RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX		CASE: PD-2017-05855 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20071115

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Data Network Specialist, medically separated for “type 1 diabetes, insulin dependent” with a disability rating of 20%.

CI CONTENTION: “Review all conditions” as well as additional conditions not identified by the Medical Evaluation Board (MEB) and/or Physical Evaluation Board (PEB) was requested. 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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20070829	VARD - 20080416	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Type 1 Diabetes, Insulin
Dependent	7913	20%	Diabetes Mellitus Type 1 With
Hypertension	7913	20%	20071218	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Type 1 Diabetes, Insulin Dependent. According to the service treatment record and MEB narrative summary (NARSUM), the CI was diagnosed with juvenile Type 1 diabetes mellitus in March 2007 after presenting to the emergency room with diabetic ketoacidosis requiring hospitalization. He was ultimately treated with oral hypoglycemic medication and insulin.

The 8 June 2007 MEB NARSUM examination, 5 months prior to separation, noted that he continued to take the same oral hypoglycemic medication and insulin (Lantus and Novalog). The examiner did not indicate that avoidance of strenuous occupational and recreational activities was medically necessary, and summarized that the CI stated he was currently “insulin dependent which precludes him from performing his duties as a Marine.” During the MEB examination (recorded on DD Forms 2807-1 and 2808), 10 days later, the examiner noted that the CI was on Lantus and Novalog with no documentation of a medical need to avoid strenuous occupational or recreational activities. On the Report of Medical Assessment (DD Form 2697), he indicated

that diabetes was the only condition that limited his ability to perform military duties or required geographic or assignment limitations.

At the 18 December 2007 VA Compensation and Pension (C&P) diabetes mellitus examination, 1 month after separation, the CI reported some hypertension, following a special diet, but no restricted ability to perform strenuous activities. He also described episodes of hypoglycemic reactions or ketoacidosis 1-3 times per month, but no required hospitalization. He was still taking both Lantus and Novalog, and the diabetes course had improved since onset. Repeated blood pressures were 150/80, 148/80, and 150/80 mmHg.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the diabetes 20%, coded 7913 (diabetes mellitus). The VA also rated the diabetes with hypertension 20% using the same code, based on the C&P examination, citing medication and a restricted diet, with non-compensable hypertension. Panel members agreed that the requirement for treatment with insulin and restricted diet justified a 20% rating. Because there was no evidence of medically-prescribed regulation of activities, the next higher 40% rating was not justified. Furthermore, following initiation of treatment at the time of diagnosis, the evidence showed no subsequent episodes of ketoacidosis or hypoglycemia requiring hospitalizations or frequent visits to a diabetic care provider (twice a month or more frequently), or complications that could support higher ratings. 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 diabetes mellitus.

BOARD FINDINGS: In the matter of the Type 1 diabetes 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.

2	PD-2017-05855

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

From: Director, Secretary ofthe Navy Council of Review Boards To:	XXXXXXXXXXXXX
Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44

IN REPLY REFER TO:
1850
CORB: 003
10 Sep 20

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 ofthe Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization ofseparation or disability rating assigned by the Department ofthe 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.