[AR Number], XXXXXXXXXX

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

XXXXXXXXXX:

	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.

,					      

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXX	CASE:  PD-2017-04754
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090425

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Human Resources Specialist, medically separated for “scalp pain and infection” 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 - 20081215	VARD - 20090624	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Scalp Pain And Infection	7899-7828	10%	Perifolliculitis Capitis Abscedens ET Suffodiens with Scar on Scalp	7899-7800	10%	2009323	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:  

Scalp Pain and Infection.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s scalp condition began in August 2007 when he experienced scalp tenderness, blood on his pillow after sleeping, abscesses and constant pain.  In December 2007, dermatology diagnosed perifolliculitis capitis abscedens et suffodiens or dissecting cellulitis of the scalp (suppurative scalp disease of unknown etiology).  Despite multiple local injections of corticosteroids, drainage of abscesses, and use of multiple topical ointments, he continued to have severe scalp pain which prevented the wear of any type of head gear or hat.    

At the 27 October 2008 MEB NARSUM examination, 6 months prior to separation, the CI reported that “wearing the helmet is almost impossible to tolerate.”  Physical examination (PE) revealed large areas of painful alopecia (hair loss) on the backside of the head, and bogginess of the underlying skin.  His diagnosis remained unchanged with a prognosis noted as “very poor” for complete recovery. 

At the 23 March 2009 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported constant crusting of his scalp skin, but no functional impairment from the condition.  The PE revealed a level and disfigured scar measuring approximately 4 cm x 1 cm in the left parietal/occipital area.  There was no ulceration, adherence, instability, tissue loss, inflammation, edema, keloid formation or hyperpigmentation present.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the scalp condition 10%, analogously coded 7899-7828 (acne), citing acne other than on the face or neck.  Additionally, the PEB noted the condition existed prior to service and did not make a rating deduction.  The VA also analogously coded and rated the scalp condition 10% but coded 7800 (scars of the head, face or neck caused by other than burns), based on the C&P examination, citing a 1-cm disfigured scalp scar.  Members agreed that either code 7828 or 7800 was appropriately supported by the evidence at no higher than a 10% rating based on either the acne-like presentation or disfiguring scar.  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 scalp condition.  

BOARD FINDINGS:  In the matter of the scalp 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: