RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01514
BRANCH OF SERVICE:  army	SEPARATION DATE:  20041220

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E1, Trainee, medically separated for “suspected grand mal seizure disorder” with a disability rating of 0%.

CI CONTENTION:  “Rating is accurate.”  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 it reasonably reflects the severity of the disability at the time of separation.

RATING COMPARISON:

SERVICE PEB - 20041209	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Suspected Grand Mal Seizure Disorder	8999-8910	0%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:

Suspected Grand Mal Seizure Disorder.  According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI had a witnessed seizure in October 2004 with 90 seconds of tonic/clonic activity without tongue biting followed by a post-ictal (altered consciousness) period consistent with a generalized motor seizure.  He was taken to the emergency room where a computerized tomography of the head and a lumbar puncture were both negative.  The CI denied a history of loss of consciousness or seizures with only a minor head injury as a child.  Magnetic resonance imaging of the brain was normal and an electroencephalogram (EEG) showed patterns of wakefulness and sleep, but no evidence of epileptiform activity.  No further spells occurred.

The 9 November 2004 MEB NARSUM physical examination, 1 month prior to separation, showed the CI to be alert with normal speech pattern and normal affect and mood.  His vital signs were normal and the examination of the head, eyes, ears, neck, throat, and chest was unremarkable.  Neurological examination revealed cranial nerves II-XII were within normal limits.  He had adequate strength without drift, atrophy or abnormal movement sensation.  Pinprick, light touch, and vibration were intact, and Romberg’s test (to determine balance) was negative.  Coordination was within normal limits without ataxia and his gait was normal.  Reflexes were 2/5 and symmetric and toe signs were negative.  The examiner noted the CI had an event that could represent a single generalized motor seizure with a negative workup.  There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the suspected grand mal seizure disorder 0%, coded 8999-8910 (epilepsy, grand mal), citing “has been seizure free since initial episode.”  Panel members noted there was no evidence in the STR showing the CI received anti-seizure medication.  However, since he had observed tonic/clonic movements, the examiner’s working diagnosis “taken at face value” was that the CI had a seizure, although not confirmed on EEG.  Nevertheless, the CI’s condition could warrant a 10% rating using code 8999-8910, which requires “a confirmed diagnosis of epilepsy with a history of seizures.”  However, there was presumably only one seizure and the VASRD requires a history of seizures.  Therefore, in the absence of a confirmed diagnosis of epilepsy and a history of only one seizure, the panel determined that a 0% rating was appropriately assigned by the PEB.  After due deliberation, considering all of 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 suspected grand mal seizure disorder.

BOARD FINDINGS:  In the matter of the suspected grand mal seizure disorder and IAW VASRD §4.124a, the panel unanimously recommends no change in the PEB adjudication.  There were 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 20161010, w/atchs
Exhibit B.  Service Treatment Record

AR20180001815, 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