RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX		CASE: PD-2017-03370 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20051107

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Unit Supply Specialist, medically separated for “chronic and deep folliculitis and cellulitis of the scalp” with a disability rating of 10%.

CI CONTENTION:  No specific contention was made. 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 - 20050729	VARD - 20060512	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic and Deep Folliculitis and Cellulitis of the Scalp	7899-7829	10%	Scalp Folliculitis and Sebaceous Cysts	7899-7829	10%	20051214	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 50%	

ANALYSIS SUMMARY:

Folliculitis and Cellulitis of the Scalp. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s skin condition began in August 2004 while deployed in Iraq. He developed acne-like bumps on the left parietal scalp that were accompanied by itching and tenderness. He reported to sick call in October 2004 and was treated with oral and topical medications for a month without improvement. The condition spread over the scalp and the CI used over-the-counter acne creams without relief or improvement. The CI returned to Washington  in  January  2006,  reported  to  sick  call  in  March  2005,  and  was  referred       to

dermatology. The CI was placed on oral and topical medications and given steroid injections to the lesions.  He received a profile for no wearing of the Kevlar helmet.

The 21 June 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of scalp cellulitis, characterized by posterior and parietal scalp scarring with lesions that itched at times and were tender. Discomfort was only present when palpated. Symptoms increased with palpation, scratching, and wearing of the Kevlar helmet. Symptoms decreased with medications, not wearing the Kevlar, and not touching the lesions. The CI was treated with minocycline, Retin- A cream topically, Robaxin and Naproxen. No involvement of the face and neck was noted. Physical examination showed areas of scarring along the vertex and parietal regions with several, mildly fluctuant lesions along the lower part of the vertex of the scalp which were tender.

At the 14 December 2005 VA Compensation and Pension (C&P) examination, one month after separation, the CI reported intermittent symptoms, as often as twice a month, with each occurrence lasting 3 weeks. There were eight attacks in the past year. The disease affected areas exposed to the sun, including the head. There was no functional impairment and no time lost from work. Physical examination showed skin lesion coverage of the exposed area was one percent and coverage relative to the whole body was one percent. There was a level scar present at the scalp measuring about 2 cm by 1 cm, without tenderness, ulceration, keloid, hypopigmentation or abnormal texture.  No involvement of the face and neck was noted.

The panel directed attention to its rating recommendation based on the above evidence. The PEB and VA both rated the skin condition 10%, analogously coded 7899-7829 (chloracne). The PEB cited deep acne with less than 40% of the face and neck involved. The VA based the rating on the C&P examination, citing that the condition covers less than 40% of the face and neck. The NARSUM and the C&P examinations showed lesions consistent with a cellulitis and localized to areas of the scalp. Panel members agreed there was no evidence of deep acne affecting 40 percent or more of the face and neck to achieve a higher rating of 30%. 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 skin condition.

BOARD FINDINGS: In the matter of the skin condition and IAW VASRD §4.71a, 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:

 PD-2017-03370 

, XXXXXXXXXXXXXX 

Dear XXXXXXXXXXXX

	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.

Enclosure

PD-2017-03370