RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX		CASE: PD-2017-05708 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20090303

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Construction Mechanic, medically separated for “vasodepressor syncope” with a disability rating of 10%.

CI CONTENTION: The condition continues to worsen and negatively affects daily activities. 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 - 20081030	VARD - 20090403	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Vasodepressor Syncope	6299-6204	10%	Vasodepressor Syncope	6299-6204	10%	20080606	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Vasodepressor Syncope. According to the service treatment record and MEB narrative summary (NARSUM), the CI developed exercise induced syncope in 2006 which involved lightheadedness and dizziness whenever she physically exerted herself. At cardiology follow-up in June 2007, the provider noted two episodes of dizziness within the previous 3 weeks while riding a stationary bike, and a tilt table test was positive. She was diagnosed with vasovagal syncope and treatment notes indicated that medications provided minimal benefit.

At the 6 June 2008 VA Compensation and Pension (C&P) examination, 9 months before separation, the CI reported a stable condition requiring no treatment, and that she was employed full-time as a mechanic. The examiner documented low but normal blood pressures and diagnosed “vasovagal syncope, exercise induced.”

The 26 June 2008 MEB NARSUM examination, 8 months prior to separation, noted complaints of exercised induced syncope/pre-syncope resulting from orthostatic hypotension and occurring only with exercise. At peak exercise, her blood pressure dropped to 60s/40s suggestive of

exercise induced vasovagal syncope. Physical examination was unremarkable and echocardiogram and EKG results were normal. During an exercise stress test, the CI became lightheaded, and the examiner noted this was likely a vagal reaction. During the 28 January 2009 MEB examination (recorded on DD Forms 2807-1 and 2808), 1 month prior to separation, the CI reported dizziness, abnormal heartbeat and pain during exercise, as well as low blood pressure.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the syncope 10%, analogously coded 6299-6204 (peripheral vestibular disorder). The VA also rated the syncope 10%, analogously coded 6299-6204, based on the C&P examination, citing symptoms involving occasional dizziness. Panel members noted that the syncope condition should have more appropriately been analogized to 8108 (narcolepsy) and rated under the rules for epilepsy (petit mal). However, the syncopal episodes only occurred during exercise and she no longer exercised for more than 30 minutes and refrained from any vigorous exercise. Therefore, application of the 8108 code would not have resulted in a rating higher than the 10% adjudicated by the PEB. 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 syncope.

BOARD FINDINGS: In the matter of the vasodepressor syncope and IAW VASRD §4.87, 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.

2	PD-2017-05708

DEPARTMENT OF THE NAVY
SECRETARY OF TIIE 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:	XXXXXXXXXXXXXX

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.