[AR Number], XXXXXXXXXX. 

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

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.

Enclosure

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX.  	CASE:  PD-2017-04632
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081016

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Air Defense Command, Control, Communications, Computers, and Intelligence Tactical Operations Center Enhanced Operator, medically separated for “heat injury” 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 - 20080709	VARD - 20090217	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heat Injury	7999-7900	10%	Heat Injury	8099-8007	NSC	20081120	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Heat Injury.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s experienced a heat injury in September 2007 after a 4-mile ruck march.  His blood work showed elevated creatine kinase (CK) levels (muscle injury) and liver enzymes.  He was admitted to the hospital for 2 days, and serial blood work showed persistent, elevated CK levels.  Screening for alternative causes of myositis (muscle inflammation) on 21 April 2008 were negative.  

The 1 June 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, was normal.  At the 5 June 2008 MEB NARSUM examination, the CI reported complaints of weakness, chronic fatigue and heat intolerance, but denied any problems with memory, concentration or attention span.  The examiner referenced the normal findings from the MEB examination.  The 20 November 2008 VA Compensation and Pension (C&P) examination, 1 month after separation, was normal, with the CI reaching a level of 10 METS (metabolic equivalents of task) during an exercise stress test indicating normal tolerance to strenuous exercise.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the heat injury 10%, coded 7999-7900 (analogous to hyperthyroidism), citing fatigue.  The VA did not service connect the heat injury, based on the C&P examination, citing no permanent residual or chronic disability due to heatstroke.  Members noted the evidence of persistent heat related symptoms at the time of the MEB NARSUM, which resolved by the time of the VA examination, 1 month after separation.  The panel agreed there was no evidence of “tachycardia, tremor, and increased pulse pressure or blood pressure” to warrant a rating higher than the PEB’s 10% rating under code 7999-7900.  There was also no evidence of seizures or seizure-like activity, due to heat injury, for a higher analogous rating under 8911 (petit mal epilepsy).  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 injury.  

BOARD FINDINGS:  In the matter of the heat injury and IAW VASRD §4.119, 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: