RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04207
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20060614

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4 (Motor Transport Operator) medically separated for discoid lupus erythematosus (DLE).  The DLE condition did not improve adequately to meet the physical requirements of his Military Occupational Specialty (MOS).  He was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB).  The “cutaneous (discoid) lupus erythematosus,” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other condition was submitted by the MEB.  The Informal PEB adjudicated “DLE” as unfitting, rated 10%, with application of the Veterans Affairs 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 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/Naval 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 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:  

IPEB – Dated 20060307	VA* – based on Service Treatment Record (STR)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
DLE	7809-7800	10%	Cutaneous (Discoid) Lupus Erythematosus	7809-7800	0%	STR	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 8	
RATING:  10%	RATING:  0%	
*Derived from VA Rating Decision (VARD) dated 20060921 (most proximate to date of separation [DOS]) 

ANALYSIS SUMMARY: 

Discoid Lupus Erythematosus (DLE).  This CI reported that he has always been “sun sensitive.”  As a young man, he learned to avoid sun exposure in order to prevent sunburn.  Shortly after entering the Army, he started having skin problems.  In January 2005, his unit was spending more time outdoors in the sun, as they were preparing for deployment.  The CI’s skin changes became worse, and he was referred to Dermatology.  After skin biopsy, he was diagnosed with DLE.  He was treated with topical steroid creams, and with Plaquenil.  Due to the chronic, persistent nature of his skin problem, an MEB was initiated.  In December 2005, the MEB physical examination (PE) was normal, except for red areas on the face.  The narrative summary (NARSUM) diagnosis was: “Cutaneous (discoid) lupus erythematosus.”  The CI was medically separated from service on 14 June 2006.  The Army PEB coded the skin condition 7809-7800, and rated it 10% (for one characteristic of disfigurement).  In September 2006, 3 months after separation, the CI was scheduled for a VA Compensation and Pension (C&P) exam, but he failed to appear for that evaluation.

The Board carefully reviewed all available information, and directed attention to its rating recommendation.  The best sources of evidence upon which to base a rating recommendation in this case, were the clinical progress notes from early 2006.  On 12 January 2006, 5 months before the date of separation (DOS), the examining dermatologist wrote: “Significant improvement noted since last office visit.  Decreased erythema/induration of the nose/cheeks.” On 8 February 2006, 4 months before DOS, the dermatologist wrote: “Much decreased erythema/edema of the nose/cheeks/forehead.  Follicular plugging on nose less prominent.”

Based on the evidence, the Board determined that prior to DOS, the CI was responding to medication, and his skin condition was improving.  IAW VASRD §4.118 (Schedule of ratings – skin), the Board could not find sufficient evidence to support a conclusion that the CI was suffering from more than one characteristic of disfigurement.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board found insufficient cause to recommend a change in the PEB adjudication of the unfitting skin condition (DLE). 

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. 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 skin condition (DLE) 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 20141015, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR Commander, US Army Physical Disability Agency (AHRC-00), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXXXXXXX AR20160004465 (PD201404207)

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
( ) OVA