RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02168
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040505

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an National Guard E4, Military Police, medically separated for “recurrent heat injuries”  with a disability rating of 0%.

CI CONTENTION:  The CI requested a review of all conditions.  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 - 20040305	VARD - 20050127	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Recurrent Heat Injuries…	7999-7900	0%	Recurrent Heat Injury	8999-8911	NSC	20040918	
Intermittent Low Back Pain	Not Unfitting 	Low Back Pain	5237	NSC	20040918	
Partial Tear of the Left Knee Medial Collateral	Not Unfitting 	Partial Tear of the Left Knee Medial Collateral Ligament	5260	NSC	20040918	
Hypertension	Not Unfitting 	Hypertension	7107	NSC	20040918	
Gastroesophageal Reflex	Not Unfitting 	Gastroesophageal Reflux	7399-7346	0%	20040918	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Recurrent Heat Injuries.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s heat injury condition began in 1985.  The CI reported he had recurrent episodes of heat exhaustion in 1992 and 1997.  On 7 June 2003, while deployed, the CI reported feeling nauseated and dizzy without improvement with oral fluids.  He was treated with intravenous fluids and placed on quarters.  On June 9, 2003, the CI reported feeling tired, weak, and dizzy.  At the time his temperature was normal but his blood pressure was elevated.  The medical assessment was heat injury/heat exhaustion and the CI was medically evacuated.  

At the September 2003 MEB examination (recorded on DD Forms 2807 and 2808), 8 months prior to separation, the pertinent physical examination was completely normal.  The 11 February 2004 MEB NARSUM examination, 3 months prior to separation, noted complaints of recurrent heat injuries.  Physical examination cited the DD Form 2808 examination summarized above.  The MEB NARSUM examiner indicated that the CI was performing the duties of his MOS, but “with the restrictions noted on the profile to protect against hot environments.”  

At the 18 September 2004 VA Compensation and Pension (C&P) evaluation, 4 months after separation, the recurrent heat injury condition was not addressed.  At the 6 October 2004 C&P Mental Disorders evaluation, 5 months after separation, the recurrent heat injury condition was noted only as the cause of the CI’s medical evacuation and subsequent medical discharge, without report of continued symptoms or recurrent episodes of heat illness.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the recurrent heat injuries condition 0%, coded analogously as 7900 (hyperthyroidism), citing “recovered.”  The VA did not service connect the recurrent heat injury condition coded analogously to 8911 (petit mal epilepsy), based on the C&P examinations 5 months after separation, citing no chronic or residual disability.  

There was no evidence of recurrent heat related symptoms or medication required to control heat related symptoms in the 11 months prior to separation (after the CI’s medical evacuation) for a higher rating than 0% under 7900.  There was no evidence of seizures or symptoms analogous to seizures, such as syncope, for a rating higher than 0% under 8911.  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 recurrent heat injuries condition.  

Contended PEB Conditions:  Intermittent Low Back Pain, Partial Tear of the Left Knee Medial Collateral Ligament, Hypertension, and Gastroesophageal Reflux Disease.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  None of the conditions were profiled or implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that any of the conditions 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 any of the contended conditions and so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the recurrent heat injuries condition and IAW VASRD §4.119, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended intermittent low back pain, partial tear of the left knee medial collateral ligament, hypertension, and gastroesophageal reflux disease, the panel unanimously recommends no change from the PEB determinations 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 20150701, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170010056, 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,