RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00878
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20071226

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Air Traffic Control (ATC) Apprentice, medically separated for “chronic laryngitis,” with a disability rating of 10%.

CI CONTENTION:  The CI makes no contentions.  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel's scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the panel for Correction of Military Records.  Furthermore, the panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determinations is based on 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 panel 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 panel 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 - 20071025	VARD - 20120911	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Laryngitis	6516	10%	Chronic Laryngitis	6516	NSC	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Laryngitis.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s chronic laryngitis condition began in October 2006 presumably due to stress and vocal strain as an ATC trainee.  Despite extensive specialty work-ups, the CI’s symptoms of voice loss and hoarseness could not be adequately rehabilitated to meet the physical requirements of her military specialty and she was referred for MEB.  The MEB forwarded “chronic laryngitis” for PEB adjudication.  The MEB NARSUM on 8 August 2007, 4 months prior to separation, noted minimal and non-voice related ear and nasal complaints under the ‘review of symptoms’ portion of the clinical encounter.  Although no physical examination was documented, the examiner listed the CI’s diagnosis as “chronic adductor spasmodic dysphonia.”  There was no VA Compensation and Pension examination in evidence.  
The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic laryngitis condition 10%, coded 6516 (laryngitis, chronic), citing fiberoptic laryngoscopy showed no lesions or masses with moderate post-cricoid edema.  The VA did not service-connect the chronic laryngitis condition, citing not incurred or caused by service.  Panel members first agreed that VASRD code 6516 was most appropriate in describing the diagnosis listed on the NARSUM.  The Panel also agreed that a 10% rating, but no higher, was justified for voice hoarseness as reported within the STR.  There was no local biopsy performed or pathologic growth seen upon the vocal cords, thus the next higher 30% rating was not justified on this basis.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB’s adjudication for chronic laryngitis condition.  

BOARD FINDINGS:  In the matter of the chronic laryngitis condition and IAW VASRD §4.97, the Panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150603, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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

Dear XXXXXXXXXXXXXXXXXX

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-00878.

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.