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Dear XXXXXXXXXX:

	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.

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXX.  	CASE:  PD-2017-03933
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060729

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Automated Logistics Specialist, medically separated for “heat intolerance” with a disability rating of 0%.  

CI CONTENTION:  In addition to the heat intolerance condition, the CI requested review of several other conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20060428	VARD - 20070511	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heat Intolerance	7999-7900	0%	Heat Intolerance	7903	30%	20070307	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Heat Intolerance.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s heat intolerance condition began in July 2005 while in Iraq, after he was found unconscious behind a fork lift.  The CI noticed hot temperatures would cause severe headaches and light headiness, which would only get better in an air conditioned room.    

The 7 April 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of fatigue, headaches and light headiness if outside for too long which resolved after returning to a cooler environment.  Physical examination was unremarkable and lab work was normal.  Neurology and cardiology consults ruled out other causes.  
At the 7 March 2007 VA Compensation and Pension (C&P) examination, 7 months after separation, the CI reported recurrent headaches if overheated which resolved relatively quickly with cooling down.  The examiner found no metabolic, mental health or neurological abnormalities.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the heat intolerance condition 0%, analogously coded 7900 (hyperthyroidism), citing the CI’s inability to remain in hot environments.  The VA rated the heat intolerance condition 30%, coded 7903 (hypothyroidism), based on the C&P examination, citing headaches, fatigue, and controlled anemia.  

There is no specific VASRD code for heat intolerance, therefore IAW VASRD rating principle §4.20 analogous ratings were applied.  The panel noted the CI had consistent symptoms of headaches and lightheadedness, but there was no mention of fatigue.  The panel also noted the presence of mild anemia that was unlikely to have played any significant role in the CI’s symptomatology.  The panel considered both the hyperthyroid and hypothyroid ratings.  Members noted that neither the NARSUM nor the C&P examination provided evidence of fatigability, tachycardia, tremor or continuous medication to meet the criteria for a 10% disability rating under either VASRD code 7900 or 7903.  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 heat intolerance condition.  

BOARD FINDINGS:  In the matter of the heat intolerance condition and IAW VASRD §4.121, 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.