RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03223
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20050527

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Fuels Craftsman, medically separated for “epilepsy, with a history of grand mal seizure,” with a disability rating of 20%.

CI CONTENTION:  “Please consider all conditions.”  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (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 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 based upon a 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 PEB - 20050408	VARD - 20131220	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Epilepsy, with History of Grand Mal Seizure	8910	20%	Epilepsy	8911	NSC	20131003	
Migraine Headaches	Cat II	No VA Placement	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  70%	

ANALYSIS SUMMARY:  

Epilepsy.  According to the MEB NARSUM, dated 14 February 2005, 3 months prior to separation, the CI had a “seizure” in March 2004, over 14 months prior to separation.  It was noted that she was warm, clammy, and lightheaded.  She went to the restroom where she lost consciousness.  She was evaluated in the emergency room (ER), but not diagnosed with a seizure.  A subsequent VA evaluation (8 years after separation) noted that this description was more consistent with syncope (fainting) than a seizure.  She had a similar episode in November 2004, 7 months prior to separation, and was noted to have shaking movements.  She was evaluated with a CT of the head and an EEG (electro-encephalogram).  The results were not recorded, but she was diagnosed with generalized seizures and started on an anti-convulsant.  She had no further seizure activity.  An MRI in January 2005 showed mild increased volume loss for her age, but was otherwise normal.  She was diagnosed with a seizure disorder and with migraines.  No comment on severity or frequency of the migraine headaches was recorded.  The commander’s statement was dated 17 February 2005.  The commander noted that she could not operate government vehicles (which included fuel servicing equipment), but made no comments on time lost from work or other duty impairment.  A VA neurology evaluation dated 3 October 2013 noted that there was a total of 6-8 events, all preceded by sweating and light-headedness.  She had not had any since 2008 and had stopped the anti-convulsant in 2008.  She had a normal neurological examination and these episodes were thought to be more consistent with a convulsive syncope rather than a seizure disorder.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the seizure disorder condition 20%, coded 8910 (epilepsy, grand mal).  The VA did not service-connect the condition, but did use the code 8911 (epilepsy, petit mal), based on the VA C&P examination over 8 years after separation.  The Board noted that the diagnosis of grand mal seizures is uncertain.  Regardless, she had one “spell” 14 months prior to separation and another over 6 months prior to separation.  This supports the 20% rating adjudicated by the PEB.  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 epilepsy with history of grand mal seizure condition.  

Contended PEB Conditions:  Migraine Headaches.  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended condition was Category II (a condition which can be unfitting but is not currently compensable or ratable).  The contended condition was referred by the MEB.  However, the profile was for the seizure disorder per the MEB NARSUM.  The commander’s statement did not specifically address the migraines or comment on lost duty time.  The NARSUM only noted that the headaches were increasing, but made no comment on frequency or severity.  Prostration was not recorded.  There is no evidence available for review upon which to recommend a change in the PEB adjudication.  Migraines were not evaluated by the VA.  There was no performance based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the epilepsy with history of grand mal seizures condition and IAW VASRD §4.124a, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the contended migraine headaches condition, the Board unanimously recommends no change from the PEB determination as Category II (not unfitting).  There were no other conditions within the Board’s scope of review for consideration.  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 20140708, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2014-03223.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Attachment:
Record of Proceedings