NAME: XXXXXXXXXX

RECORDOF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

CASE: PD-2017-05122

BRANCH OF SERVICE: AIR FORCE	SEPARATION DATE: 20050829

SUMMARY OF CASE: Data extracted from the available evidence of record reflect s this covered individual (Cl) was an active duty  ES, Personnel Craftsman, medically  separat ed for  "seizure di sorder" wit h a disability rating of 10%.

Cl CONTENTION: "Air Force rating was based on one it em; VA rating...was based on seven." The complete submissio n is at Exhibi t A.

SCOPE OF REVIEW: The panel' s scope of review is defined in DoDI 6040.44. It is limite d to review of disability ratings assigned to those conditions determ ined by the Physical Eva luat io n Board (PEB) to be unfi tt ing for continue d milit ary service, and when specifically requested by the Cl, those conditions identifi ed by the Medical Eva luat io n Board (M EB), but determine d by the PEB to be not unfi tt ing or non-compe n sable. Any conditions outside the panel' s defined scope of review, and any conte ntion not requested in this application, may remain eligible for futu re consideration by t he Board for Cor rect ion of M ili t ary Records. The panel' s authority is limite d to assessing t he fairness and accuracy of PEB rating determinations and recommending corrections when appropriate. The panel gives consideration t o VA evide nce, part icularly within 12 months of separation, but only to the extent that it reasonab ly reflects the severity of disability at the time of separation.

RATINGCOM PARISON:

SERVICE PEB • 200 506 23	VARD • 200509 15	
Condition	Code	Ratina:	Condition	Code	Ratina:	Exam	
Seizure Disorde r	8910	10%	Part ial Complex Epi lep sy,
Claimed As Sei zures	8910	40%	20050719	
Obstructive Sleep Apnea [OSA]
M anaged with CPAP [Cont in uou s Positi ve Airway Pressure]	
6847	Not Unfitt ing	
Sleep Apnea	
6847	
50%	
20050719	
COM BINED RATIN G: 10%	COMBINED RATING OF ALLVA CONDITIONS: 90%	

ANALYSIS SUMMARY:

Seizure Disorder. According to t he service treatm ent record (STR) and MEB nar rative sum mary (NARSUM), the Cl had his fi rst seizure in Sept ember 2004 (nocturnal) followed by a second seizure on 13 October 2004 (after flashing lights), without record of a recent trauma. Both seizures were witnessed and incl uded generalized t onic-clonic activit y. The Cl had a history of a severe head injury at age 1, and a brai n MRI i n November 2004 showed medial right temporal lobe volume loss and a small signal abnormality in the posterior left parietal lobe which was consiste nt wi th previous hemo rrhage. An EEG was abnormal due to the presence of bifr ont al temporal epileptifo rm discharges.

The 1 April 2005 MEB NARSUM examinatio n, 4 mont hs prio r to separation, note d Cl complaints of new onset seizure but no additio nal seizures fo ll owi ng neurology evaluat io n and starting on

anti-seizure medication s. Physical examination was noncontributory. At the 19 July 2005 VA Compensation and Pen sion (C&P) examination, 1 month before separation, the Cl reported (complex part ial) seizures that began in September/October 2004 and were contro lled wit h medication . Physical examination was noncontributory.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the seizure condition 10%, coded 8910 (epilepsy, grand mal), citing no seizures since October 2004 while on required continuous medications. The VA rated the seizure condition 40%, also coded 8910, based on the pre-separation C&P examination, citing evidence of two grand mal seizures w ithin the past 12 months. Pane l members noted that both of the Cl' s seizures were in the year prior to separation and adjudged as major seizures IAW VASRD §4.124a, (epilepsie s) and disabilit y code 8910. At the time of separation, DoD instructions differed in rating considerations from the VASRD (DODI omitted nocturnal seizures and those off of medication), and thus the panel must apply the VASRD st andards in effect at that time, in which rating s were based on fr equency and timing of seizure s. Panel members agreed that the Cl had two major seizures in the 12-month period prior to separation, which met the 40% rating criteria for "at least 1 ma jor seizure in the last 6 months or 2 in the last year." After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommend s a disability rating of 40% for the seizure condition, coded 8910.

Conte nded PEB Cond iti on: OSA Managed with CPAP. The panel's main charge is to assess the fairness of the PEB determination that the contended conditi on was not unfi tting . The contended conditi on failed retention standard s and was noted in the commander' s statement, which recommended ret ention. During evaluation of the Cl's unfitting seizure condition, he was also evaluated for daytime sleepiness and nighttime sleep disturbance, with a sleep study showing OSA and subseq uent satisfact ory CPAP titration. Neurology clinic follow-up in March and May 2005 recorded Cl reports of improved sleep with good daytime and alertness. The Forma l PEB stated that the sleep apnea had responded well to CPAP treatment and that it was current ly stable and was not unfitting. The pre-separation C&P examination also indi cated the Cl was stable on CPAP. There was no performance-based evidence fr om the record that the condition significantl y interfered with satisfactory duty performance at separation. After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additiona l disabi lity rating is recommended .

BOARD FINDINGS: In the matter of the seizure condition, the panel recommends a disability rating of 40%, coded 8910 IAW VASRD §4. 1 24a. In the matter of the contended OSA condition, the panel recommends no change from the PEB determination as not unfitting. There are no other conditions withi n the pane l' s scope of review for consideration.

The panel recommends the Cl's prior determination be modified as fo llows; and, that the discharge with severance pay be re-characterized to refl ect permanent disability retirement , effective the date of medical separation:

	CONDITION	VASRD CODE	PERMANENT RATING	
Seizure Disorder		8910	40%	

The following documentary evidence was considered:

Office of the Assistant Secretary

DEPARTMENT OF THE AIR FORCE
WASHINGTON DC

SAF/MRB
3351 Celmers Lane
IBA NAF Washington, MD 20762-6435
Dear XXXXXXXXXX:
Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05122.
After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was not in accordance with the guidelines of the Veterans Affairs Schedule for Ratmg Disabilities. Accordingly, the Board recommended your separation be re-characterized to reflect disability retirement, rather than separation with severance pay
I have carefully reviewed the evidence of record and the recommendation of the Board.
I concur with that finding, accept the recommendation and determined that your records should be conected accordingly. The office responsible for making the con ection will infonn you when your records have been changed.
As a result of the aforementioned conection, you are entitled by law to elect coverage under the Survivor Benefit Plan (SBP). Upon receipt of this letter, you must contact the Air Force Personnel Center at (210) 565-2273 to make airnngements to obtain an SBP briefing prior to rendering an election. If a valid election is not received within 90 days from the date of this letter, you will not be emolled in the SBP prograin unless at the time of your separation, you were man ied, in such a case, failure to render an election will result in automatic emollment by law.

Sincerely,

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