RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-01875
BRANCH OF SERVICE:  NAVY	BOARD DATE:  20150114
SEPARATION DATE:  20070109

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-5 (Advanced Culinary Techniques and Management Specialist) medically separated for narcolepsy.  The condition could not be adequately rehabilitated to meet the physical requirements of her rating.  She was placed on limited duty and referred for a Medical Evaluation Board (MEB).  The “narcolepsy, without cataplexy” was the only condition forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E.  The Informal PEB adjudicated “narcolepsy versus chronic insufficiency sleep syndrome” as unfitting, rated 20% citing application of the VA Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.

CI CONTENTION:  “Narcolepsy Mild grade seizures “All Conditions””

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 narcolepsy condition is addressed below.  No additional condition is within the DoDI 6040.44 defined purview of the Board.  Any condition or contention not requested in this application, or otherwise outside the Board’s defined scope of review, may remain eligible for future consideration by the Board for Correction of Naval Records.

RATING COMPARISON:

IPEB – Dated 20060926	VA* - (~2 Mos. Pre-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Narcolepsy versus Chronic Insufficiency Sleep Syndrome	8108	20%	Narcolepsy claimed as Narcolepsy and Fatigue Syndrome	8910	10%	20061103	
Other x 0 (Not In Scope)	Other x 2	
RATING:  20%	RATING:  30%	
*Derived from VA Rating Decision (VARD) dated 20070227 (most proximate to date of separation (DOS)).  

ANALYSIS SUMMARY:

Narcolepsy versus Chronic Insufficiency Sleep Syndrome.  The CI presented for evaluation of excessive daytime sleepiness in May 2006.  Symptoms had been present for approximately 3 weeks.  She reported drowsiness and falling asleep when not active, including while driving.  Evaluation by a sleep specialist noted long working hours requiring a very early wake up time (3:00 A.M.; and working until approximately 6:00 PM).  Evaluation with a sleep study demonstrated short sleep latency (rapid onset of sleep) but was otherwise normal.  Additional sleep testing with a multiple sleep latency test was consisted with either narcolepsy or chronic insufficient sleep (both characterized by rapid onset of sleep).  She was restricted to normal work hours and started on medication.  The restriction from longer work hours and shift work interfered with the requirements of her military specialty.  The MEB narrative summary on 8 August 2006, and examination on 20 September 2006, noted excessive daytime sleepiness.  At the VA Compensation and Pension examination on 3 November 2006, 2 months prior to separation, the CI reported excessive daytime drowsiness.  The examiner noted there were no seizures.

The Board directs its attention to its rating recommendation based on the above evidence.  The PEB rated the narcolepsy versus chronic insufficient sleep syndrome 20% (coded 8108 narcolepsy).  The VA rated the narcolepsy 10% (coded 8910, epilepsy).  Narcolepsy is rated under VASRD diagnostic code 8108 which provides that narcolepsy is to be rated as for epilepsy, petit mal which is rated under the General Rating Formula for Minor Seizures.  To support a rating higher than the 20% adjudicated by the PEB, there must be at least five to eight minor seizures weekly.  The Board concluded the evidence of the service treatment record did not support the next higher rating.  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 narcolepsy 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 narcolepsy 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 20140417, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 20 Aug 15

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USN