rating intervals of 20%, 40%, 60% and 100%.  The 20% rating level is the only level that does not require one or more episodes of dehydration within the past year.  This case clearly revealed that the CI had no such episodes since being on the proper medication.  Therefore, the only positive rating that was considered was the 20% level.  Panel members agreed there was evidence of polyuria with near-continuous thirst warranting a 20% rating.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the diabetes insipidus, coded 7909.  

BOARD FINDINGS:  In the matter of the diabetes insipidus condition, the panel recommends a disability rating of 20%, coded 7909 IAW VASRD §4.120.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Diabetes Insipidus	7909	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170217, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190008790, XXXXXXXXXXXXXXXXXX 

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Dear XXXXXXXXXXXXXXXXXX

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.