RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-01482
BRANCH OF SERVICE:  NAVY	BOARD DATE:  20141209
SEPARATION DATE:  20080903

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty PO2/E-5 (MM2/Machinist’s Mate) medically separated for eczema.  The condition could not be adequately rehabilitated to meet the physical requirements of his Rating.  He was placed on limited duty and eventually referred for a Medical Evaluation Board (MEB).  The condition, characterized as “dyshidriotic eczema,” was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E.  The Informal PEB adjudicated “dyshidriotic eczema” rated 10% with likely application of the VA Schedule for Rating Disabilities (VASRD).  The CI requested to remain on active duty in a permanent limited duty status until 14 August 2009, but was medically separated.

CI CONTENTION:  “ECZEMA”

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 skin condition is addressed below; and, no additional conditions are within the DoDI 6040.44 defined purview of the Board.  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 Naval Records.

RATING COMPARISON:

Service IPEB – Dated 20080104	VA - (22 Months Post-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Dyshidriotic Eczema	7806	10%	Eczema	7806	0%	20100708	
Other x 0 (Not In Scope)	Other x 2	
Combined:  10%	Combined:  10%	
Derived from VA Rating Decision (VARD) dated 20100831 (most proximate to date of separation)

ANALYSIS SUMMARY:

Eczema Condition.  The CI developed a rash on his feet diagnosed as chronic dyshidriotic eczema in 2006.  The rash was associated with breakdown of the skin with fissuring, cracking and peeling and was predominantly restricted to the feet.  The condition worsened with wearing of boots and performance of ship-board duties.  The symptoms persisted despite treatment and prevented performance of military duties.  At the time of the MEB narrative summary (NARSUM) examination on 16 October 2007, there were 3 centimeter plaques on both feet and the skin of both feet was dry.  There were small 1-to-2 millimeter vesicles on the sides of the fingers.  Clinic examinations on 29 November 2007 and 12 August 2008 recorded similar examination findings with skin changes on the feet.  
The commander’s non-medical assessment on 13 November 2007, reported outstanding performance in the office setting of the legal office.  At the VA Compensation and Pension examination on 8 July 2010, 22 months after separation, the CI reported continued scaly itchy rash of the feet and more discrete nodular rash to the hands.  At the time of the examination, there were nodular lesions of the hands and eczematous lesions along the lateral aspects of both feet.  The examiner reported that there was less than 5% of exposed skin and less than 5% of total body area affected.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the Dyshidrotic eczema condition 10%, coded 7806 (dermatitis or eczema).  The VA rated the eczema at 0% code 7806, citing involvement of less than 5% or exposed or total body surface area.  For the 10% rating, at least 5% of skin involvement is required and for a rating of 30% required skin involvement of 20% to 40% body surface area.  At the time of the MEB NARSUM examination and the treatment records prior to separation, less than 5% of exposed skin or total body surface area was involved.  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 Dyshidrotic eczema 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.  In the matter of the dyshidriotic eczema condition and IAW VASRD §4.118, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.

RECOMMENDATION:  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 20140319, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

				

XXXXXXXXXXXXXXX 
President 
DoD Physical Disability Board of Review

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS
Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATION 
Ref:	(a) DoDI 6040.44
(b) CORB ltr dtd 13 May 15

In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual's records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy' s Physical Evaluation Board:

-	XXXXXXXXXXXXXXXXXXXX, former USMC
-	XXXXXXXXXXXXXXXXXXXX, former USN
-	XXXXXXXXXXXXXXXXXXXX , former USMC
-	XXXXXXXXXXXXXXXXXXXX, former USN
-	XXXXXXXXXXXXXXXXXXXX, former USN
-	XXXXXXXXXXXXXXXXXXXX, former USMC
-	XXXXXXXXXXXXXXXXXXXX, former USN
-	XXXXXXXXXXXXXXXXXXXX, former USN

XXXXXXXXXXXXXXXXXXXX
Assistant General Counsel (Manpower & Reserve Affairs)