RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02394
BRANCH OF SERVICE:  AIR FORCE 	SEPARATION DATE:  20050726

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Tactical Aircraft Maintenance F-16/F-117 Apprentice, medically separated for “recurrent supraventricular tachycardia” with a disability rating of 0%.  

CI CONTENTION:  The CI’s condition continues to worsen and negatively impact his daily activities.  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 – 20050606	VARD – 20090505	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Recurrent Supraventricular Tachycardia	7010	0%	Paroxysmal Atrial Fibrillation	7010	0%	20090205	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Recurrent Supraventricular Tachycardia (SVT).  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s tachycardia symptoms began in April 2003 technical training school and became more frequent.  He was eventually evaluated in November 2003 when he was seen in the ER for arrhythmia and near syncope.  Treatment did not result in improvement sufficient to allow unrestricted duty and the CI was referred for a MEB.  

The 9 March 2005 cardiology evaluation, 5 months prior to separation, was with hospital admission following an emergency room visit for difficulty breathing and racing heart that documented EKG finding of atrial fibrillation with rapid ventricular response which was treated with injection and medications.  There were no other events of arrhythmia during in-hospital monitoring.  

The 28 April 2005 MEB NARSUM examination, 3 months prior to separation, noted complaints of palpitations two to four times a month lasting about 30 minutes, associated with racing heart, chest pain, shortness of breath, lightheadedness, blurry vision and feeling like he was going to faint.  Symptoms were typically brought on with physical or emotional stress.  Evaluations by cardiologist, to include EKGs, echocardiograms, stress echocardiogram and two event monitors did not identify any significant findings.  Physical examination showed normal lungs and heart.  The NARSUM conclusions indicated that “the cause of (the CI’s) symptoms has not yet been determined with studies performed by the cardiologists.  He continues to have symptoms on medical therapy.”  

At the 5 February 2009 VA Compensation and Pension (C&P) evaluation, 41 months after separation, the CI reported he continued to have episodes of rapid heart rate and near syncope.  The episodes occurred monthly and lasted up to 4 days.  The VA examination showed normal heart, lungs and echocardiogram.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the recurrent supraventricular tachycardia condition 0%, coded 7010 (supraventricular arrhythmias).  The VA rated paroxysmal atrial fibrillation condition 0%, coded 7010, based on the C&P examination 41 months after separation, citing no 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 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; however, there was one documented episode of paroxysmal atrial fibrillation or other SVT by ECG or Holter monitor in the year prior to separation.  There were not more than four episodes per year documented by ECG or Holter monitor to warrant a rating higher than 10%.  

After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the recurrent supraventricular tachycardia condition, coded 7010.  

BOARD FINDINGS:  In the matter of the recurrent supraventricular tachycardia condition, the panel unanimously or majority recommends a disability rating of 10%, coded 7101 IAW VASRD §4.104.  There were no other conditions within the panel’s scope of review for consideration.  The panel recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Recurrent Supraventricular Tachycardia	7010	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150602, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-02394.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was not appropriate under the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  The Board recommended modification of your assigned disability rating without re-characterization of your separation with severance pay. 

I carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding, accept their recommendation and direct that your records be corrected as set forth in the attached copy of a Memorandum for the Chief of Staff, United States Air Force.  The office responsible for making the correction will inform you when your records have been changed.  This will not result in any change to your separation documents or the amount of severance pay you are entitled to.  Disability severance pay is computed the same regardless of a rating of 0, 10 or 20 percent.

Sincerely,

XXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
1.  Directive 
2.  Record of Proceedings 

cc:
SAF/MRBR