RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2015-01448
BRANCH OF SERVICE:  army  	SEPARATION DATE:  20060630

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Track Vehicle Repairer, medically separated for “seizure disorder” with a disability rating of 20%.

CI CONTENTION: The CI contends his conditions are worsening and negatively impacting his daily activities.  Additionally, the CI contended three conditions were not identified by the MEB/PEB.  The 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 - 20060606	VARD - 20070222	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Seizure Disorder	8910	20%	Nocturnal Epilepsy	8910	20%	20061021	
Migraine	Not Unfitting	Chronic Headaches	8100	0%		
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Seizure Disorder.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s seizure condition began in August 2004.  Magnetic resonance imaging of the brain in September 2004 was normal.  The CI was evaluated by a neurologist in November 2005 after having had two more seizures.  All the seizures occurred in the early mornings, were witnessed by the CI’s wife and described as waking up with “whole body jerking movements.”  The second seizure occurred in approximately May 2005 and the third in approximately September 2005.  An electroencephalogram performed on 21 November 2005 was abnormal and consistent with epilepsy and the CI was started on anticonvulsant medication (Depakote).  The CI had a breakthrough seizure on 11 March 2006 while on therapeutic levels of Depakote, so his anticonvulsant medication was changed (Trileptal) and an MEB was initiated.  

The 22 May 2006 MEB NARSUM examination, 1 month prior to separation, noted complaints of nocturnal seizures.  No additional seizures after March 2006 were documented or reported.  Neurological examination was normal.  

At the 21 October 2006 VA Compensation and Pension (C&P) evaluation, 4 months after separation, the CI reported nocturnal tonic-clonic seizures and the last seizure was 6-8 months earlier.  Neurological examination was normal.  The CI was employed as a mechanic and had not lost any time from work.  

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the seizure condition 20%, coded 8910 (epilepsy, grand mal), citing a major seizure in March 2006 and subsequently controlled by medication.  The VA also rated the epilepsy condition 20% coded 8910, based on the VA C&P examination 4 months after separation, citing at least one major seizure in the last 2 years.  

The CI had a major seizure 4 months before separation, however, following his medication change in March 2006, he had no further seizures before separation or before the VA examination.  The CI had only one seizure in the 11 months after he was diagnosed with epilepsy and was started on anticonvulsant medications until the VA examination, 4 months after separation.  The panel agreed that based on the total evidence in record the disability due to the seizure disorder following institution of treatment and a medication adjustment was consistent with the 20% rating adjudicated by the PEB.  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 seizure condition.  

Contended PEB Condition:  Migraine.  The panel’s main charge is to assess the fairness of the PEB’s determination that the migraine condition was not unfitting.  The contended migraine condition was profiled, but not implicated in the commander’s statement or judged to fail retention standards.  A neurology visit on 20 April 2006, 2 months before separation, indicated that since the most recent medication changes for the migraine condition, the migraine headaches were “improved to resolved.”  At that same neurology visit the CI was referred for an MEB due to his breakthrough seizure on medication.  The NARSUM examination (also written by the neurologist), 1 month before separation, reiterated that the migraine headache condition was controlled on current medications and determined that the migraine condition met retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel  concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the seizure disorder condition and IAW VASRD §4.124a, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended migraine condition, the panel unanimously recommends no change from the PEB determination 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 20150605, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record  

AR20170008501, XXXXXXXXXXXXXXXXXX 

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Dear XXXXXXXXXXXXXXXXXX:

	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