RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-01021
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20090406

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Air National Guard E7, Broadcast Journalist Craftsman, medically separated for “occasional diplopia with blurred vision” with a disability rating of 10%.

CI CONTENTION:  CI contended he was diagnosed with asthma, IBS and PTSD.  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited 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 PEB, but determined to be not unfitting.  Any conditions outside the Board’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.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is based upon a review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation. 

RATING COMPARISON:  

SERVICE PEB - 20090224	VARD - 20090930	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Occasional Diplopia with Blurred Vision	6079	10%	Mild Epiretinal Membrane/Macular Puckering of the Retina, Right Eye	6099-6011	10%	20090514	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Diplopia.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was myopic (nearsighted) and had an astigmatism (abnormal shape of the cornea) at accession along with a color vision deficiency.  He did well until 2003 when he had double vision (diplopia) associated with an acute sinusitis.  This resolved without apparent sequelae.  He next reported an eye problem in 2007, but denied specific injury or trauma.  A brain MRI on 27 December 2007 was normal other than changes from sinusitis.  He was issued multiple prescriptions for glasses without satisfactory vision.  An evaluation by a neuro-ophthalmologist on 9 April 2008 did not yield a diagnosis.  However, on 21 August 2008, he was noted to have a membrane near the macula (part of the retina with the sharpest vision).  This was thought to be the possible cause of the “erratic and poor” testing.  He was diagnosed with macular puckering.  The MEB NARSUM examination on 18 September 2008 (6 months prior to separation) noted complaints of occasional blurred and double vision.  An eye examination was not recorded.  He was given a new prescription and at follow-up on 29 September 2008, reported that the diplopia was resolved.  He was also noted to have a posterior vitreous detachment (PVD, a pulling away of the vitreous, the “jelly” in the eyeball, from the retina).  At the 14 May 2009 VA Compensation and Pension (C&P) eye examination performed 7 weeks after separation, the CI had 20/20 vision in each eye with correction.  He was noted to have mild cellophane changes (also called epiretinal membrane, ERM, and macular pucker).  Diplopia was not recorded.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the CI for occasional diplopia with blurred vision at 10%, coded 6079 (impairment of vision at 20/100 in the bad eye and 20/40 or better in the good eye).  This is an old code no longer used in the current VASRD; the current code is 6066.  The VA also rated the eye condition at 10%, coded 6099-6011 (analogous to a localized scar, atrophy, or irregularity of the retina with an abnormal image).  The VA C&P examination documented 20/20 vision in each eye with correction and an optometry evaluation 6 months prior to separation noted that the diplopia had resolved with a new glasses’ prescription.  A higher rating is not supported by the evidence proximate to separation.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the right eye condition.  

BOARD FINDINGS:  In the matter of the occasional diplopia condition and IAW VASRD §4.79, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140220, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MR
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

Dear XXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2014-01021.

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 re-characterization or modification 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 re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

Attachment:
Record of Proceedings