RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01485
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20040509

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Fire Support Specialist, medically separated for “heat injury” with a disability rating of 0%.   

CI CONTENTION:  No specific contention.  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 (VA), 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 - 20040123	VARD - 20040823	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heat Injury	7999-7900	0%	Hypertension with Heat Injury	7101	0%	20040607	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Heat Injury.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s heat injury began in May 2003 after treatment of hypertension (HTN).  The CI developed an abnormal heart rhythm in March 2003.  During treatment for the heart condition he was diagnosed with HTN and treated with a diuretic.  The NARSUM notes an episode of heat related volume depletion while on the diuretic for HTN in May 2003 without additional elaboration.  

The 4 November 2003 MEB NARSUM examination, 6 months prior to separation, noted no complaint related to heat injury or illness.  Physical examination showed normal blood pressure, pulse and temperature.  Heart showed normal rhythm, without any abnormal sounds.  Skin was normal without rashes.  
At the 7 June 2004 VA Compensation and Pension (C&P) evaluation, 1 month after separation, the CI reported a claim for heat injury.  The review of systems noted no complaints of weakness or fatigue, no skin changes, and no neurological symptoms.  Pertinent physical examination was normal, including blood pressure.  A cardiac evaluation the same day noted the CI’s history of HTN and atrial fibrillation.  Physical examination showed normal blood pressure.  The heart was in normal sinus rhythm, an electrocardiogram was normal and the examination of the heart showed no abnormalities.  The VA examiner indicated “heat injury, currently asymptomatic.”  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the heat injury condition 0%, coded analogously as 7900 (hyperthyroidism), an analogous code for heat injury, citing “without any evidence of residuals.”  The VA rated “hypertension with heat injury” condition 0%, coded 7101 (hypertensive vascular disease), based on the C&P examination 1 month after separation, citing HTN which was controlled with medication.

There was no evidence of recurrent heat related symptoms or medication required to control heat related symptoms noted in the record in the 12 months prior to separation (other than the initial incident in May 2003) for a higher rating than 0% under 7900.  There was no evidence of seizures or symptoms analogous to seizures, such as syncope due to heat injury for a rating higher than 0% rated analogously under 8911(petit mal epilepsy), another possible analogous code for heat injury.  There was therefore no higher rating available than 0% as adjudicated by the PEB.  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 heat injury condition.  

BOARD FINDINGS:  In the matter of the heat injury condition and IAW VASRD §4.120, the panel unanimously 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 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 20161008, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180003341, 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,					      
Enclosure