RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-04282
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20080902

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Dental Craftsman, medically separated for “chronic hepatitis B” with a disability rating of 0%.  

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 - 20080710	VARD - 20090603	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Hepatitis B	7345	0%	Hepatitis B	7345	0%	20090129	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:  

Chronic Hepatitis B.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s hepatitis B began in 2003 after a needle stick in a clinical setting.  She was treated with interferon and another anti-viral agent, resulting in a temporary decrease in viral load.  During the 28 April 2008 MEB NARSUM examination, 4 months prior to separation, the CI reported being “B antigen positive” without jaundice, pain, headache, chest pain, vomiting, abdominal pain or fatigue.  Physical examination revealed normal findings.

At the 29 January 2009 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported no acute symptoms.  Lab studies showed hepatitis B core antibody and hepatitis B antigen were positive, indicating acute hepatitis.  Physical examination showed no evidence of liver, abdominal, pulmonary or other systemic problems.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the hepatitis B condition 0%, coded 7345 (chronic liver disease without cirrhosis), citing the CI did not meet the criteria for a 10% rating.  The VA also rated the hepatitis B condition 0%, also coded 7345, based on the C&P examination, citing chronic liver disease without cirrhosis that was non-symptomatic.  Neither the NARSUM nor the C&P examination showed evidence of intermittent fatigue, malaise, anorexia or incapacitating episodes to meet VASRD criteria for a higher rating.  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 hepatitis B condition.  

BOARD FINDINGS:  In the matter of the hepatitis B condition 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 no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-04282.

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.