RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00369
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20041120

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Network Switching Systems Operator, medically separated for “heat exhaustion,” with a disability rating of 0%.

CI CONTENTION:  “Review 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 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 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 - 20040924	VARD - 20041220  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heat Exhaustion	7999-7900	0%	Heat Exhaustion	7999-7900	NSC	20041007	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NSC 	

ANALYSIS SUMMARY:  

Heat Exhaustion.  According to service treatment record and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI experienced three separate episodes of a heat-related injury without significant loss of consciousness.  Each episode, the CI was successfully treated on an outpatient basis and was permanently profiled with the listed diagnosis of heat intolerance.  Despite treatment, the heat exhaustion condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for an MEB.  The MEB forwarded “heat exhaustion” for PEB adjudication.  At the MEB NARSUM examination on 20 August 2004 (3 months prior to separation), the CI’s complained of recurrent heat exhaustion.  The CI reported no new or current symptoms.  Physical examination was unremarkable.  The CI was not tachycardia (fast heartbeat) and his pulse pressure was slightly decreased at 34 (normal range = 40-60).  

At the 7 October 2004 VA Compensation and Pension examination, performed a month prior to separation, the CI voiced no further adverse physical complaints.  Physical examination did not reveal any consequences of the condition, with no alteration in the central or peripheral nervous system.  The VA examiner found no residual pathology, by review of medical history or by current physical examination, to diagnose a heat exhaustion condition. 

The Board directed attention to its rating recommendation based on the above evidence.  Both the PEB and VA rated the condition analogously under VASRD code 7900 (hyperthyroidism), the PEB rated the condition at 0% and the VA denied service connection.  There is not a specific VASRD code for such a heat related injury; and, the 7900 thyroid code is often analogized for such heat-related conditions.  Board members considered that in the absence of abnormal functional residuals or significant impact on occupational and social activity, the heat-related condition was of mild severity.  Board members agreed that the analogized VASRD 7900 code most accurately depicted the CI’s historical condition.  The Board was unable to find any pathway to a higher rating than the PEB’s rating of 0%.  The code 7900 at 10% criteria was not applicable in this case having the absence of tachycardia or the requirement for continuous medication.  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 recurrent heat exhaustion condition.

BOARD FINDINGS:  In the matter of the heat exhaustion condition and IAW VASRD §4.119, 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 20150530, w/attachments
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

19 DEC 2016

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20160018701   (PD201500369)

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