SAF/MRBD (PDBR)
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

MEMORANDUM FOR THE DIRECTOR, AIR FORCE REVIEW BOARDS AGENCY

SUBJECT:  Physical Disability Board of Review Recommendation on Case Number PD-2018-00220

	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 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 covered individual (CI) was an active duty E4, Public Health Journeyman, medically separated for “Crohn's disease” and “chronic right leg pain” rated 10% each, with a combined disability rating of 20%.  The PEB analogously coded the Crohn’s disease 7399-7323 (ulcerative colitis).  The VA also rated the Crohn's disease 10%, coded 7323, based on the Compensation and Pension (C&P) examination, citing infrequent exacerbations.  Panel members considered if the higher rating of 30%, for moderately severe disease with frequent exacerbations, was applicable in this case, but both the narrative summary (NARSUM) and C&P examinations indicated absence of exacerbations in the 3 years prior to separation.  The NARSUM examiner opined that the Crohn’s disease was not limiting the CI’s physical fitness activities and that she had not missed any duty days due to Crohn’s, which was echoed by the commander. Panel members agreed that the evidence in support of moderately severe impairment with frequent exacerbations was not present at separation.  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 Crohn's disease.

In the matter of the chronic right leg pain, the PEB analogously coded 8799-8720 (sciatic nerve neuralgia).  The VA determined the right leg condition was not service-connected.  Panel members agreed that no greater than the PEB’s 10% rating was justified for impairment of the right lower extremity.  The NARSUM and C&P examinations recorded normal movement of all extremities, and tenderness was absent during the C&P examination.  The EMG and vascular studies were normal and there was no clinical evidence of sciatica.  The only finding on examination was leg pain.  The CI’s profile restricted running but allowed walking up to a mile, swim, bicycle, and other aerobic conditioning.  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 right leg pain.  

In the matter of the contended low back pain, the condition was not profiled or implicated in the commander’s statement, 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 condition, so no additional disability rating is recommended.  

SAF/MRB
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

Dear XXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2018-00220.

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.