MEMORANDUM FOR THE DIRECTOR, AIR FORCE REVIEW BOARDS AGENCY

SUBJECT:  Physical Disability Board of Review Recommendation on Case Number PD-2017-06135

	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 (CI) from the United States Air Force.  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 CI was a Reserve E5, Supply Management Craftsman, medically separated for “obsessive-compulsive disorder (OCD)” and “Tourette syndrome,” rated 10% and 0%, respectively, with a combined disability rating of 10%.  The PEB rated the OCD 10%, coded 9404, citing tolerable depression symptoms that did not prevent gainful employment.  The VA did not rate the OCD, but rather found it to be not service connected (NSC), citing:  “Although there is a record of treatment in service for your OCD, no permanent residual or chronic disability subject to service connection is shown by the service medical records, or demonstrated by evidence following service.”  The MEB narrative summary (NARSUM) and addendum noted long term stability with continuous medication, and the CI was able to work at his civilian job and perform activities of daily living without difficulty.  Therefore, panel members agreed the evidence did not support a higher 30% rating under code 9404, which requires evidence of occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks.  

The PEB rated the Tourette’s syndrome 0%, analogously coded 8199-8103 (tic, convulsive), citing, “TS is of mild variety and the motor tics are not disabling, which indicates a mild disability.”  The VA did not rate the Tourette’s syndrome, but rather found it to be NSC, citing:  “this disability existed prior to military service and there was no evidence that the condition permanently worsened as a result of service.”  According to the VASRD, ratings for compulsive tics depend upon frequency, severity and muscle groups involved, and the CI was was able to function well at home and work.  The NARSUM noted that medication minimized the tics, and the mental status examination showed mild motor, but no verbal, tics.  Thus, findings most closely reflected a mild disability and met criteria for a 0% 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 OCD or the Tourette’s syndrome.

	Sincerely,

 

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-06135.

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.

						Sincerely,