RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-04366 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20070315

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Antitank Assault Guided Missleman, medically separated for “heatstroke” with a disability rating of 0%.

CI CONTENTION: “Heat sensitivity from heat stroke suffered in June 2005 while in U.S.M.C.” The CI also requested review of an additional condition 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 Do DI 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 - 20061113	VARD - 20070329	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heatstroke	7999-7900	0%	Heatstroke	8999-8911	0%	20070125	
Heat Sensitivity	Cat II					
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Heatstroke. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s condition began in June of 2005 when he suffered a heat stroke with his temperature rising to 109 degrees Fahrenheit. He was admitted to the intensive care unit and was found to have pancreatitis, hepatitis, acute renal failure, a coagulation disorder, and rhabdomyolysis. Liver enzymes were persistently elevated but this resolved. He had one seizure during the heatstroke episode but was not felt to have a chronic seizure disorder. The October 2005 neuropsychological testing showed an equivocal finding regarding the presence of a clinically

significant adult onset cognitive impairment. Retesting in March 2006 revealed normal findings. Lab findings were also normal. The 6 October 2006 MEB NARSUM examination, 5 months prior to separation, noted heat intolerance despite being indoors and non-active. The CI required no medications, and he worked as an administrative assistant. Physical examination showed elevated systolic blood pressure (140/80), heart rate 70, no tremor and other vital signs were normal.

At the 25 January 2007 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported recurring headaches, usually followed by vomiting whether inside or outside. It was a migraine headache and was accompanied by nausea and “therefore, very heat intolerant.” When the headache occurred, he required medications. He had headaches and problems with dizziness three to seven times a week. The functional impairment was heat intolerance. He was able to perform activities of daily living and was employed in his usual military occupational specialty (MOS). Physical examination showed elevated systolic blood pressure, a heart rate of 80, no tremor, and otherwise, no clinical findings of heat stroke.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the heatstroke condition 0%. The VASRD does not have a specific code for this diagnosis, thus the Medical [EPSS] recommends an analogous code, 7999-7900 (hyperthyroidism). The PEB also listed heat sensitivity as a related Category II condition (contributed to the primary unfitting condition but was not separately ratable). The impairment from the heat sensitivity was properly subsumed under the overall rating for the heat stroke condition IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). The VA also rated the heatstroke condition 0%, analogously coded 8999-8911 (epilepsy, petit mal) based on the C&P examination, citing no current objective findings. The NARSUM examination noted heatstroke related problems had resolved. The CI was able to work in his original MOS. There was no evidence of rapid heartbeat, tremor, or continuous medication required for control, to meet criteria for a 10% rating under the 7900 code. Although a seizure occurred during the heatstroke, there was no evidence of a seizure disorder to meet criteria for a 10% rating under the 8911 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 heatstroke condition.

BOARD FINDINGS: In the matter of the heatstroke condition and IAW VASRD §4.104, 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-2017-04366

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

IN REPLY REFER TO:
1850
CORB: 003
10 Sep 20

From: Director, Secretary of the Navy Council of Review Boards To:	

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 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.