RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04116
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20090123

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Operations Intelligence Helper, medically separated for “diabetes type 1” with a disability rating of 20%.   

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 - 20081208	VARD - 20090617	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Diabetes Type 1	7913	20%	Diabetes Mellitus	7913	20%	20090429	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Diabetes.  The CI’s diabetes was diagnosed in 2008 when her glucose was noted to be elevated at 452.  She was tested again the next day and was still elevated at 326.  She was admitted to a local hospital and started on insulin on 23 July 2008.  She was given a glucometer and referred for diet education and optometry.  A dilated eye examination done on 5 Sept 2008 was normal.  

The 29 September 2008 MEB narrative summary (NARSUM) examination, 4 months prior to separation, noted that the CI was on insulin.  The CI reported she was asymptomatic.  The examiner did not indicate that avoidance of strenuous occupational and recreational activities was medically necessary.  Following initiation of treatment at the time of diagnosis, the STR showed no subsequent episodes of ketoacidosis or hypoglycemia requiring hospitalizations or frequent visits to a diabetic care provider (twice a month or more frequently).  There was no evidence of diabetic complications.  The duty limiting condition report on 1 October 2008 listed no running more than 1/2 mile.  Her commander stated she was able to perform all her required duties and that there were no physical restrictions.  

At the 29 April 2009 VA Compensation and Pension (C&P) evaluation, 3 months after separation, the examiner reported that the CI was taking insulin.  The CI reported blurred vision, but no functional impairment from the condition.  The examiner did not indicate that avoidance of strenuous occupational and recreational activities was medically necessary.  On physical examination, the eyes, heart, lungs and sensation were normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the diabetes condition 20%, coded 7913.  The VA rated the diabetes 20%, coded 7913, citing the requirement for insulin and restricted diet.  The panel agreed that the requirement for treatment with insulin and restricted diet justified a 20% rating.  There was no evidence of medically-prescribed regulation of activities, so the next higher 40% rating was not justified.  Furthermore, following initiation of treatment, the STR showed no subsequent episodes of ketoacidosis or hypoglycemia requiring hospitalizations or frequent visits to a diabetic care provider (twice a month or more frequently), or complications that could support higher ratings.  

BOARD FINDINGS:  In the matter of the diabetes and IAW VASRD §4.120, 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:

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-04116.

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.