RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02098
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040619

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Petroleum Supply Specialist, medically separated for “seizure disorder, generalized,” with a disability rating of 10%.  

CI CONTENTION:  The CI contends her seizures were present at the time of her appeal and still continue to happen.  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 - 20040126	VARD - 20040804	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Seizure Disorder, Generalized	8910	10%	Seizure Disorder	8910	20%	20040305	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Seizure Disorder, Generalized.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s seizure disorder began in June 2000 while in AIT.  No specific incident or trauma was noted.  It was reported she had just completed a march and was observed to have generalized convulsive activity associated with tongue biting.  A neurologist memorandum from 12 July 2002 reported the CI was followed by neurology for possible seizures and vasovagal syncope controlled with medications.  Her profile was upgraded to a P2 with no restrictions.

The 5 December 2002 neurology consultation, noted the CI had not experienced problems with medication or dosage and had not experienced any seizures.  The recommendation was indefinite continued medication at the same dosage.   The CI experienced a seizure event on 24 July 2003.  The CI stated she had not taken her medications due to work schedule conflicts.  Laboratory evaluation revealed the CI’s phenytoin level was 0.50 ug/ml and the normal therapeutic level was in the 14 to 17 ug/ml range.  At the neurology follow-up on 4 September 2003, medication levels were checked and the CI reported no recurrent seizures.  

The 24 October 2003 commander’s performance statement indicated the CI had “performed as a petroleum supply specialist in all of its capacities for past 14 months.”  The CI’s condition had not limited garrison or field duty.  Her performance was nothing short of outstanding at the unit’s last NTC rotation from 11 July 2003 through 13 August 2003 and the commander recommended retention.  The 18 November 2003 MEB NARSUM examination, 7 months prior to separation, noted complaints of seizures.  Physical examination revealed an intact neurological evaluation, which included mental status, cranial nerves, cerebellar, motor, gait, sensory and deep tendon reflexes.  

At the 5 March 2004 VA Compensation and Pension (C&P) examination, 3 months before separation, the CI reported a seizure disorder.  The last incident was in July 2003, which coincided with a low drug level.  Physical examination showed the cranial nerves, motor, sensory, deep tendon reflexes and cerebellar systems were intact.  CT scan, EEG, Holter monitor and echocardiogram were normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the seizure disorder 10%, coded 8910 (epilepsy, grand mal), citing no “documented seizures in the presence of therapeutic anticonvulsant levels in the past two years.”  The VA rated the seizure disorder 20%, also coded 8910, based on the C&P examination, citing at least one major seizure in the last two years, or at least two minor seizures in the last six month.  The panel concluded the CI met the VASRD criteria for at least one major seizure in the last 2 years (July 2003).  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 disorder, coded 8910.  

BOARD FINDINGS:  In the matter of the seizure disorder, the panel recommends a disability rating of 20%, coded 8910 IAW VASRD §4.124a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Seizure Disorder, Generalized	8910	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170103, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180008186, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs. 

Sincerely,					      
Enclosure