RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXX	CASE:  PD-2014-00187
BRANCH OF SERVICE:  Army	BOARD DATE:  20141009
SEPARATION DATE:  20080311

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (27D/Paralegal Specialist) medically separated for tic, convulsive.  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards.  He was issued a permanent P2/U3/L2 profile and referred for a Medical Evaluation Board (MEB).  The right upper extremity paroxysmal clonic activity condition was characterized as “does not meet retention standards” and forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  The MEB also identified and forwarded 10 other conditions.  The Informal PEB adjudicated “Tic, convulsive” as unfitting, rated 10%, with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The remaining conditions were determined to meet retention standards.  The CI made no appeals and was medically separated.

CI CONTENTION:  The CI elaborated no specific contention in his application.

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 tic, convulsive condition is addressed below; and, 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 Admin Correction – Dated 20090316	VA - (2 Mos. Pre-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Tic, Convulsive	8103	10%	Paroxysmal Clonic Activity, Right Upper Extremity (claimed as Convulsive Tic)	8103	0%	20080118	
Other x 0 (Not in Scope)	Other x 18 (Not in Scope)	
Rating:  10%	Combined:  60%	
Derived from VA Rating Decision (VARD) dated 20080506 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:

Tic, Convulsive Condition.  In October 2006, the CI coughed while driving and noted that his right dominant arm had repeated muscle contractions (a clonic motion) without his control.  He reported feeling light-headed and dizzy. He had a headache and pulled his vehicle to the side of the road.  He developed recurrent uncontrolled muscle contractions (clonic) of the right arm associated with coughing.  According to the neurology summary performed on 6 June 2007, the episodes occurred with heavy coughing associated with tingling sensation of the right arm followed by rhythmic jerking of the right arm lasting approximately 10 seconds.  There were no other symptoms suggestive of seizure such as alteration of consciousness, speech language problems, or involvement of other areas of the body.  Evaluation including an electroencephalogram (EEG; electrical brain wave study) did not show evidence of a seizure disorder.  The diagnosis was right arm paroxysmal clonic activity of unclear etiology.  The MEB narrative summary (NARSUM), performed on 1 October 2007, noted the condition occurred 12 times per month and lasted 15 to 30 seconds and was stable.  The NARSUM noted the CI was able to perform his primary duties as a paralegal but was not worldwide deployable due to inability to fire a weapon or ride in a tactical vehicle.

The Board directs attention to its rating recommendation based on the above evidence.  The PEB rated the right arm jerking condition 10% analogously using the VASRD code 8103 for convulsive tic (moderate) noting 12 episodes per month lasting 15 to 30 seconds.  The VA rated the condition 0% (coded 8103 convulsive tic) for mild impairment.  The Board agreed that the VASRD code 8103 chosen by both the PEB and VA most closely approximated the condition.  No other movement disorder or seizure disorder was diagnosed to support consideration of rating under other diagnostic codes.  Diagnostic code 8103 (convulsive tic) provides for ratings from 0% for mild, 10% for moderate and 30% for severe impairment.  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 convulsive tic 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 tic condition, and IAW VASRD §4.124a, 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 20131219, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

		
XXXXXXXXXXXXXXX
President
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 XXXXXXXXXXXXXXX, AR20150004777 (PD201400187)

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