RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01852
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070712

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Watercraft Engineer, medically separated for “contact allergy to latex in the protective mask and to heavy work gloves,” 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 - 20070425	No VA rating decision in evidence 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Contact Allergy to Latex in the Protective Mask and to Heavy Work Gloves	7806	0%	No Exam in Eviidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Contact Allergy to Latex in the Protective Mask and to Heavy Work Gloves.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s contact allergy to latex in the protective mask and to heavy work gloves condition began 8 years prior when he experienced hand lesions.  Skin vesicles were worse with use of gloves and exposure to chemicals and was treated with topical medications.  He was referred to Dermatology in February 2006 and was diagnosed with dyshidrotic eczema/provoked contact dermatitis" involving the hands and feet confirmed by patch testing.  The CI’s hands “almost completely healed for the first time since completing AIT when he was placed on alternate duty for a period of six months.”  Hand lesions recurred with return to MOS duties.  
At the MEB examination (recorded on DD Forms 2807 and 2808) dated 15 December 2006, 7 months prior to separation, noted complaints of impaired use of the hands due to skin problems from chemicals.  Physical examination showed a rash on the hands, forearms, gluteal cleft, groin, and bilateral plantar surfaces.  The MEB NARSUM examination on 13 February 2007, 5 months prior to separation, the CI reported a constant hand rash.  The CI was on topical medications.  Physical examination showed abnormal skin with “bilateral patches of lichenification and scaling erythematous skin on both hands with mild associated edema and tenderness to palpation.”  There was no VA Compensation and Pension (C&P) evaluation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the contact allergy condition 0%, coded 7806 (dermatitis or eczema), citing less than 5% of body area, responding to topical therapy.  Rating under code 7806 is based on medication use or percent of the entire body or exposed areas affected.  The CI had “no more than topical therapy required during the past 12-month period” to warrant any rating higher than 0% for medication use.  The panel next deliberated on the percent of the entire body or the percent of the exposed areas affected.  The MEB DD Form 2808 examination (7 months prior to separation) showed a rash on the hands, forearms, gluteal cleft, groin, and bilateral plantar surfaces; however, the NARSUM examination (5 months prior to separation) showed only patchy lesions of both hands.  The panel considered the NARSUM examination had the highest probative value for rating at separation given the proximity to separation.  

The complete front and back of both hands equates to 5% of the entire body area (reference AR 635-40, Figure B-3, 8 February 2006) and the panel agreed that “patchy” involvement indicated less than 5% of the entire body was effected.  However, the hands are considered part of the “exposed areas” which is an independent rating element under code 7806.  The head (7%), neck (2%), and hands (5%) encompass the exposed areas of the body.  Therefore, complete involvement of both hands would approximate 35% of the exposed area.  Since the NARSUM examination indicated “patchy” abnormality of the skin of both hands, the panel deliberated if the skin involvement were 20 to 40 percent of exposed areas affected, (30%); at least 5 percent, but less than 20 percent, of exposed areas affected (10%); or less than 5 percent of exposed areas affected (0%).  The panel adjudged that the CI’s disability picture at separation more nearly approximated the 10% rating criteria for at least 5 percent, but less than 20 percent, of exposed areas affected.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the contact allergy condition, coded 7899-7806.  

BOARD FINDINGS:  In the matter of the contact allergy condition, the panel unanimously recommends a disability rating of 10%, coded 7899-7806 IAW VASRD §4.118.  There are no other conditions within the panel’s scope of review for consideration.  

The panel 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	
Contact Allergy to Latex in the Protective Mask and to Heavy Work Gloves	7899-7806	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150706, with attachments
Exhibit B.  Service Treatment Record

AR20170009218, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,	
Enclosure