MEMORANDUM FOR THE DIRECTOR, AIR FORCE REVIEW BOARDS AGENCY

SUBJECT:  Physical Disability Board of Review Recommendation on Case Number PD-2017-06037

	In accordance with Title 10 § 1554a and in compliance with DoDI 6040.44, the Physical Disability Board of Review (PDBR) adjudicated the disability rating accompanying the medical separation of the covered individual (CI) from the United States Air Force.  After carefully reviewing the application and medical separation case file, the PDBR recommended no re-characterization of the separation or modification of the disability rating previously assigned.  I recommend you accept this proposed decision.
  
The CI was an active duty E5, Aircraft Maintenance Craftsman, medically separated for “hypersomnolence” with a disability rating of 10%.  Both the PEB and VA rated the sleep condition 10%, coded 8108 (narcolepsy), citing neurology recommendations and continuous use of medications, respectively.  While hypersomnolence is not specifically listed in the VASRD rating schedule, the PEB’s analogous coding approach for narcolepsy was considered appropriate and consistent with the CI’s clinical history and §4.124a standards.  However, under code 8108, VASRD guidelines dictate that the rating be determined as for epilepsy and petit mal (or minor) seizures, with a minimum 10% rating warranted for a “confirmed diagnosis of epilepsy with a history of seizures.”  Absent a history of seizure activity, a positive rating was thus not supported.  An analogous rating under code 6847 (sleep apnea syndromes) was also considered, and although the CI endorsed daytime somnolence, objective evidence of persistent symptoms was not documented to warrant a higher 30% rating.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB’s adjudication for the hypersomnolence. 

	Sincerely,