RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-05172
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20090106

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Health Care Specialist, medically separated from the Temporary Disability Retired List (TDRL) 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 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 - 20090904	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Ulcerative Colitis	7323	10%	Ulcerative Colitis	7323	30%	20090805	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY

Ulcerative Colitis. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s ulcerative colitis condition was first diagnosed in April 2002. At that time, biopsy showed pancolitis. The CI was treated with prednisone twice during that year with flares of ulcerative colitis. He was placed on TDRL in March 2007. The 10 September 2008 TDRL examination, 4 months prior to TDRL removal, noted complaints of variable bowel movements that were loose and spongy-formed, with some cramping on occasion but no blood. The CI reported since TDRL placement he experienced at least two episodes of flares requiring steroid treatment. Physical examination was unremarkable and lab results were normal.

At the 5 August 2009 VA Compensation and Pension (C&P) examination, 7 months after TDRL removal , the CI reported three one-month periods of remission in a year. The last severe flare was about 2-1/2 years prior. He missed no days of work during the past year. Physical examination showed a flat, soft abdomen with normal bowel sounds and diffuse mild tenderness without mass or hepatosplenomegaly.

The panel directed attention to its rating recommendation based on the above evidence. The CI was removed from TDRL with a permanent disability disposition of separation with severance pay at 10%. The PEB rated the ulcerative colitis condition 10%, coded 7323 (ulcerative colitis), citing the CI had two episodes requiring steroid boluses with infrequent exacerbations. The VA rated the ulcerative colitis condition 30%, coded 7323, based on the C&P examination, citing remissions in the condition only 3 out of every 12 months.

The higher rating of 30% is for a moderately severe condition with frequent exacerbations. At the time of TDRL removal, the CI reported “at least two episodes” of flares that required the use of steroid boluses in the year since separation. During the C&P examination, 7 months after separation, the CI reported he had not had a flare for about 2-1/2 years but that he continued to have symptoms. He had three one-month periods of remission in a year, but missed no days of work. Panel members agreed, the condition was chronic, but evidence of moderately severe impairment with frequent exacerbations was not appreciated. 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 condition at the time of TDRL removal.

BOARD FINDINGS: In the matter of the ulcerative colitis condition and IAW VASRD §4.114, the panel recommends no change in the PEB adjudication at the time of TDRL removal. 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.

2	PD-2017-05172

ARXXXXXXXXXXX 

Dear XXXXXXXXXXXXXXXXXXXXXXXXXXX:

	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,