RECORD OF PROCEEDINGS
PHYSICAL DISABILITY REVIEW BOARD
NAME: BRANCH OF SERVICE: ARMY
CASE NUMBER: PD0900015 COMPONENT: ACTIVE
BOARD DATE: 20090604 SEPARATION DATE: 20050503
________________________________________________________________
SUMMARY OF CASE: This covered individual (CI) was an active duty NCO medically separated from the Army in 2005 after 4 years of service. The medical basis for the separation was post-operative scar complications following C-section in 2003. After initial problems with incisional healing, she underwent a plastic surgery revision, and further complications ensued. She was left with a large, painful (hip-to-hip) keloid scar interfering with her duty requirements. There were additional medical issues with both knees and Carpal Tunnel Syndrome of the left wrist. She was referred to the PEB, found unfit for the abdominal scar and separated at 10% disability. An examination by the VA 15 months later rated her 10% for the scar with additional ratings for the orthopedic conditions, yielding a combined disability of 40%. The CI contends that the rating for her abdominal scar does not fairly reflect its impact on her life and earnings, and that her orthopedic conditions should also have been considered by the PEB.
________________________________________________________________
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 PDBR 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. The Board diligently scrutinized the knee and wrist diagnoses as candidates for additional unfitting conditions overlooked by the PEB. It is true that her knee problems are currently significant issues for the CI, and were not aggressively pursued by the military in the face of her more pressing abdominal scar problem. There is nothing in provider notes, commander’s statement, medical profiles or otherwise in the record that would support a finding of unfitness had the conditions been formally adjudicated by the PEB. The Board cannot, therefore, support a recommendation for additional unfitting conditions in the separation rating. Regarding the rating for the unfitting scar, the Board notes that under the VASRD (2005) codes applied by the PEB and the VA, no rating greater than 10% is authorized. Serious consideration was given to regarding the scar as ‘deep’ under VASRD 7801, which is the only available code allowing for a higher rating. The surface area of the scar, however, would support only a 20% rating under 7801. Consideration was given to exercising the prerogative in Note (1), albeit under 7801, to code and rate separate anterior and posterior abdominal wall components. By a majority vote, the Board agreed that the PEB coding and rating was fair. The single voter for dissent (who recommended application of the ‘Note 1’ prerogative above, yielding a 20% rating) elected not to submit a minority opinion.
________________________________________________________________
RECOMMENDATION: The Board recommends that there be no recharacterization of the separation.
________________________________________________________________
The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20090114, w/atchs.
Exhibit B. Service Treatment Record.
Exhibit C. Department of Veteran's Affairs Treatment Record.
President
Physical Disability Board of Review
AF | PDBR | CY2013 | PD-2013-01365
At retention physical dated 4 September 2002, the examiner documented a prior history of bilateral hip osteoarthritis, a 2001 right hip replacement, and noted “decreased ROM left hip” (no measurements were documented). Thus, the Board cannot recommend a separate service rating for this condition. In the matter of the osteoarthritis bilateral knees condition, the Board unanimously determined that neither knee was separately unfitting and that the condition EPTS and was not permanently...
AF | PDBR | CY2011 | PD2011-00674
The PEB adjudicated the multiple keloid scarring condition as unfitting, rated 10%, with application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD), and possibly the US Army Physical Disability Agency (USAPDA) pain policy. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the left shoulder, 10% for the right ankle, 10% for the left ankle and 10% for the abdominal area...
AF | PDBR | CY2009 | PD2009-00536
The History of Right Axillary Third-Degree Burn and PTSD were determined to be medically unacceptable and the CI was referred to the Physical Evaluation Board (PEB), determined to be unfit for continued military service, and separated at 20% disability using the Veterans Affairs Schedule for Ratings Disabilities (VASRD) and applicable Navy and Department of Defense regulations. The CI was not on medication for either condition at that time, but Lexapro was restarted in January 2006. The...
AF | PDBR | CY2013 | PD-2013-01987
Burn Scar Right Hand Condition . cm.At the VA Compensation and Pension (C&P) examinationperformed 2 days after separation, the CI reported pain and paresthesia of the scar involving the dominant right hand and forearm. SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXX, AR20150003243 (PD201301987)I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings...
AF | PDBR | CY2013 | PD-2013-01887
The thigh condition, characterized as “chronic left thigh pain secondary to abundant callus and quadriceps adhesion” and “saphenous nerve palsy (sensory) after gunshot wound,” were the only two conditions forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.The Informal PEB adjudicated “chronic left thigh pain secondary to abundant callus and quadriceps adhesion” and “saphenous nerve palsy (sensory) after gunshot wound to left thigh” as unfitting, rated 0% and 0%, respectively,...
AF | PDBR | CY2009 | PD2009-00010
The Commander’s statement lumps the peripheral nerve symptoms in with the neck pain and ‘shoulder pain’ when describing interference with her performance. The only other condition rated and service-connected by the VA is a headache condition. The Board has no reasonable basis for recommending the shoulder or headache conditions as additional unfitting conditions for separation rating, and does not have jurisdiction for considering tinnitus.
AF | PDBR | CY2012 | PD2012-00518
Ulcerative Colitis Condition. The Board concluded therefore that no separate disability rating could be recommended for this condition. RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as follows; and, that the discharge with severance pay be recharacterized to reflect permanent disability retirement, effective as of the date of her prior medical separation: VASRD CODE RATING 7323 COMBINED 30% 30% UNFITTING CONDITION Ulcerative colitis The following...
AF | PDBR | CY2012 | PD2012 00572
The chronic pain, right wrist status post (s/p) fracture and retropatellar pain syndrome (RPPS) bilateral knees conditions were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.ThePEBadjudicated chronic pain, right wrist and bilateral knees as unfitting, rated 10%,with cited application of the US Army Physical Disability Agency (USAPDA) pain policy.The CI made no appeals, and was medically separated. Other x 520030307 Combined: 10%...
AF | PDBR | CY2012 | PD 2012 01293
She was then medically separated with a 10% disability rating. Prior to Separation) Effective 19990304 Condition Code Rating Condition Code Rating Exam 20030429 TDRL Sep. Ileocolonic Crohns Disease w/ DJD 7399-7323 30% 10% Crohns Disease s/p ileocolonic resection 7323 30% 19990106 Inflammatory Arthritis Secondary to Crohns 5009-5002 20%* 19990106 and 20050301 .No Additional MEB/PEB Entries. The VA GI exam, approximately 9 months prior to separation, noted that the CIs...
AF | PDBR | CY2013 | PD2013 00219
The PEB and the VA adjudicated the chronic incisional abdominal pain condition as a painful scar with a service rating of 10%. RECOMMENDATION : The Board recommends that the CI’s prior determination be modified as follows; and, that the discharge with severance pay be recharacterized to reflect permanent disability retirement, effective as of the date of her prior medical separation: Providing orders showing that the individual was retired with permanent disability effective the date of...