RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03318
BRANCH OF SERVICE:  Army	BOARD DATE:  20150707
separation date: 20041022

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E-5 (Logistics) medically separated for heat stroke.  The condition could not be adequately rehabilitated to meet the physical requirements of her Military Occupational Specialty (MOS).  The CI’s profile allowed for an alternate aerobic event to satisfy physical fitness standards.  She was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB).  The “heat stroke by history with no residuals” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other condition was submitted by the MEB.  The Informal PEB adjudicated “Heat stroke, recovered, without residuals” as unfitting, rated 0%.  The CI made no appeals and was medically separated.  

CI CONTENTION:  “Please consider 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 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:    

 IPEB - Dated 20040921	VA* - (~6 Mos. Post-Separation) 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heat Stroke, Recovered. Without Residuals	7999-7900	0%	Residuals of Heat Stroke	8911	NSC	20050504	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 4	
RATING:  0%	RATING:  NSC	
*Derived from VA Rating Decision (VARD) dated 20050706 (most proximate to date of separation [DOS])  

ANALYSIS SUMMARY: 

Heat Injury.  On 10 May 2004, while deployed overseas, this CI was outside in the heat when she started feeling light-headed and dizzy.  She then suffered loss of consciousness (LOC).  She was told that she had two seizures, and that her body temperature was 102 degrees.  She was treated at the Troop Medical Clinic (TMC) and fully recovered.  Investigation revealed that she also had history of a previous heat injury episode which had occurred earlier, during basic training.  After the 10 May 2004 incident, it was decided that she should be sent back to home station.  On 21 May 2004, after her return to the CONUS, the CI was evaluated by Neurology.  At that exam, she denied any residual symptoms.  Neurological exam revealed some motor rigidity of the right leg and an abnormal plantar reflex of the right foot.  The neurological exam was otherwise normal.  The examiner wrote: “Since she has now had 2 heat injuries, the second time without circumstantial contributing factors, per AR 40-501, an MEB is required.”  The MEB physical examination (PE) was in June 2004 and it was normal.  Lab work was done, and it was normal.  In the MEB narrative summary (NARSUM), the examiner wrote: “Although she is in perfectly fine health right now, she needs to be cautioned about performing in a high heat environment.  Her condition should be considered chronic and stable.”

The CI was medically separated on 22 October 2004.  Six months later, on 4 May 2005, she had a VA Compensation and Pension (C&P) exam.  She reported that since the heat injury episode, she had experienced fatigue, anorexia, cough, and urinary problems.  However, no medical treatments had been necessary since the treatment for h eat injury in May 2004.  A general medical PE was performed, and it was normal.  Lab work was done, and it was normal.  Based on the results of her normal PE and normal labs, the VA denied service-connection for heat stroke.  The VA rating official wrote: “We have denied service connection for this condition based on the fact that there are no ratable residuals shown on VA examination.”      

The Board directed attention to its rating recommendation based on the above evidence.  In the VASRD, there is no specific diagnostic code for Heat stroke.  The Army PEB used code 7999-7900 (analogous to hyperthyroidism), and assigned a rating of 0%, IAW VASRD §4.31.  As noted above, the CI fully recovered from the heat stroke event.  The June 2004 MEB PE was normal.  At the time of separation there was no clinical evidence of any residual symptoms, or other health problems related to heat stroke.  There was no tremor, and continuous medication was not required.  Therefore, a rating of 0% was appropriate.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board found insufficient cause to recommend a change in the PEB adjudication of the heat stroke condition (fully recovered, without residuals).  

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 heat stroke condition (fully recovered, without residuals) and IAW VASRD §4.31 and §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 20140627, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB	0 6 JUL 2016

MEMORANDUM FOR Commander, US Army Physical Disability Agency (AHRC-00), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXX, AR20160003185  (PD201403318)

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: