RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01353
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20041228

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Field Artillery Surveyor, 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 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 condition(s) 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 - 20040927	VARD - 20050412	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heat Exhaustion	7999-7900	0%	Residuals of Heat Stroke	7345	0%	20050209	
Recurrent Stress Fractures of the Bilateral Tibias	Not Unfitting	Bilateral Stress Fractures, both Legs, Resolved without Sequelae	5262	NSC		
Moderate Pes Planus		Bilateral Pes Planus	5276	NSC		
Prehypertension		Hypertension	7101	NSC		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Heat Exhaustion.  According to the service treatment record (STR) and the Medical Evaluation  Board (MEB) narrative summary (NARSUM), the CI experienced a complicated and severe case of heat stroke in July 2004 during a long distant run.  He received inpatient treatment from 21-26 July 2004.  All abnormal vital signs normalized before being release from the hospital and persistent abnormal labs were addressed in follow-up evaluations.  He developed no long-term medical complications and was eventually placed on a P3 profile secondary to “heat injury” and referred for MEB.  The MEB forwarded exertional heat stroke for PEB adjudication.
At the 09 August 2004 (NARSUM) examination, 5 months prior to separation, the CI reported no physical complaints and felt back to his baseline state of health.  His physical examination (PE) was normal excepting tenderness in his lower legs and the presence of flat feet.  His vital signs indicated that he was not tachycardic (fast heartbeat) and his pulse pressure was slightly elevated at 66 (normal range = 40-60).  At the 09 February 2005 VA Compensation and Pension (C&P) examination, 1 month after separation, the CI again reported no adverse physical complaints.  His PE was unchanged.  The CI’s diagnosis was listed as “Heat stroke: This has resolved without residual.”  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the heat-related condition at 0%, coded 7999-7900 (analogous to hyperthyroidism).  The VA also rated the condition at 0% coded 7345 (chronic liver disease without cirrhosis), based on the C&P examination 1 month after separation, citing elevated liver function, without evidence of cirrhosis, as a result of heat stroke.  There is not a specific VASRD code for such a heat-related injury; and, the PEB’s 7900 thyroid code is often analogized for such a condition.   Panel members considered that in the absence of abnormal functional residuals or a significant impact on occupational and social activity, the heat-related condition was clearly resolved near the time of separation.   Panel members agreed the analogized VASRD 7900 code most accurately depicted the CI’s prior condition.  The panel is unable to find any pathway to a higher rating than the PEB’s 0%.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the prior heat-related condition.

Contended PEB Conditions:  Tibial Stress Fractures, Pes Planus, and Hypertension.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  None of the conditions were profiled or implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at or near separation.  After due deliberation, the  panel concluded that there was insufficient cause to recommend a change in the PEB’s fitness determination for any of the contended conditions and so no additional disability ratings are recommended.  

PANEL FINDINGS:  In the matter of the heat exhaustion and IAW VASRD §4.119, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended tibial stress fractures, pes planus, and hypertension conditions, the panel unanimously recommends no change from the PEB’s determinations as not unfitting.  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 20150602, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170007634, XXXXXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,					      
						      					
Enclosure