RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2016-00567
BRANCH OF SERVICE: COAST GUARD	SEPARATION DATE: 20040625

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Boatswain’s Mate, medically separated for “peripheral vestibular disorder” with a disability rating of 10%.

CI CONTENTION:  No specific contention was made.  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 Medical Evaluation Board (MEB), but determined by the PEB 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. The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate. 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 disability at the time of separation.

RATING COMPARISON:

SERVICE PEB – 20040205	VARD - 20050225	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Peripheral Vestibular Disorder	6204	10%	Vestibular Deficit	6204	30%	20041209	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 70%	

ANALYSIS SUMMARY:

Peripheral Vestibular Disorder. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI presented in December 2002 with a complaint of incapacitating motion sickness. Caloric testing (vestibular provocation) demonstrated “low intensity” positional right peripheral vestibular dysfunction, but all other objective tests were normal. Provider entries in the STR documented intermittent episodes of right ear pain attributed to different diagnoses. There were no STR provider entries that documented any staggering or other coordination or balance complaints, and all physical testing of balance and gait was normal.

The VA audiologist on 20 January 2004, 5 months prior to separation, documented “dizziness two to three times a day ... denies spinning, but indicated environment moves (side to side).” There was no note of subjective or objective gait or balance disturbance. At the 9 December 2004 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported “daily” dizziness (15-20 minutes in duration) and “daily right ear ache.” He described episodes “at least once per week” when he would get “very, very dizzy,” for which “he has not fallen to the ground

[but] he actually has to lay down in bed.” The physical examination recorded normal neurological findings, to include posture and gait.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the vestibular disorder 10%, coded 6204 (peripheral vestibular disorder), characterizing it as “occasional dizziness.” The VA rated the vestibular disorder 30%, also coded 6204, stating that the maximum rating was indicated because of the daily dizziness and monthly severe episodes described in the C&P examination.

The panel first agreed that, given the specificity of the code for the condition under consideration, no alternative code was subject to consideration, even for analogous rating. Code 6204 provides for only two ratings: 10% for “occasional dizziness” and 30% for “dizziness and occasional staggering.” It should be noted that the higher rating requires evidence of staggering. Panel members agreed that it would be fair to concede the latter criterion even if “staggering” as such was not documented (as in this case), but that some convincing evidence of objective gait or balance disturbance would have to be present.

The panel ultimately concluded that objective evidence of impaired equilibrium equivalent to staggering was not sufficiently demonstrated. The only such indication would have to be inferred from the C&P description of severe symptoms implying that the CI had to lie down to avoid falling. There was no STR corroboration of such episodes being present at separation. There was also very convincing objective evidence of normal equilibrium that was inconsistent with the subjective symptoms. It was therefore judged that the inference from the CI’s history at the time of the C&P examination was not sufficiently probative to serve as the basis for the panel’s recommendation.       After due deliberation, considering all the evidence and mindful of VASRD
§4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the peripheral vestibular disorder.

BOARD FINDINGS: In the matter of the peripheral vestibular disorder and IAW VASRD §4.87, the panel recommends no change in the PEB adjudication. There are no other conditions within the panel’s scope of review for consideration. Therefore, the panel recommends there be no modification or re-characterization of the CI’s disability and separation determination.

UH.oSm. DeleapnadrtSmeceunrtioty·
United States Coast Guard

Dear XXXXXXXX,

• ·"

Commandant
United States Coast Guard

Mail Stop 7907
2703 Martin Luther King Jr. Ave SE Washington, DC 20593-7907
Staff Symbol: CG-1 Phone: (202) 475-5000

1850

JUNE 5 2020

I am the Designated Decision Authority for the Coast Guard on applications submitted to the Department of Defense Physical Disability Board of Review (PDBR). Under the authority of Title 10, United States Code, section 1554a, I accept the PDBR's recommendation in your case (Case Number PD-2016-00567) and decline to modify your findings.

Enclosed for your information are a copy of the PDBR's recommendation and a copy of the record of proceedings.

A copy of this decision has also been provided to Coast Guard Enlisted Personnel Management Branch, the PDBR, and the Department of Veterans Affairs.

If you have any further questions, please contact the Coast Guard Personnel Service Center at (202)795-6645.