RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00926
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20070831

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Infantry Assaultman, medically separated for “limbal vernal conjunctivitis,” with a disability rating of 0%.

CI CONTENTION:  “Review 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:  

SERVICE PEB - 20070625	VARD - 20080225	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Limbal Vernal Conjunctivitis	6018	0%	Keratoconjunctivitis Vernal	6018	0%	20080225	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Limbal Vernal Conjunctivitis.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s eye condition began in March 2007 after experiencing vernal conjunctivitis in both eyes.  The MEB forwarded health examination of defined subpopulations and vernal conjunctivitis for PEB adjudication.  

At an ophthalmology examination on 18 January 2007, the CI presented with complaints of bilateral eyes burning, itching, red and sensitive to light with blurred vision.  He stated that he had long white strings discharging from his eyes.  Ophthalmology examination showed the limbal conjunctival area congested, thick with a mucous discharge.  There was mild papillae of the tarsal conjunctivae (inflammatory red bulging eye tissue).  Visual acuity in both eyes was noted as 20/30.  An ophthalmology note dated 7 February 2007 stated that the CI had a history of severe vernal conjunctivitis for 2 years and that treatment with topical steroids and systemic steroids were ineffective.  At an ophthalmology examination on 14 March 2007, the CI presented with complaints of itchy, burning, blurred vision, and light sensitive eyes.  Additionally, he complained of a discharge from both eyes.  Examination of the eyes showed both eyes’ displayed diffuse injections of redness in the corneal and conjunctival areas, limbal palpebral papillae (inflammatory red bulging eye tissue beneath the eyelid) visual acuity 20/20, and tonometry 14.  

At the MEB examination (recorded on DD Forms 2807 and 2808) dated May 2007, 4 months prior to separation, the CI reported chronic conjunctivitis (allergic vernal conjunctivitis).  The examiner noted he was “unable to get auto-refraction and intra-ocular pressures,” however, distant vision was 20/40 and near vision was 20/60 in both eyes.  The MEB NARSUM examination on 9 May 2007, 4 months prior to separation, noted complaints of severe bilateral vernal conjunctivitis with visionary fluctuations and numerous periods of inability to open his eyes.  The CI admitted to having treatment failures with Patanol and Pred Forte.  Physical examination showed reddened eyes which were difficult to open due to lid spasm.  The CI presented for examination wearing sunglasses.  The CI failed to attend his scheduled VA Compensation and Pension (C&P) evaluation.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the conjunctivitis condition 0%, coded 6018 (chronic conjunctivitis [nontrachomatous]).  The VA also rated the conjunctivitis condition 0% coded 6018, based on STR, citing a lack of significantly disabling residuals.  In considering conjunctivitis, the Board directed its attention to whether the CI suffered from visual impairment and disfigurement or had active objective findings such as red, irritated and or muco-secretory conjunctivae.  The CI complained of inability to open his eyes on numerous occasions.  Physical examination findings of reddened conjunctivae with mucous discharge which warrants a rating of 10 percent under VASRD §4.75 diagnostic code 6018.  The CI did not demonstrate any visual impairment as his vision fluctuated due to the symptomology of his eye condition.  Therefore the condition warrants a 10% rating under diagnostic code 6018 for each eye.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the limbal vernal conjunctivitis condition for each eye, coded 6018.  

BOARD FINDINGS:  In the matter of the limbal vernal conjunctivitis condition, the Board unanimously recommends a disability rating of 10%, for each eye coded 6018 IAW VASRD §4.84a.  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, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Limbal Vernal Conjunctivitis, Right Eye	6018	10%	
Limbal Vernal Conjunctivitis, Left Eye	6018	10%	
COMBINED	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150608, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS
		   COMMANDER, NAVY PERSONNEL COMMAND	
	                          
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS          

Ref:  (a) DoDI 6040.44
	(b) PDBR ltr dtd 17 Nov 16 ICO XXXXXXXXXXXXXXXXXX     
	(c) PDBR ltr dtd 19 Nov 16 ICO XXXXXXXXXXXXXXXXXX
	(d) PDBR ltr dtd 09 Nov 16 ICO XXXXXXXXXXXXXXXXXX
	(e) PDBR ltr dtd 19 Nov 16 ICO XXXXXXXXXXXXXXXXXX
	(f) PDBR ltr dtd 19 Nov 16 ICO XXXXXXXXXXXXXXXXXX
	(g) PDBR ltr dtd 09 Nov 16 ICO XXXXXXXXXXXXXXXXXX

1.  Pursuant to reference (a), the recommendations of the Physical Disability Board of Review set forth in references (b) through (g) are approved.  The official records of the following individuals are to be corrected to reflect the stated disposition below:

     a. XXXXXXXXXXXXXXXXXX, former USMC: Retroactive placement on the Permanent Disability Retired List on date of discharge with a final disability rating of 30 percent (increased from 10 percent). 

     b. XXXXXXXXXXXXXXXXXX, former USMC: Retroactive placement on the Permanent Disability Retired List on date of discharge with a final disability rating of 30 percent (increased from 10 percent). 

     c. XXXXXXXXXXXXXXXXXX, former USN: Retroactive placement on the Permanent Disability Retired List on date of discharge with a final disability rating of 40 percent (increased from 20 percent).   

     d. XXXXXXXXXXXXXXXXXX, former USMC: Retroactive placement on the Permanent Disability Retired List on date of discharge with a final disability rating of 30 percent (increased from 0 percent).

     e. XXXXXXXXXXXXXXXXXX, former USMC: Entitlement to disability separation pay with a 20 percent disability rating (increased from 0 percent) effective date of discharge.      

     f. XXXXXXXXXXXXXXXXXX, former USMC: Entitlement to disability separation pay with a 20 percent disability rating (increased from 10 percent) effective date of discharge. 
     
3.  Please ensure all necessary actions are taken to implement these decisions, including the recoupment of disability severance pay, if warranted, and notification to the subject members once those actions are complete.

	XXXXXXXXXXXXXXXXXX
	Assistant General Counsel
	(Manpower & Reserve Affairs)