RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00626
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20050715

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Infantry Assaultman, medically separated for “neurocardiogenic syncope” with a disability rating of 10%.

CI CONTENTION:  The CI contends that the rating for his medical condition is too low.  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 - 20050603	VARD - 20060422	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Neurocardiogenic Syncope	8299-8210	10%	Neurocardiogenic Syncope	8099-8046	NSC	20060208	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Neurocardiogenic Syncope.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI fist noted syncope (fainting) began in 2002.  He reported a total for four episodes when he presented for evaluation.  He was evaluated in cardiology and diagnosed as neurocardiogenic syncope which was confirmed on tilt table testing in May 2004.  The cardiac and neurological evaluation was otherwise unremarkable.  The MEB forwarded “syncope and collapse” for PEB adjudication.  The record shows that the last syncopal episode before separation was in February 2004.  The MEB NARSUM examination on 10 January 2005, 6 months prior to separation, noted that the CI was currently asymptomatic on a regimen of increased salt and lifestyle modifications.  His examination remained normal, but he was determined to be at high risk for a recurrence and was not deployable.  The General VA Compensation and Pension (C&P) evaluation was performed on 3 February 2006, 7 months after separation.  The CI reported that his only medical complaint was neurocardiogenic syncope.  His examination was unremarkable.  The neurological VA C&P evaluation was performed 5 days later on 8 February 2006.  The CI reported two additional episodes since separation.  Both were associated with a prodrome of feeling lightheaded, tingling of the fingers and toes, tunnel vision, and then loss of consciousness.  The examination remained normal and the diagnosis of neurocardiogenic syncope was based on the report of a positive tilt table test.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the neurocardiogenic syncope 10%, coded 8299-8210 (analogous to paralysis of the tenth cranial nerve).  The VA found the neurocardiogenic syncope to be not service-connected (NSC), coded 8099-8046 (analogous to cerebral arteriosclerosis), as it found no records that the CI was treated for this condition prior to separation.  The CI reported at the VA C&P evaluation that he had two episodes in the 7 months after separation.  The record also shows that the CI had no episodes in the final 17 months prior to separation.  The Board determined that the 8210 code used by the PEB best described the condition and that the impairment better fit a moderate level than severe.  This supports the 10% rating adjudicated by the PEB.  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 neurocardiogenic syncope condition.  

BOARD FINDINGS:  In the matter of the neurocardiogenic syncope condition and IAW VASRD §4.123, §4.124, and §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 20150601, 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 7 Dec 16

      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:

		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC

						  XXXXXXXXXXXXXXXXXX
	     				  	Assistant General Counsel
						  	(Manpower & Reserve Affairs)