RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-05463
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20050513

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Aircraft Metals Technology Apprentice, medically separated for “diabetes mellitus (DM), Type I” with a disability rating of 20%.  

CI CONTENTION:  The CI makes no contentions.  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 - 20050303	VARD - 20060425	
Condition	Code	Rating	Condition	Code	Rating	Exam	
 Type I DM	7913	20%	Type I DM	7913	20%	20060111	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Type I DM,.  According to the service treatment record and MEB narrative summary (NARSUM), the CI developed Type I DM in June 2004 which ultimately required treatment with insulin injections.  The 15 October 2004 MEB NARSUM examination, 7 months prior to separation, noted the CI responding well to insulin therapy by near normalization of blood values as well as with improved adverse physical symptoms.  A general physical examination (PE) was normal.  The examiner did not indicate that avoidance of strenuous occupational and recreational activities was medically necessary.  An internal medicine encounter on 7 April 2005, one month prior to separation, noted a normal PE and active use of insulin.  At the 11 January 2006 VA Compensation and Pension (C&P) examination, 8 months after separation, the CI reported no adverse physical symptoms from the DM.  The general PE remained normal and the provider noted the DM did not cause any restriction of activities. 

The panel directed attention to its rating recommendation based on the above evidence.  Both the PEB and VA rated the DM condition at 20%, coded 7913 (DM), citing the absence of VASRD criterion for regulation of activities.  The clinical evidence near the time of separation was consistent with a 20% rating IAW VASRD §4.119.  There was no laboratory evidence that ketoacidosis or hypoglycemia were manifested at any time since the original diagnosis.  Neither the physical profile nor the commander’s statement provided evidence that any regulation of routine activities was imposed by the DM.  Panel members agreed that the higher 40% rating criteria under 7913 were not reasonably supported by the evidence and there was not reasonable doubt in the CI’s favor to justify a panel recommendation for other than the 20% rating assigned by the PEB for the DM.  

BOARD FINDINGS:  In the matter of the type I diabetes mellitus and IAW VASRD §4.119, 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.  

SAF/MRB

Dear XXXXXXXXXXX:
Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05463.
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 rating modification or re-characterization 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 modification of your disability rating or characterization of your separation is not warranted. Accordingly, I accept the recommendation that your application be denied.