RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00318
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060510

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Aviation Operations Specialist, medically separated for “recurrent bouts of urticaria, some with angioedema,” with a disability rating of 10%.

CI CONTENTION:  The CI made no specific contention.  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 - 20060123	VARD - 20070611	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Recurrent Urticaria 	7825-7118	10%	Chronic Urticaria	7825	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Recurrent Urticaria.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s urticaria condition began in October 2004 while deployed.  She experienced itchy, red bumps on her cheeks, forehead and upper arms.  She was treated with anti-histamines and steroids with resolution.  She did have a recurrence shortly thereafter.  Both followed eating melons, but subsequent provocative testing was negative.  However, the test was positive for sensitivity to Ibuprofen.  She had one additional episode on 10 April 2005 after return to her home base.  

At the 5 October 2005 MEB NARSUM examination, 6 months prior to separation, it was noted that the CI continued to have recurrent urticaria (hives) and angioedema (swelling of the oral mucosa).  Review of the record though did not show any clinical encounters for these episodes nor were they quantified.  It was noted that she had contact dermatitis, a different condition, to sunscreen products containing Aloe.  The physical examination was unremarkable.  

An allergy follow-up on 2 August 2006, 3 months after separation, showed changes about the eyes and lips which were thought to be more consistent with contact dermatitis than urticaria or angioedema.  Laryngeal involvement was not documented.  The CI did not attend her scheduled April 2007 VA Compensation and Pension (C&P) evaluation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the recurrent urticaria condition 10%, coded 7825-7118 (urticaria – angioneurotic edema), citing bouts lasting 1 to 7 days or 2 to 4 times yearly without laryngeal involvement.  The panel observed that the last clearly documented episode was on 10 April 2005, over 1 year prior to separation.  The VA rated the chronic urticaria condition 0% coded 7825, based on the STR.  This was later increased to 10% based on a VA C&P examination over 8 years after separation.  The evidence did not support a higher rating.  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 recurrent urticaria condition.  

BOARD FINDINGS:  In the matter of the recurrent urticaria condition and IAW VASRD §4.104 and §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 re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160413, w/atchs
Exhibit B.  Service Treatment Record

	AR20170015272 XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

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