Author: JOHN J. D'ORAZIO
Last saved by: BARKSDALE, JAMEILL M GS7 USAF SAF SAF/MRBE
Company: Pre-installed Company

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  	CASE:  PD1200861
BRANCH OF SERVICE:  Army	BOARD DATE:  20130710
SEPARATION DATE:  20020605

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SPC/E-4 (71L/Administrative Specialist) medically separated for symptomatic palpitations.  In 2000, the CI was diagnosed with Wolff-Parkinson-White (WPW) syndrome.  He was treated with ablation therapy, but did not improve adequately to fully perform his military duties or meet physical fitness standards.  He was issued a permanent P3 profile and underwent a Medical Evaluation Board (MEB).  Three conditions (palpitations, hypertension and deconditioning) were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other conditions were submitted by the MEB.  The PEB found the symptomatic palpitations unfitting, rated 0% IAW the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The other conditions were found to be not unfitting.  The CI made no appeals, and was medically separated.

CI’s CONTENTION:  The CI elaborated no specific contention in his application.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB, when specifically requested by the CI.  The rating for the unfitting symptomatic palpitations condition is addressed below.  No other conditions are within the defined purview of the Board.  Any conditions outside the Board’s scope of review may be eligible for consideration by the Board for Correction of Military Records.

RATING COMPARISON:

Army PEB – dated 20020123 | VA* – (4 years Post-Separation)
Condition | Code | Rating | Condition | Code | Rating | Exam
Symptomatic Palpitations | 7099-7010 | 0% | W-P-W Syndrome | 7010 | 0% | 20060915
Hypertension | Not Unfitting | Hypertension | 7101 | 10% | 20060915
Deconditioning | Not Unfitting | No VA Entry | 20060915
No Additional MEB/PEB Entries | Other x 6 | 20060915
Combined:  0% | Combined:  10%
* Derived from VA Rating Decision (VARD) dated 20060929 (the original VARD was not in evidence)

ANALYSIS SUMMARY:  IAW DoDI 6040.44, the Board’s authority is limited to making recommendations on correcting disability determinations.  The Board’s role is thus confined to the review of medical records and all evidence at hand to assess the fairness of PEB rating determinations, compared to VASRD standards, based on ratable severity at the time of separation.

Symptomatic Palpitations Condition.  In 2000, the CI had problems related to WPW pre-excitation syndrome.  On 31 August 2000, he had successful radiofrequency ablation of a right anteroseptal accessory pathway.  After the procedure, he still had palpitations, but much less than previously.  In 2001, the CI was having exertional tachycardia, chest tightness, and shortness of breath.  The symptoms would occur with running, stair-climbing, or other strenuous physical exercise.  Due to his symptoms, he had an MEB/PEB.  The MEB physical examination (PE) of heart and lungs was normal.  Holter monitoring was performed on 1 November 2001.  On the Holter recording, seven episodes of symptomatic palpitations were all correlated with normal sinus rhythm.  No supraventricular tachycardia (SVT) was noted.  The maximum heart rate was a sinus tachycardia at 128 beats per minute.  As noted above, the Army PEB found him unfit due to symptomatic palpitations, and assigned a disability rating of 0%.  The CI was medically separated from military service in June 2002.

Four years later, the CI had a VA Compensation and Pension exam.  Blood pressure was elevated.  PE of the heart and lungs was normal.  The CI reported he had a blackout episode in June 2006, while vacuuming his car.  The VA examiner opined that it was not possible to say what had caused the fainting spell.

The Board carefully reviewed all evidentiary information available, and directs attention to its rating recommendation based on the above evidence.  The Army PEB coded the cardiac condition as 7099-7010 (analogous to supraventricular arrhythmia) and rated it at 0%.  The September 2006 VARD also rated the cardiac arrhythmia condition at 0%.  The Board determined the November 2001 Holter monitoring was performed just 7 months prior to separation, and therefore had significant probative value.  On that Holter recording, seven episodes of symptomatic palpitations were all correlated with normal sinus rhythm.  No SVT was noted.  The maximum heart rate was a sinus tachycardia at 128 beats per minute.  One episode of Mobitz 1 second degree atrioventricular (AV) block was noted.  Based on his AV block, the Board deliberated at length whether VASRD diagnostic code 7015 could be applied to the CI’s cardiac condition.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the symptomatic palpitations.

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.  In the matter of the symptomatic palpitations and IAW VASRD §4.104, the Board unanimously recommends no change in the PEB adjudication.

RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:

UNFITTING CONDITION | VASRD CODE | RATING
Symptomatic Palpitations, Correlated with Sinus Rhythm | 7099-7010 | 0%
COMBINED | 0%
The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20120611, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

Physical Disability Board of Review

SFMR-RB									

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(TAPD-ZB), 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for AR20130016802 (PD201200861)

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a,   I accept the Board’s recommendation and hereby deny the individual’s application.  
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

 BY ORDER OF THE SECRETARY OF THE ARMY:

Encl						
						         (Army Review Boards)

CF: 
(  ) DoD PDBR
(  ) DVA

PD1200861