RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-05193
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20091028

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Integrated Avionics Systems Craftsman, medically separated for “seizure disorder” with a disability rating of 10%. 

CI CONTENTION:  Review of all conditions requested.  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 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 - 20090506	VARD - 20100506	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Seizure Disorder	8911	10%	Seizure Disorder	8999-8911	20%	20091230	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Seizure Disorder.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s seizure disorder first manifested in July 2008 with a 10-minute episode of lightheadedness, dizziness, slurred speech and abnormal eye movements.  There was no convulsive activity or loss of consciousness (LOC).  The work-up (including MRI and electroencephalogram) was negative.  A definitive diagnosis was not made and no treatment was instituted.  In October 2008 he suffered five consecutive 1-minute episodes, which were characterized by confusion, difficulty responding to others and slurred speech.   There was no convulsive activity or LOC.  The CI was diagnosed with seizure disorder and prescribed an anticonvulsant (Keppra).  There was ample evidence that this was the last seizure activity on active duty.  The 2 February 2009 NARSUM examination, 9 months prior to separation, the examiner recorded the CI was “responding well to treatment [Keppra].”  This was corroborated by an addended neurology consult.  The physical examination and detailed neurological findings were normal.  The examining neurologist’s diagnosis was unspecified epilepsy.  

The 30 December 2009 VA Compensation and Pension (C&P) epilepsy examination, 2 months after separation, documented that the CI was still taking Keppra and had remained seizure-free.  The physical examination and detailed neurological findings were normal.  The examining neurologist diagnosed partial complex seizures and specified they were not generalized (no convulsive activity or LOC).  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the seizure disorder 10%, coded 8911 (epilepsy, petit mal), citing “episodes are most consistent with minor seizures.”  The VA rated the seizure disorder 20%, analogously coded 8999-8911, based on the C&P examination, citing “at least one major seizure in the last 2 years, or at least two minor seizures in the last 6 months.”  Seizure conditions are rated under the general formula that classifies seizures as major or minor (VASRD §4.124a).  The formula specifies that a major seizure “is characterized by the generalized tonic-clonic convulsion with unconsciousness.”  The 10% rating specifies “a confirmed diagnosis of epilepsy with a history of seizures.”  The 20% criteria requires increasingly more frequent seizures.  Panel members agreed that the evidence compellingly indicated that all the seizures were appropriately classified as minor and that none had occurred within 6 months of separation.  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 seizure disorder.

BOARD FINDINGS:  In the matter of the seizure disorder 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 there be no modification or re-characterization of the CI’s disability and separation determination.  

SAF/MRB
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

Dear XXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05193.

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 appropriate.  Accordingly, the Board recommended no rating modification or re-characterization of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that modification of your disability rating or characterization of your separation is not warranted.  Accordingly, I accept the recommendation that your application be denied.