RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00317
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20060317

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Supply Management Craftsman, medically separated for “complex partial seizures with fatigue” 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 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 -20060127	VARD - 20060926	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Complex Partial Seizures…	8999-8911	20%	Complex Partial Seizures…	8913	20%	20060420	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:

Complex Partial Seizures.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s seizure condition began in 2002.  Evaluations included a normal brain MRI in July 2002 and normal electrophysiologic studies of the brain in August 2002.  An anti-seizure medication was started in October 2002.  Despite treatment from primary care and neurological providers the CI’s condition could not be adequately rehabilitated to satisfactory meet military occupational specialty standards.  The MEB forwarded “fatigue, seizure like activity” for PEB adjudication.

At a neurology follow-up visit in March 2005, the CI reported a “dramatic decrease in the frequency of headaches” and “occasional ataxia and fatigue.”  The neurologic examination was normal.  At a primary care visit in August 2005, the CI reported being “seizure free” with decreased fatigue on her current medication.  One week later, at a primary care visit, the CI reported an increased frequency of seizure activity on exposure to environmental stress (heat and exercise).  At a neurology follow-up visit in October 2005, the CI reported “little or no seizures until July 2005,” on exposure to environmental and emotional stress.

During an undated 2005 MEB NARSUM examination, the CI reported an increase in fatigue and seizure like activity over the last 6 months, with one seizure resulting in a motor vehicle accident.  She stated that she was able to perform her job but allowed early release (“boss frequently lets her go home”) due to fatigue.  The neurologic examination was normal.

At the 20 April 2006 VA Compensation and Pension (C&P) evaluation (1 month after separation), the CI reported that the seizures occurred with stress or in isolation (without precipitating factors), approximately twice per month, and caused 3-4 missed days of work per month.  The neurologic examination was normal.

The Board directed attention to the rating recommendation based on the above evidence.  The PEB rated the complex partial seizure condition 20%, analogously coded 8911 (epilepsy, petit mal), citing application of Department of Defense and Veterans Administration Schedule for Rating Disabilities (VASRD) guidelines.  The VA also rated the seizure condition 20%, coded 8913 (epilepsy, diencephalic), based on the VA C&P examination, citing symptoms that occurred two times per month lasting 3-4 days.

The Board agreed there was no evidence of the frequency of seizures averaging at least 5-8 times weekly in support of a 40% 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 complex partial seizure condition.

BOARD FINDINGS:  In the matter of the complex partial seizure condition and IAW VASRD §4.124a, 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 20150518, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MR
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

Dear XXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-00317.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

Attachment:
Record of Proceedings