RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-01944
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20040706

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Signal Support Systems Specialist, medically separated “central serous chorioretinopathy [CSR],” with a disability rating of 0%.  

CI CONTENTION:  The CI contends for all conditions related to the eye.  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 confined to 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 - 20040518	VARD - 20040712  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
CSR with Physical Exertion	6008	0%	CSR Right Eye	6099-6006	0%	20040602	
Protanomalous Color Defect	Not Unfitting	Protanomalous Color Defect	6099-6079	NSC		
RATING:  0%	RATING:  0%	

ANALYSIS SUMMARY:  

Central Serous Chorioretinopathy Condition.  The CI was first seen on 30 July 2003 with the complaint of blurry vision in his right eye for the past two weeks.  He was evaluated in optometry and ophthalmology extensively over the next few months and diagnosed with CSR, also called central serous chorio-retinopathy (CSCR).  This is a condition in which fluid accumulates under the retina and separates it from the back of the eye.  The impact on vision is dependent upon the location as well as the size of the defect.  The CI did show some improvement in his vision with time as is the typical course.  It was also noted that he also had a bilateral color deficiency, right worse than the left.  He had been noted to be color deficient on the accession physical (almost certainly a congenital condition).  Micronopsia (images appearing smaller than those in the other [normal] eye) was present early in his course, but not recorded in examinations proximate to separation.  The narrative summary (NARSUM) was dated 26 March 2004.  It noted that the visual acuity had returned to 20/20 bilaterally and a benign examination other than the residual changes from the CSR.  The CI also had some pigmentary changes; it was noted elsewhere in the record that he had a positive family history of retinitis pigmentosa (an inherited degenerative disease of the eye) and that these findings could be an early indication of this disease.  The color deficiency was noted to be an EPTS [existed prior to service] condition.  Diplopia was not documented.  At the VA Compensation and Pension (C&P) examination in ophthalmology, performed on 1 June 2004, 1 month before separation, the findings were consistent with old CSR.  His uncorrected distant vision was 20/40 on the right and 20/20 on the left.  Corrected values were not recorded.  Pigmentary changes were present.  Diplopia was not documented.  

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB rated the CSR condition at 0%, coded 6008 (detachment of the retina).  The VA rated the CSR condition at 0% as well, but coded it 6099-6006 (analogous to retinopathy or maculopathy).  The Board also considered the code 6011 (retinal scar, atrophy, or irregularities), but there was no pathology documented in the examinations proximate to separation to support this.  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 CSR condition.  

Contended PEB Conditions.  The Board’s main charge is to assess the fairness of the PEB’s determination that the color vision deficiency was not unfitting.  The color deficiency was not judged to fail retention standards and in fact was noted to be present at accession.  While it does appear from the record that this may have progressed from accession, it also appears to have done so for the unaffected left eye; regardless, while color deficiency restricts an individual from training in certain career fields (such as aviation), is not unacceptable for all career fields.  It was reviewed and considered by the Board.  There was no performance based evidence from the record that it significantly interfered with satisfactory duty performance.  After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the color deficiency and so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the CSR condition and IAW VASRD §4.79, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the contended color deficiency condition, the Board unanimously recommends no change from the PEB determination as not unfitting.  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 20140501, 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 XXXXXXXXXXXXXXXXXXXXXXX AR2016001 0876 (PD201401944)

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