RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00378
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20070302

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

CI CONTENTION:  “Review all conditions.”  The 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 - 20061227	VARD - 20070920	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heat Injuries in April and June 2006	7999-7900	0%	Residuals, Heat Stroke	8999-8911	NSC	STR	
Heat Stroke in June 2006	Cat II					
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Heat Injuries.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI suffered a confirmed heat stroke in June of 2006 and also reported several undocumented episodes of heat injury in April and June 2006, which were treated and resolved with intravenous fluid hydration.  Laboratory evaluation in June 2006 showed elevations of liver and muscle enzymes, however, there was no evidence of kidney or liver damage.  

The 31 August 2006 MEB NARSUM examination, 6 months prior to separation, noted no complaints of heat injury or stroke sequellae.  No physical examination was recorded.  

The 12 September 2006 MEB examination (documented on DD Forms 2807-1 and 2808) noted dizziness after prolonged exercise.  He denied headaches, memory loss, seizures, or other neurological problems.  The heart, lung, and neurological examinations were checked “normal.”  
The 19 September 2006 non-medical assessment (NMA) did not identify any misconduct, and described the CI as being “capable and competent,” and “motivated and performed well within standards.”  

The CI did not report for his VA Compensation and Pension (C&P) evaluation.  

The panel directed attention to the rating recommendation based on the above evidence.  The PEB rated the heat injury condition 0%, analogously coded 7900 (hyperthyroidism).  The Navy PEB listed “heat stroke June 2006” as a related diagnosis (Category II) contributing to the disability in this case.  The panel concluded the Category II diagnosis was not a separate condition which could be reasonably justified as separately unfitting; nor would a separate rating be achievable without violation of VASRD §4.14 (avoidance of pyramiding).  

The VA denied service connection for heat stroke residuals, analogously coded 8911 (epilepsy, petit mal), based on STR, citing failure of the CI to report for a scheduled VA examination.  

There is no VASRD code for heat exhaustion, and therefore it is rated analogously and according to its sequellae, if any.  The panel considered the evidence for rating.  In this case, there was no documentation of persistent sequellae at the time of separation.  The NMA did not reference any mental disabilities or limitations that interfered with his safety and performance or with unit readiness.  There were no cognitive findings in the record, no referral for formal neurological examination, and no documentation of head injury, and therefore, no clinical documentation to support any neurocognitive deficits.  There was no documentation of persistent “end organ” damage, such as hypertension, kidney abnormalities, or liver synthetic dysfunction.  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 heat stroke condition.  

BOARD FINDINGS:  In the matter of the heat stroke condition and IAW VASRD §4.119, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150530, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 26 Apr 17

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXXXXX, former USMC 
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USMC

				XXXXXXXXXXXXXXXXXXXXX
	     		             Assistant General Counsel
						             (Manpower & Reserve Affairs)