RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-03016
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20070228

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Motor Vehicle Operator, medically separated for “convulsions as a symptom” with a disability rating of 20%.

CI CONTENTION:  Condition demands a higher rating. 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 - 20061214	VARD - 20070522	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Convulsions as a Symptom	8910	20%	Epilepsy	8910	20%	20070504	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Convulsions as a Symptom. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s convulsions condition began in February 2005. Per the emergency care note dated 24 February 2005, the CI was “not breathing normally while sleeping.” The CI’s roommate reported the CI’s eyes rolled back and he had difficulty speaking.  According to the  12 October 2005 emergency care and treatment note, there was a witnessed seizure at work though no description of the seizure was recorded. There was no head trauma, tongue biting or incontinence.         While he was on duty at work on 24 November 2005, he “fell asleep at work.
…bystanders said he was difficult to orient.” There was no incontinence or evidence of tongue biting. The symptoms described above were consistent with generalized tonic clonic activity. An

MRI in December 2005 was unremarkable, however the request for an EEG was never completed. The CI “reported no recurrence of activity with compliance of dosing medication.” The physician reported that “tested time was passed with respect to efficacy of medicine and the need for completion of the EEGs considered OBE, even if it did show up epileptiform discharge, adequate control was achieved with medication.” The 16 June 2006 MEB NARSUM examination, 8 months prior to separation, noted “no reoccurrence of activity with compliance of dosing medication.” Depakote was prescribed. Physical examination was unremarkable. Neurological examination was within normal limits. The examiner stated the CI “has demonstrated he was well controlled on medication.”  Long term monitoring was recommended.

At the 4 May 2007 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported he had good response to his treatment with no side effects and was without seizures in the last 12 months. He had no functional limitations on activities of daily living due to seizure disorder; he continued to use Depakote. Physical examination was within normal limits to include the neurological examination.

The panel directed attention to its rating recommendation based on the above evidence. The PEB and VA rated “convulsions as a symptom” 20%, coded 8910 (epilepsy, grand mal). The VA based the rating on the STRs and C&P examination, citing “there is evidence of at least one major seizure in the last 2 years, or at least two minor seizures in the last 6 months. We cannot assign a higher evaluation as there is no evidence showing least one major seizure in the last 6 months. The last seizure we have a record of was November 24, 2005.” 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 “convulsions as a symptom.”

BOARD FINDINGS:        In the matter of the convulsions as a symptom 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:

2	PD-2017-03016

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) PDBRltr

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 of no 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.

Copy to: PDBR