RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01325
BRANCH OF SERVICE:  marine corps	SEPARATION DATE:  20040615

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Light Armored Vehicle Crewman, medically separated for “Vogt-Koyanagi-Harada disease” with a disability rating of 10%.

CI CONTENTION:  The condition continues to worsen.  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 it reasonably reflects the severity of the disability at the time of separation.

RATING COMPARISON:  

SERVICE PEB - 20040312	VARD - 20051115	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Vogt-Koyanagi-Harada Disease	6006-6079	10%	Vogt Koyanagi-Harada Syndrome, Bilateral Eyes 	6078	30%	20040909	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:

Vogt-Koyanagi-Harada Disease.  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI first noticed decreased vision in May 2002.  He was treated with high-dose oral steroids with a gradual taper for a total of 12 months.  Although there was great improvement in his vision after high-dose oral steroid treatment, he continued to complain of decreased night and color vision, and the inability to see well enough to qualify with his assigned weapon.

The 15 October 2003 ophthalmology evaluation documented best-corrected visual acuity as 20/25 in the right eye and 20/20 in the left eye.  The 27 January 2004 ophthalmology evaluation recorded best-corrected vision as 20/25 bilaterally.  At the 3 February 2004 MEB NARSUM ophthalmology examination, 4 months prior to separation, the CI complained of decreased visual acuity and problems with night vision.  Physical examination revealed 20/50 vision in the right eye and 20/30 vision in the left eye with no improvement from correction.  

During the 25 February 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the CI had an uncorrected distant visual acuity of 20/50 in the right eye and 20/70 in the left; a corrected visual acuity test was not addressed.  His color vision test showed his ability to correctly identify 8 of 14 pseudoisochromatic plates.

At the 9 September 2004 VA Compensation and Pension (C&P) ophthalmology evaluation, 3 months after separation, the CI reported the inability to read except for large print and had difficulty focusing on objects and print.  He was unable to distinguish between red and green colors correctly.  Physical examination showed best corrected distal visual acuity of 20/70 in the right eye and 20/60 in the left.  The CI was able to identify 3 of 12 pseudoisochromatic plates.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral eye condition 10%, coded 6006-6079 (retinitis-partial blindness, one eye only).  The VA rated the bilateral eye condition 30%, coded 6078 (partial blindness, both eyes) based on the C&P examination 3 months after separation, citing impairment of the central visual acuity with objective testing.

Although the above evaluations show the CI’s visual acuity gradually worsening, the panel agreed the MEB NARSUM evaluation, which revealed a best-corrected visual acuity of 20/50 in the worst eye and 20/30 in the other, most closely approximated the CI’s visual acuity at separation.  IAW Table V, Ratings for Central Visual Acuity Impairment, this warrants a 10% rating under code 6079.  There are no other applicable codes or rating schemes.  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 bilateral eye condition.

BOARD FINDINGS:  In the matter of the Vogt-Koyanagi-Harada disease and IAW VASRD §4.79, the panel unanimously 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 20160923, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment 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 USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN