RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04204
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050812

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E4, Personnel Specialist, medically separated for “acute cerebral thrombosis" with a disability rating of 10%.  

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 - 20050721	VARD - 20060307	
Condition	Code	Rating	Condition	Code	Rating	Exam	
…Acute Cerebral Thrombosis…	8007-7199-7120	0%	Residual of Stroke…	8008-8405	10%	20051019	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Acute Cerebral Thrombosis.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s stroke occurred in November 2004.  The MEB forwarded “acute cerebral thrombosis” for PEB adjudication.  

The Neuro-Psychiatric MEB NARSUM examination on 09 March 2005, 5 months after the stroke and 5 months prior to separation, noted complaints of numbness to the right side of her face, decreased vision, fatigue with decreased stamina, occasional headaches and decreased ability to concentrate.  The physical examination showed mild deficits in attention and minor impairments of motor functioning, but otherwise normal physical evaluation.  

At the 28 October 2005 VA Compensation and Pension (C&P) evaluation, performed 2 months after separation, the CI reported that her eyes were weaker requiring glasses, numbness of her right face, imbalance when walking, occasional headaches and constipation.  The physical examination showed decreased sensation in the right face and minimal impairment of her ability to demonstrate rapid alternating movements with the right hand.  Otherwise her physical examination was normal.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the stroke and residuals condition 10%, analogously coded 8007-7199-7120 (embolism of brain vessels – hypercoagulable states requiring chronic anticoagulation), citing a lack of significant neurological residual impairment and requiring ongoing anticoagulant therapy.  The VA rated the stroke and residuals condition 10% analogously coded 8008-8405 (thrombosis of brain vessels – neuralgia of the 5th cranial nerve), based on the VA C&P examination 2 months after separation, citing fatigue, occasional imbalance, headache, decreased ability to concentrate, short term memory loss, mood lability, mild depression and irritability.  The CI sustained a stroke and subsequently had nearly complete recovery with only mild decrease in sensation of the right face.  Her cognitive functioning was within the average range as was her motor strength supporting a 10% evaluation.  The CI did not have evidence of severe or complete loss of function of the 5th cranial nerve or other severe residuals favoring a 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 stroke and residuals condition.  

Contended PEB Condition: Headaches.  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The contended condition was not profiled or implicated in the commander’s statement or judged to fail retention standards.  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 stroke and residuals condition and IAW VASRD §4.124a, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the contended headaches, the Board unanimously recommends no change from the PEB determination as 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 20141022, 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 
XXXXXXXXXXXXXXXXXX, AR20160018280 (PD201404204)

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