RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02073
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20051014

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Aerospace Control & Warning Systems, medically separated for “recurrent atypical spells with altered vision and impaired concentration” with a disability rating of 10%.  

CI CONTENTION:  “The rating should be changed because I believe I was unfairly evaluated and diagnosed by Air Force doctors.”  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’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20051006	VARD - 20051115	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Recurrent Atypical Spells, Altered Vision and Impaired Concentration	8999-8914	10%	Partial Complex Seizure Disorder 	8910-8045	10%	20050808	
Migraines, Existed Prior to Service	Cat II	Confusional Migraine Headaches 	9304	10%	20050808	
Hypertension		Hypertension, Stage I	7101	0%	20050808	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20% 	

ANALYSIS SUMMARY:  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s seizure disorder began in February 2003 when he slipped and struck his head.  During an 18 October 2004 flight medicine examination the CI reported that he “occasionally has time lapses during these episodes where he can't remember what happened and doesn't respond to people talking to him.  Sometimes has conversations during these but doesn't recall them either.”  The examiner opined the CI’s episodes might be complex partial seizures, but noted an inconclusive electroencephalogram (EEG).  A neurologist diagnosed the CI with complex partial seizures that included an abnormal EEG.  

During the 18 January 2005 neurology consultation, 9 months prior to separation, the CI reported that his wife had witnessed him “zoning out.”  The neurologist recorded a normal examination.  The results of an EEG study from April 2004 were inconclusive as the CI did not experience any episodes during the five day study.  The examiner noted the CI was accepted for an in-patient evaluation, which included an EEG study based upon a history of staring spells.  The CI, however, declined due to a history of dermatitis provoked by the electrode paste.  The neurologist continued the Depakote at the same dose.  

At the 8 August 2005 VA Compensation and Pension (C&P) evaluation, 2 months before separation, the CI reported occasional seizure episodes.  Physical examination showed normal speech pattern, gait, posture, motor, coordination and sensory.  Imaging was essentially unremarkable.  The physician stated the CI was returned to full activities of normal daily living, to include driving.  

The 16 August 2005 MEB NARSUM examination, 2 months prior to separation, noted complaints of recurrent attacks.  Physical examination showed speech was fluent without dysarthria or evidence of aphasia.  Mental status, motor, reflex and sensory examinations were intact.  The physician stated the CI’s profile was changed to allow driving and performance of radar duties with cross check available after his last neurology evaluation in January 2005.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the seizure condition 10%, analogously coded 8999-8914 (epilepsy, psychomotor).  The VA also rated the seizure condition 10%, coded 8045-8910 (residuals of traumatic brain injury-epilepsy), based on the C&P examination, citing “a history of symptomatic seizures with daily medication for control.”  

The panel noted a history of symptomatic seizures and ongoing continuous medication for treatment of the CI’s seizure disorder.  The panel also noted the CI’s profile was changed to allow driving and performance of radar duties in January 2005.  An evaluation of 10 percent is assigned, since there is a history of symptomatic seizure with daily medication for control.  A higher evaluation of 20 percent is not warranted unless evidence demonstrates at least one major seizure in the last two years, or at least two minor seizures in the last six months.  The available evidence does not show that the criteria has been achieved for a higher evaluation.  The panel agreed that the evidence supports a disability rating of 10% for a confirmed diagnosis of epilepsy with a history of seizures.  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 seizure condition.  

Contended PEB Conditions:  Migraines and Hypertension.  The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting.  Neither of the conditions were profiled or implicated in the commander’s statement.  There was no performance-based evidence from the record that either of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions, so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the seizure condition and IAW VASRD §4.124a, the panel recommends no change in the PEB adjudication.  In the matter of the contended migraine headaches and hypertension, the panel recommends no change from the PEB determinations as not unfitting.  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 20170224, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs 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-2017-02073.

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 appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

						Sincerely,

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings