RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02017
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090327

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Fire Support Specialist, medically separated for “supraventricular arrhythmia” with a disability rating of 10%.  

CI CONTENTION:  The CI requests that all conditions be considered.  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 panel 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 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 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 - 20090126	VARD - 20151008	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Supraventricular Arrhythmia…	7010	10%	Paroxysmal Atrial Fibrillation…	7010	0%	20151005	
Lumbago	Not Unfitting 	Back Condition…	5237	NSC		
Torn Meniscus		R Knee, Residuals…Repair	5260	10%		
Tonsillectomy		No VA Placement	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Supraventricular Arrhythmia.  According to the service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s supraventricular arrhythmia condition began in summer 2007 with episodic fluttering sensation changes in pulse rate, and chest pain.  In April 2008, the CI presented to the emergency department with reports of prolonged irregular heart rate.  The CI was diagnosed with acute onset atrial fibrillation which was converted to normal sinus rhythm with cardioversion treatment.  An echocardiogram performed on 20 May 2008 demonstrated mild mitral valve prolapse without regurgitation.  In August 2008, the CI underwent electrophysiological studies and ablation for an irregular heartbeat (atrial fibrillation).  

The 9 October 2008 MEB NARSUM examination, 5 months prior to separation, the examiner noted that the CI was asymptomatic for several weeks after the ablation, but symptoms recurred upon returning to physical training.  The CI reported decreased severity of the palpitations which occurred 2 times per week, lasting 10-15 minutes.  The cardiac examination was normal.  The NARSUM Addendum dated 06 January 2009 noted three episodes of atrial fibrillation documented by ECG or Holter monitor.  A Holter monitor report dated 20 January 2010 reported one supraventricular ectopic complex which apparently was symptomatic.”  An echocardiogram cited was reported as normal with left ventricular function ejection fracture of greater than 55%, mild mitral valve regurgitation and trace tricuspid valve regurgitation.  There was no VA examination in evidence proximate to separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the supraventricular arrhythmia condition 10%, coded 7010 (Supraventricular arrhythmias (SVT, tachycardia): citing atrial fibrillation which required cardioversion and an ablation procedure with return of symptoms.  The panel agreed that the CI’s condition met criteria warranting a rating of 10% under 7010.  The evidence did not support a 30% rating for more than four episodes per year documented by ECG or Holter monitor.  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 supraventricular arrhythmia condition.  

Contended PEB Conditions:  Lumbago, torn meniscus, and tonsillectomy.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  The conditions were not profiled, implicated in the commander’s statement nor judged to fail 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 contended conditions and so no additional disability rating are recommended.  

BOARD FINDINGS:  In the matter of the supraventricular arrhythmia described as paroxysmal atrial tachycardia condition and IAW VASRD §4.104 the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended lumbago, torn meniscus, and tonsillectomy conditions, the panel unanimously or majority recommends no change from the PEB determinations as not unfitting.  There were 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 20150717, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170011065 , XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

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,