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-2018-00274

	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 E5, Dental Craftsman, medically separated for “rheumatoid arthritis” with a disability rating of 20% and coded 5002 (arthritis, rheumatoid) by both the PEB and the VA. The PEB cited the condition was stable and did not require a disease modifying anti-rheumatic drug.  The VA based the rating on the Compensation and Pension (C&P) examination, citing one or two exacerbations a year in a well-established diagnosis.  Using the VA criteria, the 20% rating was supported based on all examinations proximate to separation.  There was no evidence of “definite impairment of health objectively supported by examination findings or incapacitating exacerbations 3 or more times per year” for higher rating under 5002.  If the condition was alternatively rated on residuals the evidence at the C&P joints examination supports a 10% rating and no higher for combined range of motion of the thoracolumbar spine not greater than 235 degrees, with mild discomfort, coded 5002-5237 and a 10% rating is supported for painful motion of the left shoulder, coded 5002-5003.  There was no evidence of limitation of arm motion limited to shoulder level for a higher rating under 5201 (limitation of arm motion).  The remaining joints addressed at the C&P joints examination – neck, right shoulder, wrists, hands, and knees, and did not meet the rating thresholds for greater than a 0% rating each.  Therefore, rating based on residuals results in a combined 20% rating and provides no ratings benefit to the CI.  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 rheumatoid arthritis condition.  

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

Dear XXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2018-00274.

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.