RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXX	CASE: PD-2017-05416
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20060619

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E1, Electrical Mechanical Equipment Repairman, medically separated for “neurocardiogenic syncope” with a disability rating of 10%.

CI CONTENTION: No specific contention was made. 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 - 20060505	VARD - 20061109	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Neurocardiogenic Syncope	8299-8210	10%	Neurocardiogenic Syncope	7099-7015	10%	20061101	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Neurocardiogenic Syncope. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s syncope condition began in December 2005 after fainting while standing at attention in formation. An EKG in December 2005 showed normal sinus rhythm, and an echocardiogram in February  2006  showed  normal  heart  structure.  Tilt-table  testing  on  8 February 2006 was positive for neurocardiogenic syncope.

The 22 February 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of inability to successfully perform his military duties as reflected by the diagnosis of neurocardiogenic syncope. The CI was prescribed preventative medication and recommended to avoid situations likely to trigger fainting, including those that may produce stress, fear or anxiety. Physical examination showed blood pressure was 108/58 and heart rate 89. Heart sounds were normal with regular rate and rhythm. Neurologic system was grossly intact. During the February/April MEB examination (recorded on DD Forms 2807-1 and 2808), 4 and 2 months prior to separation, the CI reported having passed out twice within the previous 3 months.

At the 1 November 2006 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI reported no additional episodes of syncope since discharge, but he occasionally had a sensation of pressure in his chest, and would feel pale and break out in a sweat. Physical examination was unremarkable.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the syncope condition 10%, analogously coded 8299-8210 (paralysis of, tenth (pneumogastric, vagus) cranial nerve). The VA also rated the syncope condition 10%, analogously coded 7099-7015 (atrioventricular block), based on the C&P examination, citing workload greater than 7 METs but not greater than 10 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope, or continuous medication.

The higher rating of 30% under code 8210 requires evidence of severe impairment which was not supported by the evidence. The CI reported two episodes during 3 months, and there had been no episodes during the 5 months after separation. Panel members agreed the 10% rating and no higher was justified for the syncope condition under analogous code 8210. Panel members also agreed a higher rating was not achievable under the 7015 code since there was no evidence of dyspnea, fatigue, chest pain, dizziness or abnormal cardiac findings. There were no additional applicable codes to consider that would result in a higher rating than 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 condition.

BOARD FINDINGS: In the matter of the neurocardiogenic syncope 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 no modification or re-characterization of the CI’s disability and separation determination.

2	PD-2017-05416

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:	XXXXXXXXXXXXX

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.