RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00196
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20071122

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4, Military Police, medically separated for “episodes of transient alternation of awareness” with a disability rating of 20%.  

CI CONTENTION:  Her condition continues to worsen and negatively impact her daily activities.  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical conditions at the time of separation.  The panel 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 panel 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 - 20071002	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Episodes of Transient Alteration of Awareness	8999-8914	20%	No VA Examination in Evidence	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Episodes of Transient Alteration of Awareness.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s condition began in November 2005.  Extensive neurologic evaluations in 2006 and 2007 (which included magnetic resonance imaging (MRI), cardiac echo sonography, three electroencephalograms, a second neurology consultation, and psychological evaluation) resulted in no clear etiology for the transient episodes of altered awareness.  The presumptive diagnosis was partial simple seizures.  Several entries in March, August, September, and November 2006, and March, April, and May 2007 documented a frequency that did not surpass more than one episode per week.  All neurologic examinations in evidence were normal.   The MEB forwarded “episodes of transient alteration of awareness possibly secondary to non-epileptic seizures” for PEB adjudication.  

At the June 2007 MEB examination (documented on DD Forms 2807-1 and 2808), 5 months prior to separation, the physical and neurologic examinations were checked as “normal.”  At the 26 July 2007 MEB NARSUM examination, 4 months prior to separation, the CI reported recurrent episodes.  The neurologic and mental status examinations were normal.  There was no VA Compensation and Pension examination in evidence for review.  

The panel directed attention to the rating recommendation based on the above evidence.  The PEB rated 20% for the CI’s condition, analogously coded 8999-8914 (epilepsy, psychomotor), citing episodes of transient alternation of awareness, occurring once every one to two weeks.  

The panel considered the evidence for rating.  There was no documentation of episodes averaging at least 5 to 8 times weekly in support of the higher 40% rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the CI’s condition.  

PANEL FINDINGS:  In the matter of the CI’s condition and IAW VASRD §4.124a, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, 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 20140428, w/attachments
Exhibit B.  Service 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 XXXXXXXXXXXXXXXXXXXXX, AR20170003447 (PD201500196)

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