RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00280
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20051227

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Information Management Journeyman, medically separated for “seizure disorder…”, with a disability rating of 10%.  

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 - 20051021	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Seizure Disorder…	8999-8910	10%	No VA Exam in Evidence	
Headaches	Cat II		
Seasonal Allergic Rhinitis			
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Seizure Disorder.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s seizure condition began in June 2005 after experiencing a seizure, witnessed by friends.  She had a work-up which was unremarkable.  She had a normal head computed tomography scan, electroencephalogram (test that measures and records the electrical activity of your brain by using sensors), and brain magnetic resonance imaging studies.  Local neurologist was consulted and his impression was for a "First Ever Seizure (witnessed), most probably caused by the prescribed Elavil medication she was taking for her migraine headaches."  She was followed clinically and due to persistent right arm twitching and migraines she was started on prescribed Neurontin medication in July 2005.  After titrating dose (finding the proper amount of a prescription), she had some relief.  A second neurologist evaluation was accomplished on 30 August 2005.  His impression was for a partially controlled seizure disorder with recommendation to discontinue Neurontin in favor of Levetiracetam.  The 11 September 2005 MEB NARSUM examination, 1 month prior to separation, noted the history of a single generalized convulsive seizure on 2 June 2005.  Physical examination was normal including gait, heart and neurological exams.  The 13 October 2005 addendum to the NARSUM noted complaints of 2 focal seizures in her right arm, from 11 September 2005 through 13 October 2005, lasting about 30 seconds with no loss of consciousness.  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 seizure disorder condition 10%, coded analogous to 8910 (grand mal epilepsy).  The panel noted that the evidence showed that CI had documentation of 1 major seizure from June 2005 to December 2005 (7 month period) and 2 minor seizures from 11 September 2005 through 13 October 2005 (1 month period).  Panel members agreed that the evidence supports at least 1 major seizure in the last 2 years; or at least 2 minor seizures in the last 6 months for a 20% rating.  She did not have at least 1 major seizure in the last 6 months or 2 in the last year; or averaged at least 5 to 8 minor seizures weekly to justify a 40% rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the seizure condition, coded 8910.  

Contended PEB Conditions:  Headaches and Seasonal Allergic Rhinitis.  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, implicated in the commander’s statement nor 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 seizure disorder condition, the panel unanimously recommends a disability rating of 20%, coded 8910 IAW VASRD §4.124a.  In the matter of the contended headaches, seasonal allergic rhinitis conditions, 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 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	
Seizure Disorder	8910	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160512, w/atchs
Exhibit B.  Service 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-2016-00280.

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.  Accordingly, the Board recommended modification of your assigned disability rating without re-characterization of your separation with severance pay. 

I have 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,

Attachment:
1.  Directive 
2.  Record of Proceedings 

cc:
SAF/MRBR