RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX 	CASE:  PD-2019-00063
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070412

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Maintenance Management Analyst, medically separated for “abdominal pain” with a disability rating of 10%.  

CI CONTENTION:  No specific contention was made.  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 Physical Evaluation Board (PEB) to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the Medical Evaluation Board (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 - 20070212	VARD - 20071129	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Abdominal Pain	7629	10%	S/P TAH and Bilateral Salpingo-Oophorectomy 	7617	50%	20070727	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  100%	

ANALYSIS SUMMARY:  

Abdominal Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent multiple interventional tests and procedures that culminated in a total abdominal hysterectomy (TAH) in December 2003, removal of both fallopian tubes and ovaries in May 2005 and an excision of a pelvic mass and lysis of adhesions in July 2006.  The pre-surgical working diagnosis was “severe endometriosis” or “abdominal pain of unknown etiology.”  The 12 January 2007 MEB NARSUM examination, 3 months prior to separation, noted complaints of continued abdominal pain.  The physical examination (PE) revealed tenderness in the left-sided lower abdomen and along the mid-line of the surgical abdominal scar.  All other gastro-intestinal PE parameters were normal.  There was no gynecological examination documented.

At the 27 July 2007 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported chronic left-sided pelvic pain.  Her abdominal-focused PE was detailed and normal.  An internal gynecological examination revealed left-sided tenderness within the pelvis.   

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the abdominal pain 10%, coded 7629 (endometriosis).  The VA rated the abdominal pain 50%, coded 7617 (complete removal of the uterus and both ovaries), based on the C&P examination, citing complete loss of the uterus and both ovaries following a period of post-surgical convalescence.  Panel members first agreed that the removal of the CI’s gynecological organs supported an impairment rating in and of itself under code 7617.  The clear diagnosis of endometriosis is also ratable under code 7629.  Excluding the acute temporary 3-month recovery time from gynecological surgery, the greatest rating level with either code is 50%.  In this case, not having evidence that the diagnosis of endometriosis was currently demonstrating bowel or bladder symptoms, code 7629 was least appropriate.  Therefore, after due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that the CI’s removal of gynecological organs clearly met the 50% rating criteria under code 7617.

BOARD FINDINGS:  In the matter of the abdominal pain, the panel recommends a disability rating of 50%, coded 7617 IAW VASRD §4.116.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows; and, that the discharge with severance pay be re-characterized to reflect permanent disability retirement, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Abdominal Pain	7617	50%	

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-2019-00063.

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 not in accordance with the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended your separation be re-characterized to reflect disability retirement, rather than separation with severance pay

I have carefully reviewed the evidence of record and the recommendation of the Board.    I concur with that finding, accept the recommendation and determined that your records should be corrected accordingly.  The office responsible for making the correction will inform you when your records have been changed.

As a result of the aforementioned correction, you are entitled by law to elect coverage under the Survivor Benefit Plan (SBP).  Upon receipt of this letter, you must contact the Air Force Personnel Center at (210) 565-2273 to make arrangements to obtain an SBP briefing prior to rendering an election.  If a valid election is not received within 90 days from the date of this letter, you will not be enrolled in the SBP program unless at the time of your separation, you were married, in such a case, failure to render an election will result in automatic enrollment by law.