RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02996
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20091013

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Infantryman, medically separated for “irritable colon syndrome” 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 - 20090901	VARD - 20100121	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Irritable Colon Syndrome	7319	10%	Irritable Bowel Syndrome	7319	10%	20091020	
Asthma	Not Unfitting	Asthma	6602	30%		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Irritable Colon Syndrome.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s irritable colon syndrome began around August 2008 with frequent stools occurring 6 to 7 times per day.  He was referred to see a gastroenterologist, who completed a workup with a negative stool study and lactose intolerance screening, and normal capsule study and colonoscopy.  Medication and diet modifications did not stop the diarrhea.  At the 27 July 2009 MEB NARSUM examination, 3 months prior to separation, the CI complained of diarrhea with 6 to 7 episodes a day, described as “mostly watery but with splotches of stool.”  The CI denied any recent fever or weight loss.  Physical findings from the February 2009 MEB examination history and physical were unremarkable.

At the 20 October 2009 VA Compensation and Pension (C&P) examination, 7 days after separation, the CI reported he only missed one day of work due to a colonoscopy, and denied any impairment of activities of daily living.  He described having six loose stools a day, and intermittent cramps in the lower abdomen and with defecation, but dietary changes had improved symptoms.  Physical examination revealed tenderness over the right lower quadrant, normal bowel sounds, and no masses or enlargement of the liver or spleen.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the irritable colon syndrome 10%, coded 7319 (irritable colon syndrome), citing moderate symptoms and frequent episodes of bowel disturbance with abdominal distress.  The VA also rated the irritable colon syndrome 10%, coded 7319, based on the STR and C&P examinations, citing frequent episodes of bowel disturbance with abdominal distress.  Panel members agreed there was no evidence of severe diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress to justify a higher rating of 30%.  There were no additional applicable codes to consider, and thus, the panel adjudged that a 10% rating and no higher was justified for the condition.  After due deliberation, considering all 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 irritable colon syndrome.  

Contended PEB Condition:  Asthma.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was not profiled or implicated in the commander’s statement, and did not fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the irritable colon syndrome and IAW VASRD §4.114, the panel recommends no change in the PEB adjudication.  In the matter of the contended asthma, the panel agrees it cannot recommend it for additional disability rating.  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 20170323, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190008728, XXXXXXXXXXXXXXXXXX

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Dear XXXXXXXXXXXXXXXXX

	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.

A copy of this decision has been provided to the counsel you listed on your application, Veterans Service Office, 2851 Jefferson Street, Marianna, FL 32448.