RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03167
BRANCH OF SERVICE:  AIR FORCE	BOARD DATE:  20141024
SEPARATION DATE:  20091030

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty A1C/E-3 (2A531C/Aerospace Maintenance Apprentice) medically separated for a dermatitis condition.  The condition could not be adequately rehabilitated to meet the physical requirements of his Air Force Specialty.  He was placed on limited duty and referred for a Medical Evaluation Board (MEB).  The dermatitis condition, characterized as “contact dermatitis to hydraulic fluid” was forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123.  No other conditions were submitted by the MEB.  The Informal PEB adjudicated “contact dermatitis to hydraulic fluid” as unfitting, rated at 10% with likely application of the VA Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.

CI CONTENTION:  “Please consider all conditions.”

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 dermatitis condition is addressed below; 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 Military Records.

RATING COMPARISON:

Service IPEB – Dated 20090821	VA - (58 Mos. Post-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Contact Dermatitis to Hydraulic Fluids	7806	10%	Contact Dermatitis Associated with Allergy to Hydraulic Fluid	7806	0%	20140818	
Other x 0  (Not in Scope)	Other x 3 	20140818	
Combined:  10%	Combined:  10%	
Derived from VA Rating Decision (VARD) dated 20140821 (most proximate to date of separation [DOS]).
* Ratings in chart are taken from the original VARD dated 20140821 with a C&P exam conducted 2014818.

ANALYSIS SUMMARY:

Dermatitis Condition.  A Family Practice note on 1 July 2008, 15 months prior to separation, documented the CI was seen in the emergency room for a rash due to an allergic reaction at work.  The note further documented he was treated with a “shot and some cream.”  The rash went away, but came back.  The narrative summary (NARSUM) performed on 23 May 2009, 5 months prior to separation, noted a history since July 2008 for an itchy rash on both forearms for about a week.  The NARSUM documented the CI was referred to a dermatologist who treated the condition with Clobetasol cream (topical corticosteroid cream).  The NARSUM stated the CI had an allergy patch test, which was positive for hydraulic fluid developing significant itching, muscle aches and a mild erythematous (red) rash surrounding the area of testing.  The NARSUM diagnosis was a type-one hypersensitivity allergic reaction to an ingredient in hydraulic fluid and the recommendation was to avoid all future contact with this fluid.  The rash resolved and a profile was issued to preclude contact with hydraulic fluid.  NARSUM skin examination was normal.  The condition was described as in remission by the NARSUM examiner.

At the VA Compensation and Pension (C&P) exam performed on 21 August 20014, 3 years after separation, the CI reported no current break outs.  The C&P exam noted the CI was treated for contact dermatitis for less than 6 weeks within the past 12 months with a topical corticosteroid cream.  He had not experienced any debilitating episodes in the past 12 months.  At the time of the C&P examination, he was working as a truck driver and no longer had exposure to automobile fluids that caused breakouts.  Physical examination was negative for dermatitis.

The Board directs attention to its rating recommendation based on the above evidence.  The Board considered VASRD diagnostic code 7806 (dermatitis or eczema) used by the PEB for a 10% rating, and the VA for a 0% rating.  The Board did not find evidence for a higher rating such as: dermatitis over 20% to 40% of the entire body or 20% to 40% of exposed areas affected; or, systemic therapy (taken orally or injected) such as corticosteroids or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, during the past 12-month period.  There were no alternate or additional VASRD codes applicable in this case.  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 contact dermatitis to hydraulic fluids condition.

BOARD FINDINGS:  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 contact dermatitis to hydraulic fluids condition and IAW VASRD §4.118 (Schedule of Ratings – Skin), 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 20140612, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

		
XXXXXXXXXXXXXXXXXX
President
DoD Physical Disability Board of Review

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

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXX:

	Reference your application submitted under the provisions of DoDI 6040.44 (Title 10 U.S.C. § 1554a), PDBR Case Number PD-2014-03167.

	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,

XXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings