RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE:  PD1300148
BRANCH OF SERVICE:  ARMY		BOARD DATE:  20140227
SEPARATION DATE:  20040714

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty Specialist/E-4 (21B10/Combat Engineer) medically separated for cholinergic urticarial (hives).  The CI was first seen for a complaint of hives in January 2004.  It was determined he would be non-deployable and the condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty or satisfy physical fitness standards.  He was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB).  The MEB forwarded cholinergic urticaria, severe, to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other conditions were submitted by the MEB.  The Informal PEB (IPEB) adjudicated the cholinergic urticaria condition as unfitting, rated 0%.  The CI made no appeals and was medically separated.

CI CONTENTION:  “Rash, hives, and the fact that the Army retired me without a rating and other medical issues that I have since then.  I had asthma since 2003 and I was taking medications for it and also Rhinitis too, and I didn’t get a rating for those either.”

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI.  The rating for the unfitting cholinergic urticaria is addressed below.  The requested asthma and rhinitis conditions were not identified by the MEB/PEB, and thus are not within the DoDI 6040.44 defined purview.  No additional conditions are within the Board’s purview.

RATING COMPARISON:

Service IPEB 20040405	VA Exam (2 Weeks after Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Cholinergic Urticaria	7825	0%	Cholinergic Urticaria	7825	10%	20040727	
No Additional MEB/PEB Entries	Other x 7	20040727  	
Rating:  0%	Combined:  30%	
Derived from VA Rating Decision (VARD) dated 20041122 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:  The Board acknowledges the CI’s assertions that his disability disposition was in some way unfair.  It is noted for the record that the Board has no jurisdiction to investigate or render opinions in reference to such assertions.  Any conditions or contention not requested in this application, or otherwise outside the Board’s defined scope of review, remain eligible for future consideration by the Board for Correction of Military Records or redress by the United States judiciary system.

Cholinergic Urticaria.  The narrative summary (NARSUM) notes the onset of intermittent whole body hives with heat exposure in January 2004.  The CI reported that he developed large red itching wheals once a week approximately several hours in duration.  He stated that his hives were worsened by heat, physical training and hot showers.  His hives and itching were relieved by cold showers and the use of anti-histamine medications.  All laboratory results were normal and a diagnosis of cholinergic urticaria was rendered.  The NARSUM examination was normal.  At the VA Compensation and Pension exam performed at separation, the CI reported a history of shortness of breath, dizziness, burning sensation to his skin, wheezing and urticaria with exposure to heat dating back to 2003.  He reported the use of Allegra two times a day for his urticarial and allergic rhinitis.  His skin examination was normal.

The Board directs attention to its rating recommendation based on the above evidence.  The PEB adjudicated the cholinergic urticarial condition as unfitting with a 0% disability rating coded 7825.  The VA rated the cholinergic urticarial condition at 10% for recurrent episodes occurring at least 4 times during the past 12-month period and responding to treatment with anti-histamines.  The Board noted that the PEB described the cholinergic urticarial condition as recurrent and treated with antihistamines. There was no evidence of systemic immunosuppressive therapy.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the cholinergic urticarial condition.

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.  In the matter of the cholinergic urticarial condition, the Board unanimously recommends a disability rating of 10%, coded 7825 IAW VASRD §4.118.  There were no other conditions within the Board’s scope of review for consideration.

RECOMMENDATION:  The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical separation:

UNFITTING CONDITION	VASRD CODE	RATING	
Cholinergic Urticaria	7825	10%	
RATING	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20121123, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

				
SFMR-RB									

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation 
for XXXXXXXXXXXXXXXXXX, AR20140009361 (PD201300148)

1.  I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a,   I accept the Board’s recommendation to modify the individual’s disability rating to 10% without recharacterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

BY ORDER OF THE SECRETARY OF THE ARMY:

Encl						     

CF: 
(  ) DoD PDBR
(  ) DVA