RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04021
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050928

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Combat Engineer, medically separated by the Informal Physical Evaluation Board (PEB) for “partial complex seizures with generalization” with a disability rating of 10%.  

CI CONTENTION:  The CI contended that the rating should be changed for the following conditions: “epilepsy, PTSD, memory loss, ringing in the ears, headaches, eye sensitivity to sunlight, and speech problems.”  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 - 20050824	VARD - 20060217	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Partial Complex Seizures with Generalization	8914	10%	Generalized Seizure Disorder	8911	20%	20051117	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Partial Complex Seizures with Generalization.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summaries (NARSUMs), the CI’s seizure disorder began in December 2002 during basic training when he had his first seizure episode, reported as with shaking movements.  He had another episode in April 2003 (witnessed with brief convulsive activity), and a third episode in November 2004.  Following the November 2004 seizure he began medication for treatment of this condition.  He noted occasional episodes of nighttime dizziness without vertigo, and reported brief episodes of inability to mentally focus and process information correctly.  Sleep deprived EEG (electroencephalogram) was abnormal.  Diagnostic imaging of the brain, neurologic and cardiac specialist evaluations were normal.  

The MEB NARSUM examination on 9 August 2005 (2 months prior to separation) noted a seizure and evaluation history as above.  In conjunction with neurology NARSUMs, the CI’s medication history was mixed, but indicated that the CI started on Dilantin (anti-seizure medication), was poorly compliant and stopped taking his medication due to side effects.  On 17 May 2005 after having stopped the medication for one week, the CI “had a recurrent episode of what is described as ‘syncope.’”  The CI was then started on Tegretol, was compliant, and had no further episodes or seizures.  Physical examination was non-contributory.  

At the VA Compensation and Pension (C&P) examination in November 2005, performed 2 month after separation, the CI reported history of seizures as above plus a fourth seizure when he stopped taking Dilantin.  The CI was “not as clear about the details of that event.”  He had no further episodes after beginning Tegretol.  Physical examination was non-contributory.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating under the 8914 code (Epilepsy, psychomotor), citing a confirmed diagnosis of epilepsy with a history of seizures.  The VA assigned a 20% rating using the 8911 code (Epilepsy, petit mal) based on the VA C&P examination 1 months after separation, citing at least one major seizure in the last 2 years.  The rating criteria for seizures depends on the type, frequency and proximity of seizures under the general rating formula for major and minor epileptic seizures.  The record indicated the CI had major seizures (generalized tonic-clonic) as well as minor seizures (syncope without convulsive activity) IAW VASRD §4.124a.  There was no evidence of any major seizure in the 6 months prior to separation.  The Board deliberated if there was sufficient evidence supporting two major seizures in the last year (since 28 September 2004), or at least one major seizure in the last 2 years (since 28 September 2003).  The Board adjudged that there was evidence to support at least one major seizure in the last 2 years supporting the 20% rating criteria.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 20% for the seizure condition, coded 8914.  

BOARD FINDINGS:  In the matter of the seizure disorder, the Board unanimously recommends a disability rating of 20%, coded 8914 IAW VASRD §4.124a.  There were no other conditions within the Board’s scope of review for consideration.  

The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Partial Complex Seizures with Generalization	8914	20%	
COMBINED	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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 AR20160013670 (PD201404021)

1.  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, accept the Board’s recommendation to modify the individual’s disability rating to 20% without re-characterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

 BY ORDER OF THE SECRETARY OF THE ARMY:

CF: 
(  ) DoD PDBR
(  ) DVA