RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01260
BRANCH OF SERVICE:  Coast Guard 	SEPARATION DATE:  20061204                                                                                                             

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Machinery Technician, medically separated for “dermatitis”,  rated 10% with a disability rating of 10%.

CI CONTENTION:  “The VA rated me at 0%.  The Coast Guard rated me at 10%.”  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 Board 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 determination 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(s) 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 FPEB - 20060627	VARD – 20080313 > 20080528	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Dermatitis	7806	10%	Bilateral Dermatitis of the Hands	7806	100%*	20071227	
					0%	20080331	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: 100% > 0%	
*Pre-stabilization rating. 

ANALYSIS SUMMARY:    

Dermatitis.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI developed a rash on both hands about six months prior to separation.  This was diagnosed by patch testing as a chemical contact dermatitis from an agent (phenylenediamine) that could not be avoided in his work as a mechanic.  The condition did not clear with treatment (topical corticosteroids only).  There was ample documentation in STR clinical entries that the dermatitis remained confined to his hands. 

The 27 February 2006 NARSUM (dermatology) examination, 7 months prior to separation, stated, “No treatment to date had fully cleared the dermatitis ... he will continue to have the dermatitis as long as he continues handling oil and lubricants working as a mechanic ... treatment (long term) with topical steroid is recommended.”  The NARSUM provided measurements of surface areas affected on each hand from an earlier examination; but, a more precise worksheet was in evidence that appeared to have been the source document for the PEB’s rating determination.  This calculated that the total percentage of exposed areas affected was 5.0%.  

A VA Compensation and Pension (C&P) examination on 27 December 2007 (13 months after separation) documented a persistent dermatitis (still confined to hands) that had prohibited the CI’s return to civilian employment as a mechanic, and noted the daily use of a topical corticosteroid.  In an addendum, the examiner recorded the total percentage of exposed areas affected as 0.5%.  A follow-up VA examination four months later (31 March 2008) documented only sporadic flares treated topically without current symptoms, and the physical examination recorded “no signs of skin disease present.”

The panel directed attention to its rating recommendation based on the above evidence.  The PEB’s 10% rating under code 7806 (dermatitis or eczema) cited the VASRD §4.118 10% criteria for the code, “at least 5 percent, but less than 20 percent, of exposed areas affected.”  Based on the evidence from the first C&P examination (above), the VA initially conferred a pre-stabilization rating of 100% under the same code, citing the temporary circumstance of “gainful employment is not feasible or advisable.”  A rating decision soon afterwards, based on the above follow-up examination, conferred a 0% rating under code 7806 citing the 0% criterion “less than 5 percent of exposed areas affected, and; no more than topical therapy required during the past 12-month period.”

Code 7806 is specific for the condition under consideration, and no alternative VASRD code is applicable or justifiable for analogous rating.  The attendant rating criteria, as quoted above, are thus obligatory; and, clearly support the panel’s conclusion that there was no evidence in this case to support a rating higher than the 10% conferred by the PEB .

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 adjudication of the dermatitis condition.

BOARD FINDINGS:  In the matter of the dermatitis condition and IAW VASRD §4.118, 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 20150525, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX,

I am the Designated Decision Authority for the Coast Guard on applications submitted to the Department of Defense Physical Disability Board of Review (PDBR).  Under the authority of Title 10, United States Code, section 1554a, I accept the PDBR’s recommendation in your case (Case Number PD-2015-01260) and decline to modify your findings. 

Enclosed for your information are a copy of the PDBR’s recommendation and a copy of the record of proceedings. 

A copy of this decision has also been provided to Coast Guard Enlisted Personnel Management Branch, the PDBR, and the Department of Veterans Affairs. 

If you have any further questions, please contact the Coast Guard Personnel Service Center at XXXXXXXXXXXXXXXXXXX. 

	Sincerely,

2 Enclosures	

Copy:	CG Personnel Service Center (EPM-1)
DoD Physical Disability Board of Review
Department of Veterans Affairs