RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03626
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20030410

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Utilities Equipment Repairer, medically separated for “painful scar following multiple surgical procedures,” with a disability rating of 10%.

CI CONTENTION:  “Please consider all conditions.” 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:  

SERVIC PEB – 20030210	VARD - 20030404	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Painful Scar Following Multiple Surgical Procedures	7804	10%	Surgical Scar, Posterior Scalp	7800	30%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Painful Scar.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent a surgical scar revision in January 2001 after numerous attempts to drain and removed a cyst on the back of his head.  Pursuant to surgical intervention, the CI’s Kevlar adornment continued to cause irritation and pain to the back of the CI’s head.  There was no additional surgical indication and further treatment did not result in improvement sufficient to allow unrestricted duty and wearing of Kevlar battle protection.  The MEB forwarded “chronic cephalgia [headache] secondary to multiple scalp procedures” for PEB adjudication.
At the MEB NARSUM physical examination (PE) performed on 9 January 2003, 3 months prior to separation, the CI endorsed the inability to wear Kevlar secondary to irritation of prior area of scar revision in the back of his head resulting in headaches and edema.  His PE revealed an “exquisitely tender” scar on the back of his head measuring 14 cm in length and 1.5-2.0 cm in width.  There were no signs of swelling or infection.  There was no VA Compensation and Pension (C&P) examination contained in the case file and any impairment rating will be rated according to STR encounters as well as MEB-derived documents.  

The Board directed attention to its rating recommendation based on the above evidence.  Although using different but similar VASRD codes, both the PEB and VA rated the residual scar condition at 10% and 30%, respectively.  The VASRD criterion for rating scars of the head include codes 7800 (non-burn scars) and 7804 (scars; unstable or painful).  This case represented a linear and surgical (non-burn) scar that remained painful and supported the PEB’s 10% under code 7804; however, Board members further agreed that a higher rating was supported under code 7800 in meeting two diagnostic criteria of disfigurement.  The VASRD lists eight disfigurement criteria which includes, a scar of at least 13 cms in length and at least .6 cms in width.  This case, as presented in the NARSUM, met and exceed both measured parameters and is supported by meeting two characteristic criteria at a 30% impairment rating. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt) and VASRD §4.118, the Board recommends a disability rating of 30% for the surgical scar condition.

BOARD FINDINGS:  In the matter of the painful scar condition, the Board unanimously recommends a disability rating of 30%, coded 7800 IAW VASRD §4.118.  There were no other conditions within the Board’s scope of review for consideration.  

The Board recommends that the CI’s prior determination be modified as follows; and, that the discharge with severance pay be re-characterized to reflect permanent disability retirement, effective as of the date of his prior medical separation: 

CONDITION	VASRD CODE	RATING	
Painful Scar Following Multiple Surgical Procedures	7800	30%	
COMBINED	30%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140725, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB																		

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 
, AR20160017554 (PD201403626)

1.  Under the authority of Title 10, United States Code, section 1554(a), I approve the enclosed recommendation of the Department of Defense Physical Disability Board of Review (DoD PDBR) pertaining to the individual named in the subject line above to re-characterize the individual’s separation as a permanent disability retirement with the combined disability rating of 30% effective the date of the individual’s original medical separation for disability with severance pay.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum:

	a.  Providing a correction to the individual’s separation document showing that the individual was separated by reason of permanent disability retirement effective the date of the original medical separation for disability with severance pay.

	b.  Providing orders showing that the individual was retired with permanent disability effective the date of the original medical separation for disability with severance pay.

	c.  Adjusting pay and allowances accordingly.  Pay and allowance adjustment will account for recoupment of severance pay, and payment of permanent retired pay at 30% effective the date of the original medical separation for disability with severance pay.

	d.  Affording the individual the opportunity to elect Survivor Benefit Plan (SBP) and medical TRICARE retiree options.

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

Enclosure
					
CF: 
(  ) DoD PDBR
(  ) DVA