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AF | PDBR | CY2013 | PD-2013-02756
Original file (PD-2013-02756.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXX       CASE: PD-2013-02756
BRANCH OF SERVICE: Army  BOARD DATE: 20150417
SEPARATION DATE: 20051221


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an activated Reserve E-4 (Infantryman) medically separated for chronic conjunctivitis. The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty. He was issued a permanent E3 and referred for a Medical Evaluation Board (MEB). The chronic conjunctivitis and left eye condition(s), characterized as “chronic bilateral conjunctivitis/blepharitis” and “traumatic glaucoma of left eye,” were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. Also identified and forwarded by the MEB were five other conditions (see rating chart below), designated as medically acceptable. The Informal PEB adjudicated “chronic conjunctivitis” as unfitting, rated 10%. The remaining conditions were determined to be not unfitting . The CI appealed to the Formal PEB (FPEB) but then requested cancellation of the FPEB. The CI was then medically separated.


CI CONTENTION: “* No legal counsel @ time of board hearing. * I don’t believe at the time I received enough treatment to concur with the findings. * I believe the findings should award me with a higher rating, the medications given to me cause other illness and prolonged exposure cause skin disorders. * I believe I was neglect fairness treatment to any injuries.”


SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2). It is limited to those conditions determined by the PEB to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting. Any conditions outside the Board’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/Naval Records. Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate. The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. The Board 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, operating under a different set of laws. The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.



 RATING COMPARISON :

Service IPEB – Dated 20051019
 VA - (22 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Chronic Conjunctivitis, Allergic Type 6018 10% Bilateral Conjunctivitis/Blepharitis 6018 10% 20071016
Traumatic Glaucoma of Left Eye Not Unfitting Glaucoma, Left Eye 6099-6013 NSC 20071026
Back Pain Not Unfitting Recurrent Back Pain 5237 Deferred
Heartburn Not Unfitting No VA Entry
Ringworm Not Unfitting Skin Disorder 7813 Deferred
Elevated LFT Not Unfitting No VA Entry
Headaches Not Unfitting Headaches (Migraine) 8100 NSC STR
Other x 0 (Not in Scope)
 Other x 1 20071016
Combined: 10%
 Combined: 10%
Derived from VA Rating Decision (VA RD ) dated 20 080201 ( most proximate to date of separation [ DOS ] ).
VARD 20080529: Recurrent Back Pain given 20%, Tinea Corporis given 10%


ANALYSIS SUMMARY:

Chronic Conjunctivitis, Allergic Type. Treatment records evidenced that the CI presented for care on 9 June 2002 with a 1-week history of eye irritation, watering, and discharge. He was diagnosed with bilateral conjunctivitis and treated. The records were silent for conjunctivitis until 10 February 2004 when the CI was evaluated by Ophthalmology for corneal scarring, neovascularization (new blood vessel growth), light sensitivity (photophobia), and discharge. He was diagnosed with chronic conjunctivitis and underwent testing for an infectious source. All tests were negative. Despite multiple medication trials, the CI continued to report severe, chronic pain and irritation in both eyes (conjunctivitis) with inflammation of the eyelids (blepharitis). The narrative summary noted that due to Doxycycline use, he was limited from exposure to sunlight; however the CI was able to perform tasks when not exposed to direct sunlight. The physical examination demonstrated signs of inflammation in both eyes, scaring on the left cornea (stromal scars), and new blood vessels in both eyes. The examiner rendered diagnoses of chronic bilateral conjunctivitis and blepharitis. At the VA Compensation and Pension examination performed 22 months after separation, the CI reported pain, redness, swelling, discharge, watering in both eyes. The eye examination revealed bilateral decreased visual acuity and a cataract in the left eye. Diagnoses of left eye myopia and astigmatism, blepharitis, and left cataract were rendered.

The Board directs attention to its rating recommendation based on the above evidence. The PEB adjudicated the chronic conjunctivitis, allergic type condition as unfitting. The PEB and VA rated the condition at 10%, coded 6018 (Chronic conjunctivitis [non-trachomatous]). The Board noted that the highest rating for active conjunctivitis is 20% and that there was no avenue to a higher rating. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), members agreed that a disability rating of 10% for the chronic conjunctivitis, allergic type condition was appropriately recommended in this case. The Board concluded therefore that this condition could not be recommended for additional disability rating.

Contended PEB Conditions. The Board’s main charge is to assess the fairness of the PEB’s determination that traumatic glaucoma left eye, back pain, heartburn, ringworm, elevated liver function tests (LFTs), and headaches were not unfitting. The Board’s threshold for countering fitness determinations is higher than the VASRD §4.3 (reasonable doubt) standard used for its rating recommendations, but remains adherent to the DoDI 6040.44 “fair and equitable” standard. The traumatic glaucoma left eye, back pain, heartburn, ringworm, elevated LFTs, and headaches were not profiled or implicated in the commander’s statement and were not judged to fail retention standards by the MEB. All were reviewed by the action officer and considered by the Board. There was no performance based evidence from the record that the traumatic glaucoma left eye, back pain, heartburn, ringworm, elevated LFTs, and headaches conditions significantly interfered with satisfactory duty performance. After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the traumatic glaucoma left eye, back pain, heartburn, ringworm, elevated liver function tests, and headaches contended conditions and so no additional disability ratings are recommended.


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 chronic conjunctivitis, allergic type condition and IAW VASRD § 4.84a, the Board unanimously recommends no change in the PEB adjudication. In the matter of the contended traumatic glaucoma left eye, back pain, heartburn, ringworm, elevated LFTs, and headache conditions, the Board unanimously recommends no change from the PEB determinations as not unfitting. 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.


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20131212, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record









XXXXXXXXXXXXXXX
President
DoD Physical Disability Board of Review




SAMR-RB                                                                         


MEMORANDUM FOR Commander, US Army Physical Disability Agency
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557


 SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXXXX , AR20150012841 (PD201302756)

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                                                  XXXXXXXXXXXXXXXXXXXX
                                                      Deputy Assistant Secretary of the Army
                                                      (Review Boards)
                                                     
CF:
( ) DoD PDBR
( ) DVA

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