RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01138
BRANCH OF SERVICE:  Navy	SEPARATION DATE:  20050221

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an E3, Aviation Structural Mechanic, medically separated for “psoriasis” with a disability rating of 10%.  

CI CONTENTION:  He should have received a 60% rating at time of separation.  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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20041115	VARD - 20050618	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Psoriasis	7816	10%	Psoriasis	7816	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Psoriasis.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s psoriasis condition began in February 2002 when he developed skin symptoms (papules, plaques, etc.) on his forearms, elbows, chest, and back, as well as hairline scaling.  Dermatology diagnosed psoriasis and he was started on topical steroid creams, shampoos, phototherapy, and daily oral Soriatane (acitren), which decreased symptoms; however, discontinuance of phototherapy resulted in significant exacerbations.  

The 7 June 2004 MEB NARSUM examination, 8 months prior to separation, noted complaints of “mild psoriasis, with satisfactory control as long as he continues with his phototherapy sessions and topical steroids and pimecrolimus [topical medication].”  Physical examination showed scattered 1-2 centimeter erythematous macules, patches, and thin plaques, with faint scale, over the torso and bilateral upper and lower extremities. There was erythema and scaling on both eyebrows, the hairline, and groin and buttock areas.  There was no VA examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the psoriasis condition 10%, coded 7816 (psoriasis).  The VA rated the psoriasis condition 0%, also coded 7816, based on the STR and citing a missed VA examination, less than 5 percent of the entire body or exposed areas affected, and no more than topical therapy required during the past 12-month period.  VA evidence remote from separation indicated the CI was later started on systemic immunosuppressive therapy and was rated at 60% for psoriasis effective 31 October 2011.  Members noted that proximate to separation, there was no non-dermatologic disability related to the psoriasis, and therefore it was appropriately rated under the criteria of code 7816.  The only systemic medication the CI had been taking was oral Soriatane (an anti-psoriatic retinoid), which is not considered a corticosteroid or immunosuppressive drug required for a higher rating.  Additionally, 20% or more of the entire body or exposed area was not affected proximate to separation for any rating higher than the 10% adjudicated by the PEB.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the psoriasis condition.  

BOARD FINDINGS:  In the matter of the psoriasis condition and IAW VASRD §4.118, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends 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 20160930, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44

      In accordance with reference (a), I have reviewed the cases listed below and approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN

					XXXXXXXXXXXXXXXXXX
	     				Acting