RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03543
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090127

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 “pilonidal cyst” with a disability rating of 10%.  

CI CONTENTION:  No specific contention 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 - 20081230	VARD - 20090512	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Pilonidal Cyst	7899-7820	10%	Pilonidal Cyst with Abscess, Low Back	7804	10%	20090320	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  70% 	

ANALYSIS SUMMARY:  

Pilonidal Cyst.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s pilonidal cyst developed in January 2005.  He underwent an initial surgical excision in August 2005 and a subsequent excision in July 2007 with many incision and drainage procedures between and after.  He continued to have pain and multiple fistulae.  During the 15 August 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, physical examination showed three scars on the buttocks. One scar was four inches long and two were one inch long.  The 3 November 2008 MEB NARSUM examination, 3 months prior to separation, noted complaints of continued pain in the buttock area making it difficult to sit for extended periods.  Physical examination noted “a 4 cm scar going from the midpoint of the buttock crease jagging to the left, thickened in character.”  

At the 20 March 2009 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported scars from cyst removal.  Physical examination showed a 4 cm X 0.5 cm scar and two 1 cm X 0.25 cm scars in the low back/buttock area that were non-tender.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the pilonidal cyst condition 10%, coded 7899-7820 (analogous to infections of the skin not listed elsewhere), citing the VASRD criteria for this condition at 10%.  The VA also rated the pilonidal cyst condition 10%, coded 7804 (unstable or painful scars), based on the C&P examination, citing a superficial scar that was painful on examination.  

Although the scar in question was associated with underlying soft tissue damage, the total area of scarring was less than 6 square inches, which did not satisfy the requirements for the minimum rating under code 7801.  Code 7802 had an even greater area required for rating superficial scars.  Code 7804 has no such area requirement and the CI had one painful scar, which fulfilled the requirement for a 10% rating.  The panel noted benign neoplasms of the skin (7819) and infections of the skin not listed elsewhere (7820) are rated as scars.  There are no other applicable codes.  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 pilonidal cyst condition.  

BOARD FINDINGS:  In the matter of the pilonidal cyst 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 20170405, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180009202, 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.

A copy of this decision has been provided to the counsel you listed on your application, XXXXXXXXXXXXXXXXXX.

Sincerely,					      
Enclosure