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

MEMORANDUM FOR THE DIRECTOR, ARMY REVIEW BOARDS AGENCY

SUBJECT:  Physical Disability Board of Review Recommendation on XXXXXXXXXXXX 
	Case Number PD-2020-00002

	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 Army.  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 an active duty E4, Infantryman, medically separated for “right lower quadrant neuralgia following appendectomy” with a disability rating of 20%.  The PEB rated the neuralgia 20%, analogously coded 5099-5003 (arthritis, degenerative) citing a need for narcotic analgesia and that “pain is completely incapacitating at times.” The VA rated reflex sympathetic dystrophy (right lower quadrant status post appendectomy) 30%, analogously coded 7399-7301 (peritoneum, adhesions of), based on the VA Compensation and Pension (C&P) examination, citing “symptoms which are more closely approximated by the evaluation criteria of a partial obstruction manifested by delayed motility and painful episodes.”  

The panel considered rating analogously under code 7301, noting that the MEB narrative summary examiner recorded abdominal muscle and surgical scar pain with abdominal muscle activity.  However, at the time of separation, there was no evidence of motility disturbance, actual partial obstruction or reflex disturbances, and thus a 10% rating was warranted for “pulling pain on attempting work or aggravated by movements of the body, or occasional episodes of colic pain, nausea, constipation, or abdominal distension.”  Although the CI reported a 60-pound weight loss at the C&P examination, this was not corroborated by the service treatment record.  Additionally, there was no documentation of a reflex sympathetic dystrophy diagnosis.  Since a rating assigned by the PEB may not be lowered, using code 7301 was of no benefit to the CI.  There were no additional VASRD codes to consider for the condition.  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 lower quadrant condition. 

 AR20210008627
 
Dear XXXXXXXXXXXXX: 

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate. I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation. I regret to inform you that your application to the DoD PDBR is denied. 

This decision is final. Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.