RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-02975 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20050715

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Fixed Wing Aircraft Power Plants Mechanic, medically separated for “episodic vertigo” with a disability rating of 10%.

CI CONTENTION: “Condition has not changed, continuous effects.” 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 - 20050429	VARD – 20060215	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Episodic Vertigo associated with Dysautonomia, Near or Frank Syncope	8299-
8210	10%	Dysautonomia with Dizziness, Vertigo, Occasional Syncope	8199-
8108	10%	20060127	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Episodic Vertigo associated with Dysautonomia and Near or Frank Syncope. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s vertigo condition began in September 2002, and consisted of an episodic sensation of spinning, profuse sweating, red eyes, and bitemporal headache. The symptoms occurred abruptly in any position, at any time of the day, without any obvious trigger. Work-up for this condition included MRI of the brain, echocardiogram, tilt table test for vertigo, Holter monitor, and EEG; all were normal.

The April 2005 MEB NARSUM examination, 3 months prior to separation, noted complaint of dizziness. The CI underwent evaluations with psychiatry, neurology, cardiology, and ENT; no cause was found. He reportedly experienced more than 10 episodes of actual syncope. Neurological examination was normal. The examiner noted that the spells were inconsistent with seizures or migraines, and the history was most suggestive of episodic dysautonomia (vaso-vagal syncope).

At the 27 January 2006 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported his last episode occurred in November 2006. At the time he was employed as a warehouse supervisor and had lost no time from work because of his condition. Physical examination was unremarkable.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the vertigo condition 10%, analogously coded 8299-8210 (tenth (pneumogastric, vagus) cranial nerve paralysis of: incomplete, moderate). The VA also rated the vertigo condition 10%, analogously coded 8199-8108 (narcolepsy), based on the STR and C&P examination. Panel members agreed, the 10% rating and no higher was warranted for the condition under the 8210 code. The STR demonstrates a moderate level of burden. The spells were intermittent and episodic. Panel members found insufficient evidence to support the higher rating of 30% for the severe level. A higher rating was not justified under any applicable code. 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 vertigo condition.

BOARD FINDINGS: In the matter of the vertigo condition and IAW VASRD §4.124a, 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 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 20170327, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

2	PD-2017-02975

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN   REPLY  REFER  TO,
1850
CORB: 003 20May20

From: 

Director, Secretary of the Navy Council of Review Boards 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW  (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 11 Apr 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate  action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation  Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.