RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05240
BRANCH OF SERVICE:  air force	SEPARATION DATE:  20050506

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Avionic Test Station and Aircraft Component Apprentice, 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 - 20050119	VARD - 20050526	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Ulcerative Colitis	7323	10%	Ulcerative Colitis 	7346-7323	30%	20050412	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:

Ulcerative Colitis.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s ulcerative colitis was initially treated on 18 August 2003 after reporting a 9-day history of diarrhea; his weight was 173 pounds.  A colonoscopy was performed on 12 September 2003 and ulcerative colitis was diagnosed.  He was treated with oral medications and steroid enemas which helped resolve his symptoms.  

The 5 November 2004 MEB NARSUM examination, 6 months prior to separation, noted the CI’s symptoms were well-controlled and asymptomatic and the CI was well nourished.  Physical examination was normal.  The commander’s statement, dated 30 November 2004, documented the CI’s ability to work a full duty shift in his military specialty without a significant amount of time lost due to illness.  The CI’s retention was recommended for the enhancement of the mission.  The PEB determined the CI was doing well, but his symptoms might not be well controlled in a high stress and/or deployed environment; therefore, separation was rendered.

At the 12 April 2005 VA Compensation and Pension (C&P) evaluation, 1 month before separation, the CI reported a weight drop from 180 to 158 pounds in 1 month, but his current weight was 171 pounds.  [The panel found the CI’s weight was stable for 17 months prior to separation, and 9 months thereafter.]  The CI gained weight after separation.  The CI reported flares of his condition lasting 3-4 days every month during which time he could not work.  [These flares were not noted in the STR.]  The CI reported having abdominal cramping one-third to two thirds of the time.  [The STR showed the CI was asymptomatic after initial treatment 18 months prior to separation through 9 months after separation.]  Physical examination was benign and the blood work did not show anemia.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the ulcerative colitis 10%, coded 7323 (ulcerative colitis), citing a well-controlled condition in a non-stressful environment.  The VA rated the ulcerative colitis 30%, analogously coded 7346-7323, (hiatal hernia-ulcerative colitis), citing frequent exacerbations.  A 30% rating requires a “moderate severe [impairment]; with frequent exacerbations.”  The 10% rating requires a “moderate [impairment]; with infrequent exacerbations.”  The STR showed the CI was asymptomatic and clinically stable for the year leading up to separation and for 9 months following separation.  The panel determined that the STR evidence most closely approximates a “moderate” level of impairment at separation.  After due deliberation, considering all of 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:

Exhibit A.  DD Form 294, dated 20170524, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

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

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05240.

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.

						Sincerely,

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings