RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03914
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040921

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Multiple Launch Rocket System Automated Tactical Data System Specialist, medically separated for “coronary artery disease with angina,” with a disability rating of 10%.  

CI CONTENTION:  The CI made no specific contention in their application.  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 - 20040525	VARD - 20050228	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Coronary Artery Disease with Angina	7005	10%	Coronary Artery Disease with Stent Placement	7005	10%	20040428	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Coronary Artery Disease with Angina.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s coronary artery disease (CAD) with angina condition began in December 2003 while performing an Army physical fitness assessment.  The CI sustained a heart attack and underwent catheterization with stent placement in December 2003.  He was started on blood pressure and anti-blood clot medications.  His cholesterol medication was also increased.  He underwent cardiac stress testing in February 2004, which showed a maximal workload of 15.9 metabolic equivalents (METS) and ejection fraction of 48%.  During the stress test the CI did not experience dyspnea, fatigue, angina, dizziness or syncope.  The MEB forwarded “atherosclerotic coronary artery disease…” and “angina pectoris” for PEB adjudication.  

At the MEB NARSUM examination on 27 February 2004, 7 months prior to separation, the CI reported that he was unable to run for any significant distance due to chest pain.  Physical examination showed a normal cardiovascular evaluation.  At the 28 April 2004 VA Compensation and Pension (C&P) evaluation, 5 months prior to separation, the CI reported chest and arm pain, fatigue and inability to perform regular Army physical training.  The physical examination showed a normal cardiovascular evaluation.  The examiner noted no signs of congestive heart failure.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the CAD condition 10%, coded 7005 (arteriosclerotic heart disease), citing 15.9 METS and continuous medication required.  The VA rated the CAD condition 10%, coded 7005 (arteriosclerotic heart disease), citing continuous medication required.  A higher evaluation of 30% was not warranted because there was no evidence of workload greater than 5 METs but not greater than 7 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope; or evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray.  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 coronary artery disease with angina condition.  

BOARD FINDINGS:  In the matter of the coronary artery disease with angina condition and IAW VASRD §4.104, the Board unanimously recommends no change in the PEB adjudication.  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 20140902, 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 
 (PD201403914)

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:

Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA