RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-04300
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20060519

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Fire Protection Journeyman, medically separated for “ulcerative colitis” 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 - 20060328	VARD - 20070331	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Ulcerative Colitis	7323	10%	Ulcerative Colitis	7323	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Ulcerative Colitis.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s ulcerative colitis began in August 2004 with complaints of bright red blood per rectum/melenic (black) stools, 3-4 bowel movements per day, and a history of abdominal pain.  A colonoscopy on 26 October 2004 revealed multiple polyps and chronic active colitis, which was confirmed by biopsies.  The CI had not responded to oral anti-inflammatory medication, and mesalamine (5-ASA) suppositories was prescribed along with simethicone for flatulence.  However, the CI discontinued the 5-ASA suppositories secondary to discomfort and inconvenience, and mesalamine (Rowasa) enemas were prescribed as an alternative.  
At the gastroenterology follow-up on 5 January 2006, the CI reported he was on no medications and had daily abdominal cramping and blood in his stool.  He requested a surgical consult as he did not wish to pursue further any other medical treatments.  The surgical consult on 24 January 2006 noted “minimal symptoms now on enemas, although the patient is not using enemas very often.”  Physical examination of the abdomen was normal and surgery was not recommended.  

The 13 February 2006 MEB NARSUM examination, 3 months prior to separation, noted good control with diet and occasional Rowasa enemas.  The CI reported a small amount of blood in his stool 1-2 times per month.  Physical examination was not performed.  There was no VA examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the ulcerative colitis 10%, analogously coded 7323 (colitis, ulcerative), citing the condition was not in remission but controlled with diet and enemas.  The VA rated the ulcerative colitis 0% citing the CI failed to attend a C&P examination.  Panel members agreed that a 10% rating was supported for moderate ulcerative colitis with infrequent exacerbations.  There was no evidence of moderately severe symptoms with frequent exacerbations 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 ulcerative colitis.   

BOARD FINDINGS:  In the matter of the ulcerative colitis 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-2017-04300.

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.