RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02843
BRANCH OF SERVICE:  ARMY	SEPARATION DATE:  20050321

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Automated Logistics Specialist, medically separated for “panic disorder with repeated episodes of loss of consciousness” with a disability rating of 10%.

CI CONTENTION:  “Review all conditions.”  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 - 20050216	VARD - 20050719	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Panic Disorder with Repeated Episodes of Loss of Consciousness	9412	10%	Conversion Disorder with Seizures or Convulsions	9424	10%	20050506	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Panic Disorder with Repeated Episodes of Loss of Consciousness (LOC).  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI passed out at church 2 years prior to service entry, but there was no recurrence, and she was cleared for enlistment.  In April 2003, she had another fainting spell and a subsequent seizure disorder evaluation was unrevealing.  Metabolic disorders were ruled out and she was eventually diagnosed with a panic disorder.  On 27 September 2004, the commander’s statement noted she could perform administrative tasks, but was limited by profile from operating machinery and military vehicles.  

The 26 January 2005 MEB NARSUM neurology examination, 2 months before separation, recorded a recent episode manifested as nausea and bilateral arm and leg shaking without LOC.  Neurological findings were normal and “probable non-epileptic seizures manifested by nonstereotyped attacks” was assessed.  The MEB NARSUM mental health addendum, on the same day, noted the CI passed out twice in late 2004, with the STR showing a pseudo-seizure diagnosis on 9 October 2004 and syncope on 8 December 2004.  She was on an anti-depressant with improved symptoms and stayed busy helping family with childcare and transportation; she planned to attend college.  The mental status examination (MSE) was essentially normal and she was diagnosed with panic disorder manifested by repeated episodes of LOC.

At the 6 May 2005 VA Compensation and Pension (C&P) mental health evaluation, 2 months after separation, the CI reported multiple headaches with shaking and LOC triggered when she became panicked and then hyperventilated.  The MSE documented that she was aloof and detached and picked at her clothing, but was otherwise unremarkable.  The examiner diagnosed a conversion disorder with a Global Assessment of Functioning (GAF) score of 75 (transient symptoms, slight impairment).  The VA C&P general evaluation, 2 weeks later, noted the CI’s episodes were not seizures and mostly related to anxiety and hyperventilation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the panic disorder condition 10%, coded 9412 (panic disorder and/or agoraphobia).  The VA also rated the condition 10%, coded 9424, (conversion disorder), based on the C&P evaluation, citing occupational and social impairment due to mild or transient symptoms.  Members considered whether the criteria for a 30% rating (occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks) or higher were met.  Although the CI was unable to perform the physical aspects of her specialty, she successfully managed comprehensive administrative duties, and there was no evidence showing an inability to effectively interact with coworkers.  Additionally, the NARSUM and VA examinations reported essentially normal MSEs and GAF scoring.  Thus, the panel determined the CI’s condition most approximated a 10% rating at separation IAW §4.130.  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 panic disorder.

BOARD FINDINGS:  In the matter of the panic disorder with repeated episodes of LOC condition and IAW VASRD §4.130, 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 20170427, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180006110, 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