RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-05314 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20050822

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Navy Law Enforcement Specialist, medically separated for “psoriasis, non-arthropathic” with a disability rating of 10%.

CI CONTENTION: Given a higher rating by the VA for the psoriasis. 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 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 - 20050516	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Psoriasis, Non-Arthropathic	7816	10%	No VA Examination in Evidence Proximate to Separation	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Psoriasis. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s skin condition began as early as December 2000. He was diagnosed with a plaque psoriasis, which caused extensive skin scaling and bleeding, and placed on limited duty for the condition on 28 April 2004. Treatment included subcutaneous administration of Enbrel (immunosuppressive agent) in addition to ultraviolet light treatments, topical steroids and emollients. A brief course of oral Methotrexate (antimetabolite) was prescribed, but he reasonably elected to discontinue it based on potential side effects. In December 2004, he requested restarting Enbrel due to the recurrence along his extremities.

At the 15 January 2005 MEB NARSUM examination, 7 months prior to separation, the CI reported that he had stopped using Enbrel by the end of August 20905 because his skin had completely cleared up. Physical examination showed red papules and small plaques, with a scant amount of silver scaling of the extensor surfaces of the arms, anterior legs, and right cheek. There was diffuse erythema of the lower legs which appeared to be a remnant of the previous plaques.

On 31 March 2005, the CI’s dermatologist noted he had completed 3 months of Enbrel, and at a visit on 25 April 2005, the psoriasis was noted to be fairly well controlled on the medication, with involvement of small areas of the arms, thighs, face, and scalp. Examination showed the presence of plaques without scaling, with an affected body surface area of 5% (improved from initial 40%). 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 psoriasis 10%, coded 7816 (psoriasis). Panel members noted that a 30% rating under this code requires systemic therapy such as corticosteroids or other immunosuppressive drugs for a total duration of 6 weeks or more, but not constantly, during the previous 12-month period. The March 2005 dermatology note indicated the CI had just completed a 3-month course of Enbrel, well within the year before separation. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 30% for the psoriasis, coded7816.

BOARD FINDINGS: In the matter of the psoriasis, the panel recommends a disability rating of 30%, coded 7816 IAW VASRD §4.118. There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows; and, that the discharge with severance pay be re-characterized to reflect permanent disability retirement, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Psoriasis	7816	30%	

2	PD-2017-05314

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

Ut REPLY REFER TO:
1850
CORB:003 12 Oct 20

From: To:

Subj:

Ref:

Director, Secretary of the Navy Council of Review Boards 

PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

(a) DoDI 6040.44
(b)	PDBR ltr of 23 Dec 19
(b)	

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy for appropriate action.

2.	On 5 October 2020, the Assistant Secretary of the Navy took action in your case by accepting the correct recommendation of the PDBR.	Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Physical Evaluation Board from 10 to 30 percent with assignment to the Permanent Disability Retired List.

3.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, was sent to the Navy Personnel Command, for correction of your records as stated above.	You will be notified once those changes are complete.