RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01829
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050706

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Finance Specialist, medically separated for “osteoma of skull,” with a disability rating of 0%.  

CI CONTENTION:  “Review all conditions.”  The 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 PEB - 20050509	VARD - 20060119	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Osteoma of Skull	5015	0%	Osteoma, Right Forehead	5099-5015	0%	20051202	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Osteoma.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s osteoma was first evaluated in October 2001.  Further imaging (bone scan, X-rays, and CT) in 2002 and 2005 documented a stable and benign osteoma.  However, wearing helmets resulted in headaches due to the osteoma’s right forehead location and surgery was declined.  

At the April 2005 MEB examination (recorded on DD Forms 2807 and 2808), 3 months prior to separation, the CI reported headaches while wearing combat helmets.  The physical examination showed a “bony prominence” of the right forehead.  The 19 April 2005 MEB NARSUM examination noted complaints of pain and headaches when wearing helmets.  
Physical examination showed a 3.5 cm x 3.5 cm bony prominence of the right forehead, elevated to 1.5 cm, which was tender to palpation.  

At the 2 December 2005 VA Compensation and Pension (C&P) evaluation, performed 5 months after separation, the CI denied any symptoms referable to the osteoma, such as pain, headache, and weakness.  Physical examination showed a nontender 3.5 cm bony prominence above the eyebrow.  

The panel directed attention to the rating recommendation based on the above evidence.  The PEB rated the osteoma condition 0%, coded 5015 (bones…growths, benign), citing pain with wear of head gear.  The VA rated the osteoma condition 0% analogously coded 5099-5015 (bones…growths, benign), based on the C&P examination citing no objective evidence of pain, weakness, or other symptoms associated with the osteoma.  

This condition is not specifically listed in the rating schedule; therefore, it is rated analogously to a disability in which not only the functions affected, but the anatomic localization and symptoms, are closely related.  Alternative coding based on residuals was also considered.  There was no documentation of recurrent headaches for a rating under VASRD code 8100 (migraines).  There was no documentation of constitutional symptoms, such as fever, weight loss, anemia or residuals of chemotherapy for rating under malignant bone disease (5012, 8002, or 8003).  There was no documentation of seizures, altered consciousness, neuritis or neuralgia for coding under the VASRD §4.124 section.  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 for the osteoma condition.  

BOARD FINDINGS:  In the matter of the osteoma condition and IAW VASRD §4.71a, 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 20150626, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20170009273  , XXXXXXXXXXXXXXXXXX 

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Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,					       
						      					
Enclosure