RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03584
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060120

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Human Resources Specialist, medically separated for “chronic left flank pain status post (S/P) nephrectomy” 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 - 20050710	VARD - 20061121	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Flank Pain S/P Nephrectomy	5099-5003	10%	Left Flank Pain	5099-5003	NSC	20060504	
			Renal Cell Cancer, S/P Nephrectomy	7500	30%	20060504	
Asthma	Not Unfitting	Asthma	6602	10%	20060504	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  70% 	

ANALYSIS SUMMARY:  

Chronic Left Flank Pain S/P Nephrectomy.  According to the service treatment record and MEB narrative summary (NARSUM), the CI was initially evaluated in September 2004 for a 2-3 week history of left flank pain.  In addition to kidney stones, the CT of the abdomen showed a large left renal mass.  The initial biopsy was suspicious for renal cell carcinoma so a radical nephrectomy was performed.  The final diagnosis of the tissue removed was a benign renal tumor.  Since the operation, he continued to have left flank pain necessitating activity limiting profiles.  There was no further surgical indication.  

The 10 July 2005 MEB NARSUM examination, 6 months prior to separation, noted complaints of persistent flank pain.  Physical examination showed the incision site was clean, dry, and intact with no obvious hernia.  At the 4 May 2006 VA Compensation and Pension (C&P) examination, 4 months after separation, the examiner recorded no functional impairment resulting from the left flank pain.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left flank pain 10%, analogously coded 5099-5003 (degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA determined the left flank pain condition was not service-connected.  Though the CI did have a nephrectomy, removal of the kidney, there was no performance-based evidence from the record that the condition in and of itself significantly interfered with satisfactory duty performance at separation.  Panel members agreed they could not recommend an additional disability rating based on nephrectomy.  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 left flank pain.  

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, implicated in the commander’s statement, or judged to 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 left flank pain and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended asthma condition, the panel recommends no change from the PEB determination as not unfitting.  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.  

AR20180015390, 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.