RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00030
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050218

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Quartermaster and Chemical Equipment Repairer, medically separated for “discoid lupus erythematosus” with a disability rating of 10%.

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 - 20041208	VARD - 20050609	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Discoid Lupus Erythematosus	7809-7806	10%	Discoid Lupus Erythematosus without Evidence of Systemic Lupus	7809-7806	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Discoid Lupus Erythematosus.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI initially presented in November 2003 with lesions on his scalp.   He was treated twice unsuccessfully for a possible fungal infection.  In August 2004 he was diagnosed with discoid lupus erythematosus by dermatology.  The scalp and face lesions were treated with intralesional steroid injections which improved them greatly.  Because these lesions are very photosensitive and may lead to scarring, the CI needed to avoid sun exposure making him unfit for continued service.

At the 21 October 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the CI reported he was diagnosed with discoid lupus erythematosus.  Physical examination showed hyperpigmented plaques involving the right side of his face, anterior chest wall and the left deltoid.

There was no VA examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the discoid lupus erythematosus condition 10%, coded 7809-7806 (discoid lupus erythematosus-dermatitis).  The VA rated the discoid lupus erythematosus condition 0% coded 7809-7806, citing a non-compensable evaluation is granted if the record shows dermatitis or eczema involving less than 5 percent of the entire body or less than 5 percent of exposed areas affected, and: no more than topical therapy required during the past 12 month period.

The panel noted that the CI had lesions on the scalp, right side of face, anterior chest and left deltoid.  If all areas were affected at the same time that would account for between 15 and 20% of the body surface area using the rule of 9s (used for estimating body surface area).  The panel agreed that a 10% rating is justified for greater than 5% but no more than 20% of the entire body affected using code 7806.  Members agreed that the evidence did not support greater than 20% of the entire body or more than 6 weeks of systemic corticosteroids or other immunosuppressive drugs to validate the next higher 30% 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 discoid lupus erythematosus condition.

BOARD FINDINGS:  In the matter of the discoid lupus erythematosus condition and IAW VASRD §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 modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160113, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170013188, 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