DEPARTMENT OF THE AIR FORCE
WASHINGTON DC

Office of the Assistant Secretary

SAF/MRBD (PDBR)
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

MEMORANDUM FOR THE ASSISTANT SECRETARY OF THE NAVY, MANPOWER AND RESERVE AFFAIRS

SUBJECT: Physical Disability Board of Review Recommendation on XXXXXXXXXXXX Case Number PD-2017-05059

In accordance with Title 10 § 1554a and in compliance with DoDI 6040.44, the Physical Disability Board of Review (PDBR) adjudicated the disability rating accompanying the medical separation of the covered individual from the United States Marine Corps. After carefully reviewing the application and medical separation case file, the PDBR recommended no re- characterization of the separation or modification of the disability rating previously assigned. I recommend you accept this proposed decision.

The covered individual (CI) was an active duty E3, Electrician, medically separated for “schizophreniform disorder” and “history of fractured back and hip,” rated 10% each, with a combined disability rating of 20%. The PEB coded the schizophreniform disorder 9210 (psychotic disorder, not otherwise specified) and noted it existed prior to separation (EPTS) with 0% disability reduction. The PEB also listed bipolar disorder as a related Category II condition that contributed to the primary unfitting condition but was not separately ratable. The impairment from the bipolar disorder was properly subsumed under the overall rating for the schizophreniform condition IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). The VA rated the schizophrenia/bipolar disorder condition 30%, coded 9203 (schizophrenia, paranoid type), based on the Compensation and Pension (C&P) examination, citing difficulty sleeping, panic attacks, and anxiety. The panel considered the provisions of VASRD §4.129 (mental disorders due to traumatic stress), and agreed there was no evidence of a traumatic event or stressor causing the unfitting mental health condition, and that application of VASRD §4.129 was not appropriate in this case.

The narrative summary (NARSUM) noted that a September 2004 Medical Board had recommended 8 months of limited duty. The CI received outpatient psychiatric care in October 2004 and was able to perform menial tasks per order of her Command but she was unable to return to full duty. However, she was considered stable and a mental status examination (MSE) showed mild symptoms. The C&P examination noted the CI had mild transient symptoms, worked 30 hours per week, had good relationships with staff, and lost no time from a job that required contact with the public. She reported she felt better with medication and had a good response to medication. MSE was essentially unremarkable. Panel members concluded the preponderance of evidence showed symptoms controlled by continuous medication, thereby

meeting criteria for 10% disability. 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 schizophreniform disorder.

In the matter of the history of a fractured back and hip condition, the PEB dual coded 5235-5242 (vertebral fracture or dislocation - degenerative arthritis of the spine). The VA rated for residuals, compression fracture of thoracic spine 0%, coded 5235, based on the C&P examination, citing no ratable features above 0%. The VA also rated the right hip condition as not service connected, coded 5251 (thigh, limitation of extension), citing no permanent residual or chronic disability subject to service connection shown by the service medical records or demonstrated by evidence following service. The panel noted hip X-rays in 2004 were negative and no additional evidence of pathology and treatment for the right hip was found, thus the panel agreed the hip was not unfitting. The NARSUM examination noted a healed fracture of T1 and observational measurement of “about” 50 degrees of spine flexion but noted the CI could touch her toes, suggesting a near 90 degree flexion. There was no clear limitation of thoracolumbar spine motion to support a 10% rating under the General Rating Formula for Diseases and Injuries of the Spine, however the NARSUM examination noted the presence of painful motion. A 10% rating for the fractured back was therefore warranted per VASRD §4.59. There was no muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis. The C&P examination noted no evidence of back pathology. There was no evidence of intervertebral disc syndrome which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of rating under that alternate VASRD formula. The 5235-5242 code was applicable in this case and warranted a 10% rating for the fractured back, but not the hip. However, this provided no benefit to the CI. There was therefore no separate or combined VASRD §4.71a rating higher than the 10% adjudicated by the PEB under any applicable code. 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 history of fractured back and hip condition.

2	PD-2017-05059

DEPARTMENT OF THE NAVY
SECRETARY OF TIIE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO:
1850
CORB: 003
10 Sep20

From: Director, Secretary of the Navy Council of Review Boards To:	

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.