RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX	CASE:  PD-2013-01953
BRANCH OF SERVICE:  Army	BOARD DATE:  20141003
SEPARATION DATE:  20050107

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an activated Reservist SPC/E-4 (31B/Military Police Officer) medically separated for recurrent heat exhaustion.  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty but could perform an alternate physical fitness test.  He was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB).  The condition, characterized as “recurrent episodes of heat exhaustion,” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other conditions were submitted by the MEB.  The Informal PEB adjudicated “recurrent heat exhaustion” as unfitting, rated 0%, with likely application of the VA Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.

CI CONTENTION:  “I am still suffering from the condition which impairs my performance.”

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 those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI.  The rating for the unfitting heat exhaustion condition is addressed below; no additional conditions are within the DoDI 6040.44 defined purview of the Board.  Any conditions or contention not requested in this application, or otherwise outside the Board’s defined scope of review, remain eligible for future consideration by the Board for Correction of Military Records.

RATING COMPARISON:

Service  IPEB – Dated 20041115	*VA - (No Show for C&P Exam)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Recurrent Heat Exhaustion	7999-7900	0%	Recurrent Heat Exhaustion	8999-8911	NSC	
Other x 0 (In Scope)	Other x 0	
Combined:  0%	Combined:  0%	
Derived from VA Rating Decision (VARD) dated 20051108(most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:

Recurrent Heat Exhaustion Condition.  The service treatment record contained few, but detailed documents with regard to his heat injury.  The CI was activated twice for deployment; once in 2002 and again in 2004.  With each deployment, he experienced a single (heat related) physical collapse while performing a long distance run as part of physical fitness training.  His symptoms were lightheadedness, dizziness, weakness, and nausea.  There was no loss of consciousness or reported altered mental changes or seizure activity.  He was treated in the emergency room for each episode without overnight stay.  All abnormal vital signs or laboratory values were normalized either before release from the medical facility or upon follow-up evaluation.  He developed no medical complications from these episodes and was placed on a P3 profile secondary to a recurrent heat-related condition and referred for an MEB in 2004.  At the narrative summary examination, performed on 8 July 2004, (6 months prior to separation) the CI’s chief complaint was, “recurrent exertional heat injuries.”  The CI reported no new or current symptoms.  The physical examination was normal.  He was not tachycardic (fast heartbeat) and his pulse pressure was slightly elevated at 64 (normal range = 40-60).  The CI failed to report for his VA Compensation and Pension examination which was scheduled for 24 June 2005.

The Board directs attention to its rating recommendation based on the above evidence.  The PEB rated the condition 0%, coded 7999-7900, analogous to hyperthyroidism.  The VA rated the condition as not service-connected (appointment no show), coded 8999-8911 analogous to epilepsy.  There is not a specific VASRD code for such a heat-related injury; and, the PEB’s 7900 thyroid code is often analogized for such conditions.  Board members considered that in the absence of abnormal functional residuals or significant impact on occupational and social activity, the heat-related condition was of mild severity.  Board members agreed that the analogized VASRD 7900 code most accurately depicted the CI’s condition.  The Board is unable to find any pathway to a higher rating than the PEB’s 0%.  Code 7900 at 10% criteria is not applicable in this case having the absence of tachycardia or the requirement for continuous medication.  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 recurrent heat injury 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 recurrent heat injury condition and IAW VASRD §4.119, 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.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 2013, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

				
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 XXXXXXXXXXXXXXXXX, AR20150003246 (PD201301953)

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						     
CF: 
(  ) DoD PDBR
(  ) DVA