RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02030
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040715

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Power Generator Equipment Repairman, medically separated for “palpitations…” with a disability rating of 0%.   

CI CONTENTION:  The CI contends for his unfitting palpitations and conditions not identified by either the MEB or 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 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 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 - 20040315	VARD - 20040615	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Palpitations…	7099-7010	0%	Status Post ASD Repair with Palpitations; Status Post Subxiphoid Hernia Repair	7099-7010	Voc Rehab	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Palpitations.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s symptomatic heart palpitations began in April 2001 after undergoing cardiac surgery for the repair of an atrial septal defect (ASD).  The CI’s symptoms remained despite no persistent objective findings of sustained abnormal heart rhythm on continuous cardiac monitoring.  Secondary to continued, but undocumented arrhythmias, the CI underwent empiric radiofrequency cardiac ablation therapy in February 2003.  Post-procedural monitoring continued not to identify any sustained abnormal cardiac rhythm despite the CI’s subjective and persistent complaints of “pounding heartbeats.”  
Two prolonged cardiac monitoring tests (Holter monitor) were conducted in April and August 2003 whereby 1 episode of irregular supraventricular tachycardia (SVT) rhythm (fast abnormal heartbeat) was observed in the April test and no such episodes were observed in the August evaluation.     

At the 10 November 2003 MEB NARSUM examination, 8 months prior to separation, the CI endorsed no new or additional physical symptoms.  A review of his historic cardiology evaluations to include electrocardiograms (ECG), echocardiograms, stress echocardiograms, and multiple event monitors did not identify any significant or sustained abnormal findings.  His physical examination was normal and his diagnosis remained unchanged.  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 cardiac palpitation condition at 0%, analogously coded to 7010 (supraventricular arrhythmias) citing, non-correlation of symptoms and monitoring; whereas, the VA noted the same condition and stated “vocational rehabilitation is not established” based on the STR, utilizing the same analogous code.  The next higher 10% rating under code 7010 is for “permanent atrial fibrillation (lone atrial fibrillation), or; one to four episodes per year of paroxysmal atrial fibrillation or other supraventricular tachycardia documented by ECG or Holter monitor.”  The CI did not have permanent atrial fibrillation and there was only one documented episode of paroxysmal SVT by Holter monitor at 15 months prior to separation.  Specifically, as stated above, the time frame for such findings is during a 12 month period and this case does not support that criteria at a 10% level.  Therefore, 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’s adjudication for the cardiac palpitation condition.  

BOARD FINDINGS:  In the matter of the cardiac palpitation condition and IAW VASRD §4.104, the panel unanimously recommends no change in the PEB adjudication.  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 20150722, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170011074, 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,