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 Case Number PD-2017-05615

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 Navy. 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 E5, Submarine Nuclear Propulsion Operator, medically separated for “thoracic myofascial pain syndrome” and “bipolar disorder,” rated 10% each with a combined disability rating of 20%. The PEB rated the thoracic pain syndrome 10%, analogously coded 5299-5003 (degenerative arthritis).  The Category II diagnosis of “lumbar myofascial pain syndrome” was intrinsic to the rated condition and a separate rating could not be supported without pyramiding (VASRD §4.14); thus, it is appropriately subsumed under the same rating. The VA did not service-connect the thoracic pain syndrome. The VA Compensation & Pension (C&P) examination showed normal range of motion and no painful motion with otherwise normal physical examination of the thoracolumbar spine. Panel members agreed there was no evidence to support a rating higher than the PEB’s 10% rating. 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 thoracic pain syndrome.

In regards to the bipolar disorder, the PEB rated it 10%, coded 9432 (bipolar disorder).
The VA rated the bipolar disorder 30%, coded 9432, based on the C&P examination. Panel members agreed that the provisions of VASRD §4.129 (mental disorders due to traumatic stress), were not applicable in this case. Both the narrative summary and C&P examinations noted persistent depressive and hypomanic symptoms with partial improvement with ongoing therapy and medications. There was no evidence of psychiatric hospitalizations, emergency room visits or legal problems. After due deliberation, considering all the evidence and mindful of VASRD
§4.3, the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the bipolar disorder.

The panel assessed the fairness of the PEB determination that the contended insomnia was not unfitting. The insomnia was not noted on limited duty forms or implicated in the non- medical assessment, and did not fail retention standards. There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation. After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended insomnia, so no additional disability rating is recommended.

Sincerely,

2	PD-2017-05615

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

Ill REPLY Rl':FER TO:
1850
CORB: 003
10 Sep 20

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

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.