RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02022
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081112

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, basic trainee, medically separated for “heat stroke” 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 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 - 20081021	VARD – 20090602	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heat Stroke	7999-7900	0%	Residuals, Heat Stroke	7813-8911	NSC	20090312	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NSC	

ANALYSIS SUMMARY:  

Heat Stroke.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s heat stroke condition began in August 2008 while participating in a 2 ½ mile run.  He experienced dizziness, tachycardia (increased heart rate), temperature to 104 degrees, vomiting and altered mental status and was admitted to intensive care, intubated and placed on a ventilator.  He was diagnosed with heat stroke and hospitalized from 27 August-1 September 2008.  On the day of discharge and return to his unit, he became dizzy while standing at ease and collapsed without loss of consciousness.  There was no increased heart rate, tremors or respiratory distress.  A 48-hour stay in the medical quarters unit was recommended.  Follow up labs were unremarkable.  Brain scan was normal.  The MEB forwarded “heat stroke” for PEB adjudication.  

At the MEB examination (recorded on DD Forms 2807 and 2808) dated September 2008, 2 months prior to separation, the CI reported no current medications.  Physical examination showed normal vital signs (blood pressure, heart rate, temperature) and no evidence of tremor.  The 2 October 2008 MEB NARSUM examination, 1 month prior to separation, noted the CI complained of dizziness and headaches when getting up from a sitting position and sweating a lot when he was outside.  His training and physical activities were limited as a result.  He could not be in heat for long periods of time or participate in activities that required him to perform hard labor e.g. lifting, or yard work.  He planned to attend an emergency medical technician program and was not taking any medication.  He could not perform all the duties of his MOS, and was unable to pass his fitness test due to the history of heat stroke.  Physical examination was unremarkable with blood pressure 128/91, heart rate 101, respiratory rate 16 and temperature 100 degrees.  At the 12 March 2009 VA Compensation and Pension (C&P) General Medical evaluation, performed 4 months after separation, the CI reported excessive sweating with vigorous activity without observable sequelae of heat stroke.  Physical examination showed mildly elevated systolic blood pressure and otherwise normal heart rate and neurological findings.  The examiner rendered no diagnosis and opined there was no outward or observable sequelae of heat stroke on examination.    

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the heat stroke condition 0%, analogously coded 7999-7900 (hyperthyroidism), determining the CI’s condition was asymptomatic but limited him from performing military duties in the heat, for long periods of time.  The VA considered the condition as residuals, heat stroke, coded 7813-8911, finding the condition not service connected (NSC), based on the C&P examination 4 months after separation.  The panel considered a higher rating of 10% under code 7900.  A 10% rating would require evidence of intermittent tachycardia and tremor or; continuous medication required for control.  None of these findings were in evidence at the time of separation.  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 were no other conditions within the panel’s scope of review for consideration.  The panel, 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 20150720, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170011071, 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,