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-2017-05839

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 E4, Administrative Clerk, medically separated for “recurrent atypical chest pain” with a disability rating of 10%. The PEB analogously coded the condition 7199-7121 (post-phlebitic syndrome (post-thrombotic) of any etiology).  The Category II conditions “recurrent bilateral deep venous thrombosis” and “bilateral pulmonary embolism (PE),” which contributed to the primary condition, were not separate conditions which could be reasonably justified as separately unfitting; nor was a separate rating achievable without violation of VASRD §4.14 (avoidance of pyramiding). Panel members agreed that the MEB narrative summary (NARSUM) cardiology addendum noted the presence of constant mid-sternal chest pain despite preventive PE and deep vein thrombosis (DVT) treatment and no heart/cardiac limitations. Physical examination showed slight calf swelling with tenderness, and the remainder of the examination, to include the heart and lungs, was unremarkable. Anti-coagulation medication treatment continued. The panel agreed the CI’s condition met criteria for a 10% rating in accordance with the presence of intermittent edema under analogous coded 7121. There was no evidence of persistent swelling, incompletely relieved by elevation of either leg, to meet criteria for a higher 20% 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 recurrent atypical chest pain condition.

In the matter of the contended extrinsic asthma, the panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting. The contended condition was on the final limited duty form but was not specifically implicated in the non- medical assessment and did not fail retention standards. During the 6 September 2006 MEB NARSUM examination, 12 months prior to separation, the examiner opined that the CI was not

able to perform his military duties because of increased risk of hemorrhage due to anticoagulation medication treatment. At the 6 February 2006 MEB NARSUM cardiology addendum, 7 months before separation, the examiner documented that the CI’s shortness of breath was improved and not present anymore. During the 13 June 2007 MEB Report of Medical Assessment, 3 months prior to separation, the CI documented PE and DVT were the conditions that limited his ability to work in his primary military specialty. The panel agreed there was not a preponderance of 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 condition, so no additional disability rating is recommended.

Sincerely,

2	PD-2017-05839

DEPARTMENT OF THE NAVY
SECRETARY OF TI!E 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 Sep 20

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

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.