RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-01567
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080224

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Information Technology Specialist, medically separated for “systemic lupus erythematosus with raynaud’s syndrome,” with a disability rating of 10%.  

CI CONTENTION:  The CI contends the Army has changed the rating criteria for Lupus.  Additionally, the CI contends a condition not listed in the MEB or PEB.  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 –20090204	VARD - 20080910   	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Systemic Lupus Erythematosus with Raynaud’s Syndrome	6350	10%	Systemic Lupus Erythematosus with Raynaud's Disease	7117-6350	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Systemic Lupus Erythematosus with Raynaud's.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s systemic lupus erythematosus with Raynaud’s phenomenon condition began in Month 2004.  The condition was well controlled on medication until deployment in 2007.  During the 2007 deployment the CI presented with butterfly rash, joint pain, and swelling of the hands which worsened in cold weather.  The CI was removed from deployment with resolution of his joint pain and Raynaud’s phenomenon.  Despite treatment, the systemic lupus erythematosus with Raynaud’s phenomenon condition could not be adequately rehabilitated to meet deployment standards and the CI was referred for MEB.  The MEB forwarded systemic lupus erythematosus with Raynaud’s phenomenon for PEB adjudication.  The MEB NARSUM examination on 3 October 2007 (4 months prior to separation) noted complaints of that he was doing well on his medication, but that he must be protected from exposure to sunlight and temperatures below 50 degrees.  Physical examination showed left greater then right butterfly facial rash (typical of lupus).  The remainder of the physical examination was normal.  The CI did not report for the VA Compensation and Pension (C&P) examination in April 2008 

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating under the 6350 code (Lupus erythematosus, systemic [disseminated]), citing exacerbations once or twice a year or symptomatic during past 2 years.  The VA assigned a 0% rating using 7117-6350 code (Raynaud’s syndrome-Lupus erythematosus, systemic [disseminated]) citing lack of service treatment records and failure to report to the scheduled VA examination.  The Board determined that there was no evidence of characteristic Raynaud’s attacks occurring 4 to 6 times a week (7117) or lupus exacerbations lasting a week or more, 2 or 3 times per year (6350) under the applicable VASRD coded for a higher than 10% rating.  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 systemic lupus erythematosus with Raynaud’s phenomenon condition.  

BOARD FINDINGS:  In the matter of the systemic lupus erythematosus with Raynaud’s phenomenon condition and IAW VASRD §4.88b, 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 20140315, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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 XXXXXXXXXXXXXXXXXXXXX AR20160013474 (PD201401567)

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 and hereby deny the individual’s application.  
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

 BY ORDER OF THE SECRETARY OF THE ARMY:

Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA