RECORD OF PROCEEDINGS 

 AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS 

 

IN THE MATTER OF: DOCKET NUMBER: BC-2012-01873 

 COUNSEL: 

 HEARING DESIRED: NO 

 

________________________________________________________________ 

 

THE APPLICANT REQUESTS THAT: 

 

His disability discharge, with severance pay (DWSP,) be changed 
to a disability retirement, rated at 50 percent, with the 
corresponding change to his narrative reason for separation, re-
entry code and separation code. 

 

________________________________________________________________ 

 

THE APPLICANT CONTENDS THAT: 

 

He should have been medically retired with a combined 
compensable disability rating of 40 percent for Neurocardiogenic 
Syncope and General Anxiety Disorder. 

 

Counsel states the applicant’s conditions resulted from his 
deployment to Southwest Asia and is unfitting for military 
service. 

 

In support of his appeal, the applicant provides a letter from 
counsel; copies of the Secretary of the Air Force Personnel 
Council (SAFPC) Physical Evaluation letter, dated 6 May 11, and 
extracts from his Department of Veterans Affairs/servicemembers’ 
medical record (DVA/SMR). 

 

The counsel’s complete submission, with attachments, is at 
Exhibit A. 

 

________________________________________________________________ 

 

STATEMENT OF FACTS: 

 

The applicant, a former member of the Ohio Air National Guard 
(OHANG) was called to active duty on 8 Dec 10, in support of 
Operation NEW DAWN. 

 

Based on a Medical Evaluation Board (MEB) report, on 3 Nov 09, 
the applicant was diagnosed with neurocardiogenic syncope and 
his case was referred to Informal Physical Evaluation Board 
(IPEB). On 30 Mar 10, the IPEB found the applicant unfit for 
both anxiety disorder, not otherwise specified, and 
neurocardiogenic syncope, and determined that both conditions 
existed prior to service (EPTS), not permanently service 
aggravated. They recommended the applicant be discharged under 
other than Chapter 61, with a condition that was EPTS. The 
applicant nonconcurred with their findings and his case was 
referred to the Formal PEB (FPEB). On 29 Jun 10, the FPEB 
agreed with the unfit findings of the IPEB, but found his 
conditions service aggravated and recommended DWSP, with a 


combined compensable disability rating of 20 percent, with a 
10 percent disability rating assigned to each condition. The 
applicant disagreed with the findings of the FPEB and requested 
his case, with rebuttal, be referred to SAFPC. On 6 May 11, 
SAFPC found only the applicant’s neurocardiogenic syncope 
condition unfitting and directed the applicant be discharged 
with severance pay with a 10 percent compensable disability 
rating. 

 

On 24 Aug 11, the applicant was discharged with severance pay 
with a compensable disability rating of 10 percent. 

 

________________________________________________________________ 

 

THE AIR FORCE EVALUATION: 

 

AFPC/DPSD recommends denial, stating, in part, that based on a 
preponderance of the evidence no error or injustice occurred 
during the disability process. 

 

DPSD notes that SAFPC found the applicant’s neurocardiogenic 
syncope unfitting for continued military service. They noted 
the anxiety could be unfitting but the medical records did not 
provide evidence to support imposition of duty or mobility 
restrictions … the physical evaluation board is required by law 
to rate a disability using criteria outlined in the Veterans 
Affairs Schedule of Rating and Disabilities (VASRD). The 
applicant began to experience blackouts Aug 07 after several 
months of extensive work-up; he was diagnosed with 
neurocardiogenic syncope. In relation to his syncope, it has 
been associated with a chronic cough that reportedly stemmed 
from his exposure to a burn pit while deployed. The treating 
physician states in his note the applicant experienced reflex 
medicated cough syncope and his cough is the trigger for his 
episodes. Although he contends that he still experiences 
prodrome of lightheadiness, dizziness, shortness of breath, 
medical record provides evidence that he has been treated with 
Beta blocker and selective serotonin reuptake inhibitor (SSRI) 
and that he has not had any episodes of syncope since May 10. 
In relation to his anxiety the psychiatrist stated in his 
evaluation that "member does not suffer with a condition that 
would make him unfit; therefore there is insufficient evidence 
to show that his anxiety was an unfitting medical condition." 
SAFPC rated the applicant's neurocardiogenic syncope at the 
10 percent disability rating per VASRD guidelines. 

 

The complete DPSD evaluation is at Exhibit C. 

 

________________________________________________________________ 

 

APPLICANT'S REVIEW OF THE AIR FORCE EVALUATION: 

 

Counsel requests the applicant be medically retired with a 
combined rating of 50 percent. 

 

He notes that while the applicant did not report his condition 
immediately following his second deployment, he did report 


exposure to environmental toxins in theater and within a short 
period began to experience the symptoms which led to his 
diagnoses of neurocardiogenic syncope and anxiety disorder. 

 

He notes the disagreement in the advisory opinion as to whether 
both diagnoses of neurocardiogenic syncope and anxiety disorder 
were unfitting and that, in 2007; the DVA rated the applicant at 
10 percent for anxiety. 

 

Further, a major difficulty in evaluating the applicant’s 
medical condition is that the condition of Neurocardiogenic 
Syncope is not listed in the VASRD. According to the VA, if a 
disability is not specifically listed in the rating schedule it 
is rated "analogous to a disability in which not only the 
functions affected, but anatomical localization and symptoms, 
are closely related." The applicant contends that his 
neurocardiogenic syncope condition is more closely associated 
with epilepsy or narcolepsy, and that his frequency of syncope 
episodes and his requirement for continuous medication justify a 
higher rating than either the VA or the military has given him. 

 

He understands the disability boards must rate his condition at 
the time of the evaluation. Although he did not have a complete 
copy of his medical records at the time that he submitted his 
appeal, he has since obtained additional copies of his medical 
and mental health records and the VA records for 2006 through 
2011. At the time of the FPEB, he testified that he was 
experiencing four to five syncopal episodes per week. This is 
consistent with the frequency he was reporting to his physicians 
at the Toledo VA from around that same period of time and 
continuing through Nov 11. It is also evident from a review of 
his medical records, both medical and mental health that his 
syncopal episodes are closely related to stress and we would 
argue that his anxiety disorder exacerbates his neurocardiogenic 
syncope and both medical conditions render him unfit for 
military service. 

 

In the most current edition of the VASRD, narcolepsy (diagnostic 
code 8108) is rated as petit mal epilepsy. Under diagnostic 
code 8911, an individual qualifies for a 40 percent rating if 
they have experienced at least one major seizure in the last six 
months or two in the last year or average at least five to eight 
minor seizures weekly. A minor seizure is defined as "a brief 
interruption in consciousness or conscious control associated 
with staring or rhythmic blinking of the eyes or nodding of the 
head, or sudden jerking movements of the arms, trunk, or head, 
or sudden loss of postural control." This definition is 
consistent with the applicant’s description of his blackouts in 
his medical records at or near the time of his disability 
evaluations. 

 

In conclusion, they believe the applicant’s conditions are 
analogous of narcolepsy or petit mal epilepsy as found by the 
VA. Unlike the VA assessment, however, they believe that his 
epilepsy-like symptoms, the necessity of continuous medication 
and his description of at least five syncopal episodes per week 
justifies the higher rating of 40 percent for neurocardiogenic 


syncope. They also argue that his anxiety disorder both 
separately and as an exacerbating factor in his syncope, renders 
him unfit for military service and justifies a 10 percent rating. 

 

In further support of his appeal, the applicant provides 
counsel’s letter; extracts from his DVA/SMR, and various other 
documents. 

 

The counsel’s complete response, with attachments, is at 
(Exhibit D). 

 

________________________________________________________________ 

 

THE BOARD CONCLUDES THAT: 

 

1. The applicant has exhausted all remedies provided by 
existing law or regulations. 

 

2. The application was timely filed. 

 

3. Insufficient relevant evidence has been presented to 
demonstrate the existence of error or injustice. We took notice 
of the applicant's complete submission in judging the merits of 
the case. While the applicant contends that he should have 
received a higher rating for his unfitting conditions of 
neurocardiogenic syncope and anxiety disorder, we note that 
prior to his separation, the DVA records reflect that his 
symptoms had somewhat resolved and rated his vasovagal syncope 
condition at zero percent and the anxiety disorder at 10 
percent. Contrarily, SAFPC found only the applicant’s analogous 
condition of neurocardiogenic syncope unfitting and rated it at 
10 percent. In this respect, the applicant is advised that 
diagnoses and opinions resulting from a given set of symptoms 
and stressors, as reported by a patient at a given point in 
time, may change over time. Consequently, different medical 
providers may reach different diagnostic conclusions, based upon 
disclosures that may vary between the time initial evaluation 
and subsequent evaluation. Addressing the contention that the 
applicant’s syncope should be rated under seizure disorder, the 
Board collectively noted that based on the demonstrated evidence 
after a series of testing and evaluations, the applicant’s 
symptoms were more likely vasovagal in origin and not due to a 
seizure disorder. The applicant’s case has undergone an 
exhaustive review by the Air Force office of primary 
responsibility (OPR) and we did not find the evidence provided 
sufficient to overcome its assessment of the case. In addition, 
we note the Military Disability Evaluation System (MDES), 
operating until Title 10, United States Code (USC), only offers 
compensation for the medical condition that is the cause for 
career termination; and then only to the degree of impairment 
present at the time of final disposition or military separation. 
Conversely, the Department of Veterans Affairs (DVA), operating 
under Title 38, USC, rates all conditions that are determined to 
be service-connected, regardless of whether they were unfitting. 
In doing so, the DVA takes into account the fact that a person 
can acquire physical conditions during military service that, 
although not unfitting at the time of separation, may later 


progress in severity and alter the individual's lifestyle and 
future employability. Thus the two systems represent a 
continuum of medical care and disability compensation that 
starts with entry onto active duty and extends for the life of 
the veteran. Therefore, we agree with the opinion and 
recommendation of the OPR and adopt the rationale expressed as 
the basis for our decision the applicant has failed to sustain 
his burden that he has suffered from an error or injustice. In 
the absence of evidence to the contrary, we find no basis to 
recommend granting the relief sought in this application. 

 

________________________________________________________________ 

 

THE BOARD DETERMINES THAT: 

 

The applicant be notified that the evidence presented did not 
demonstrate the existence of material error or injustice; that 
the application was denied without a personal appearance; and 
that the application will only be reconsidered upon the 
submission of newly discovered relevant evidence not considered 
with this application. 

 

________________________________________________________________ 

 

The following members of the Board considered AFBCMR Docket 
Number BC-2012-01873 in Executive Session on 11 Feb 13, under 
the provisions of AFI 36-2603: 

 

The following documentary evidence was considered: 

 

 Exhibit A. DD Form 149, dated 11 Apr 12, w/atchs. 

 Exhibit B. Applicant's Master Personnel Records. 

 Exhibit C. Letter, AFPC/DPSD, dated 12 Jun 12. 

 Exhibit D. Letter, SAF/MRBR, dated 19 Jun 12. 

 Exhibit E. Letter, Applicant Counsel, 

 dated 19 Jul 12, w/atchs. 

 

 

 

 

 Panel Chair