RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW NAME: XXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY CASE NUMBER: PD1201315 SEPARATION DATE: 20010927 BOARD DATE: 20130212 SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty PFC/E-3 (11B/Airborne Infantry) medically separated for Raynaud’s phenomenon (RP). He was treated, but was not able to fully perform his military duties. The CI was issued a permanent P3 profile and underwent a Medical Evaluation Board (MEB). The MEB found the RP condition medically unacceptable IAW AR 40-501, and referred him to a Physical Evaluation Board (PEB). No other conditions were listed on DA Form 3947. The PEB found the RP condition unfitting, and rated it 10% IAW the Veterans’ Administration Schedule for Rating Disabilities (VASRD). The CI made no appeals, and was medically separated with 10% disability. CI CONTENTION: “I have been evaluated and enlisted in the Department of VA Vocational Rehab program. My disability is worse than originally thought.” SCOPE OF REVIEW: The Board’s scope of review as defined in DoDI 6040.44, is limited to those conditions which were determined by the PEB to be specifically unfitting for continued military service; or, when requested by the CI, those condition(s) “identified but not determined to be unfitting by the PEB.” The unfitting RP condition meets the criteria prescribed in DoDI 6040.44, and is accordingly addressed below. No other conditions are within the Board’s purview. Any condition outside the Board’s defined scope of review may be eligible for future consideration by the Army Board for Correction of Military Records. RATING COMPARISON: Army PEB – dated 20010810 VA (6 mos. Post-Separation) – Effective 20020318 Condition Code Rating Condition Code Rating Exam Raynaud’s Phenomenon 7117 10% Raynaud’s Phenomenon 7122 0% 20020102 Combined: 10% Combined: 0% ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed by the CI regarding the impairment with which his RP condition continues to burden him, and the significant impact it has had on his quality of life. It is noted for the record that the Board is subject to the same laws for disability entitlements as those under which the Disability Evaluation System (DES) operates. The DES has neither the role nor the authority to compensate the CI for future severity or potential complications of conditions. That role and authority is granted to the Department of Veterans’ Affairs (DVA). The Board evaluates DVA evidence in arriving at its recommendations, but its authority resides in evaluating the fairness of DES fitness and rating determinations at the time of separation. Compensation can only be granted for the degree of severity present at separation. The DVA, however, is empowered to re-evaluate a CI’s conditions for the purpose of adjusting the disability rating should the degree of impairment change. Raynaud’s Phenomenon (RP). The CI presented in January 2001 complaining that since moving to Alaska, his distal extremities would turn purple after exposure to cold. In addition to color change, he reported pain and paresthesia. Symptoms were worst in the left hand. As noted above, the CI underwent a MEB. His MEB narrative summary (NARSUM) was dictated on 20 July 2001, and was based on two previous physical examinations. At his 27 February 2001 Internal Medicine (IM) visit, the CI reported classic tricolor changes. He was in the “red phase,” with an outside temperature of 42 degrees Fahrenheit. There was marked erythema of the hands, with sparing of the thumbs. Pulses were diminished (one out of four) bilaterally. The remainder of exam was essentially normal. There was no clinical or laboratory evidence of a secondary etiology for the RP. The IM physician stated, “Do not feel medications will make a significant difference...Do not expect resolution of this problem.” The CI was medically separated from the Army on 27 September 2001, due to his unfitting RP condition. After separation, he filed a claim with the VA but failed to report for a Compensation and Pension (C&P) exam scheduled on 14 February 2002. The VA granted service-connection for the RP, but assigned a rating of 0% due to lack of current clinical findings. The Board carefully reviewed all evidentiary information available, and directs attention to its rating recommendation based on the above evidence. The Army PEB coded the RP condition as 7117 (Raynaud’s syndrome) and rated it 10%, based on characteristic attacks occurring one to three times weekly. The next higher rating of 20% would require characteristic attacks occurring four to six times a week. The Board could not find sufficient evidence in the treatment record to justify the higher rating of 20%. The Board was unable to find a pathway to a higher rating using any other applicable VASRD code. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the RP condition. BOARD FINDINGS: IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication. The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised. In the matter of the RP condition and IAW VASRD §4.104, the Board unanimously recommends no change in the PEB adjudication. There were no other conditions within the Board’s scope of review for consideration. RECOMMENDATION: The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination, as follows: UNFITTING CONDITION VASRD CODE RATING Raynaud’s phenomenon 7117 10% COMBINED 10% The following documentary evidence was considered: Exhibit A. DD Form 294, dated 20120626, w/atchs Exhibit B. Service Treatment Record Exhibit C. Department of Veterans’ Affairs Treatment Record xxxxxxxxxxxxxxxxxxxxxx, DAF Acting Director Physical Disability Board of Review SFMR-RB MEMORANDUM FOR Commander, US Army Physical Disability Agency (TAPD-ZB / xxxxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for xxxxxxxxxxxxxxxxxxxxx, AR20130007466 (PD201201315) I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual. Under the authority of Title 10, United States Code, section 1554a, I accept the Board’s recommendation and hereby deny the individual’s application. This decision is final. The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail. BY ORDER OF THE SECRETARY OF THE ARMY: Encl xxxxxxxxxxxxxxxxxxxxxxx Deputy Assistant Secretary (Army Review Boards)