RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02050
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060409

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty O2, Military Intelligence Officer, medically separated for “chronic fatigue syndrome” with a disability rating of 10%.

CI CONTENTION:  The CI contended for a higher rating for her unfitting condition. 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 - 20051230	VARD - 20060419	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Fatigue Syndrome…	6354	10%	Chronic Fatigue Syndrome	6354	40%	20060306	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Chronic Fatigue Syndrome.  According to service treatment records (STRs) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s condition of fatigue began in mid-2004 and was definitively diagnosed with chronic fatigue syndrome (CFS) on 17 December 2004.  Despite long term treatment consisting of restrictions, medications, and sleep hygiene, her condition did not result in improvement sufficient to allow unrestricted duty.  

At the MEB NARSUM examination performed on 12 May 2005, 11 months prior to separation, the CI’s chief complaint was listed as “CFS”.  Her generalized physical examination (PE) was normal except for tenderness about her upper back.  Her diagnosis remained unchanged and her restrictions included a status of non-deployability and a 6-hour maximum workday.  At the MEB examination (recorded on DD Forms 2807 and 2808) dated 22 June 2005, 10 months prior to separation, the provider noted the CI’s diagnosis as “CFS-stable”.  At the 6 March 2006 VA Compensation and Pension (C&P) evaluation, performed 1 month prior to separation, the CI’s clinical course was summarized and her general PE was normal.  The CI stated her only use of medication was “…Tylenol for pain.” 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the CI’s condition at 10%, coded 6354 (CFS), citing restrictions of work duration.  Utilizing the same code, the VA rated the same condition at 40%, based on the C&P examination 1 month prior to separation, citing decreased workday.  Panel members first agreed that the VA examination provided the most appropriate status of the CI’s condition near the time of service separation.  Specifically for CFS, the VASRD rating of 20% requires “nearly constant” symptoms or at least two weeks of incapacitation per year.  The panel majority agreed that neither criteria was supported one month prior to separation.  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 CFS condition.  

BOARD FINDINGS:  In the matter of the CFS condition and IAW VASRD §4.88b, the panel by a majority vote recommends no change in the PEB adjudication.  The single voter for dissent recommended modification of the assigned rating but did not elect to submit a minority opinion.  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 20150720, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170010033, 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,