RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX 	CASE:  PD-2017-03001
BRANCH OF SERVICE:  Army 		SEPARATION DATE:  20081002

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Motor Transport Operator, medically separated for “epidermolysis bullosa simplex [EBS]” with a disability rating of 10%.  

CI CONTENTION:  “Skin disorder was not caused by Army but made worse due to service.”  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 – 20080623	VARD - 20090422	
Condition	Code	Rating	Condition	Code	Rating	Exam	
EBS	7815	10%	Polydysplastic Epidermolosis Bullosa	7899-7806	NSC	20071203	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

EBS.  According to the service treatment record and MEB narrative summary (NARSUM), the CI was evaluated for blister type lesions to the bilateral arms, elbows, knees, and right neck in July 2005.  The dermatologist diagnosed him with EBS in August 2005 and biopsy confirmed the diagnosis. The 2006 PEB found the CI fit for duty with limitations however, he was unable to care for his skin while deployed to Iraq in 2006.  The CI reported he had been told of skin problems prior to age 6 or 7 but did not experience further problems until he served in Iraq in 2003.  He reported he was able to care for his skin and described flare-ups mainly on his arms.  His condition worsened with heat, physical activity, wearing equipment, and basic soldiering skills.  

At the 3 December 2007 MEB NARSUM examination, 10 months prior to separation, the CI reported an inability to perform simple tasks as described above.  There was no treatment of benefit and he had no systemic treatment.   Physical examination showed multiple quarter size, pink and red sores on his feet and arms. At the same-day VA Compensation and Pension (C&P) examination the CI reported rash and blisters that only occurred when aggravating factors were present. Lotion was an alleviating factor. The May 2008 dermatology follow-up visit estimated 10% of total body surface area (BSA) was involved.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the EBS condition 10%, coded 7815 (bullous disorders), citing 10% total body surface area involvement.  The VA determined the polydysplastic epidermolosis bullosa condition, coded 7899-7806 (dermatitis, eczema) was not service connected.  The panel noted the dermatology estimated total BSA involvement was 10%, which did not meet VASRD criteria of 20-40% BSA to achieve a higher 30% rating.  The panel agreed the affected area met criteria for 10% disability.  After due deliberation, considering all 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 EBS condition. 

BOARD FINDINGS:  In the matter of the epidermolysis bullosa simplex 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 20170323, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

	PD-2017-03001

AR20190010584, XXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXX

	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.

	

	PD-2017-03001