RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX  	CASE:  PD-2017-04990
BRANCH OF SERVICE:  Army 		SEPARATION DATE:  20090110

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Food Service Operations Specialist, medically separated for “Crohn’s Disease” with a disability rating of 10%.    

CI CONTENTION:  No specific contention was made.  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 – 20081126	VARD - 20090511	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Crohn’s Disease	7399-7323	10%	Crohn’s Disease	7399-7323	10%	20081215	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Crohn’s Disease.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s Crohn’s disease was diagnosed in September 2007 after several months of frequent diarrhea, a 30-pound weight loss, iron deficiency, anemia, and abdominal pain.  Biopsy results were consistent with the diagnosis of Crohn’s disease.  One month after diagnosis the CI underwent successful ileocecectomy due to terminal ileal perforation. The CI subsequently deployed to Korea, where she had a flare of her Crohn’s disease, was hospitalized and eventually sent back to her stateside post.  On 21 October 2008 the CI requested an MEB due to inability to perform physical training.  The 24 October 2008 MEB NARSUM examination, 3 months prior to separation, noted complaints of lethargy and increased bowel movements with exercise.  Otherwise, she reported she was healthy and had no abdominal pain.  The CI took two medications to treat the illness.  Physical examination showed a thin female in no distress with normal abdominal findings.  

At the 15 December 2008 VA Compensation and Pension (C&P) examination, one month before separation, the CI reported her condition was controlled by medications.  Physical examination showed her to be 66 inches tall and 157 pounds.  There was evidence of bloating with percussion and hyperactive bowel sounds.  There was also a mild keloid, tender surgical scar.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB and the VA both rated the Crohn’s disease 10%, analogously coded as 7323 (ulcerative Colitis).  The PEB cited moderate, infrequent exacerbations.   The VA based the rating on the C&P examination, citing infrequent exacerbations.  The NARSUM examination noted the CI had few complaints and was taking medications.  The C&P examination, one month prior to separation, showed the condition was well controlled.  There was no evidence of a moderately severe condition with frequent exacerbations. 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 Crohn’s condition.  

BOARD FINDINGS:  In the matter of the Crohn’s 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.  

	PD-2017-04990

XXXXXXXXXXXX 

Dear XXXXXXXXX

	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.

Sincerely,					      

Enclosure

	

	PD-2017-04990