RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200400 SEPARATION DATE: 20080816 

BOARD DATE: 20130416 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (13D/Field Artillery Tactical Data Systems 
(AFATDS) Specialist), medically separated for supraventricular tachycardia (SVT) (classified by 
the Medical Evaluation Board [MEB] as arrhythmia). The CI reported an episode of fast heart 
beat in late 2002 just prior to deploying to Iraq. He continued to have several undocumented 
episodes per year. In 2007, an event recorder finally captured one of his episodes and the 
diagnosis of SVT was made. An ablative procedure was performed in late 2007. His SVT 
(arrhythmia) condition could not be adequately rehabilitated as he continued to have 
subjective episodes of palpitations. The CI did not improve adequately with treatment to meet 
the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness 
standards. He was issued a permanent P3 profile (311111) and referred for a MEB. (1) 
hypertension, (2) hyperlipidemia, (3) sleep apnea and (4) anxiety not otherwise specified (NOS) 
conditions, identified in the rating chart below, were also identified and forwarded by the MEB. 
The Physical Evaluation Board (PEB) adjudicated the SVT condition as unfitting, rated 10%, with 
application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The remaining 
condition(s) were determined to be not unfitting. The CI made no appeals, and was medically 
separated with a 10% disability rating. 

 

 

CI CONTENTION: In Items #3 and 12, the CI contends, “Everything that is documented with the 
VA is what I was trying to get with the Army. I was told that the Army picks one condition to be 
evaluated that is the worst. SVT heart condition was suggested and we rolled with it. Little did 
I know I was losing huge benefits, Tricare retirement (sic). This has been a nightmare since I 
was released. All findings from the VA need to be evaluated and it will show that I should be 
retired. Please make this right for me and my family.” 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44, Enclosure 3, paragraph 5.e.(2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.” The ratings 
for unfitting conditions will be reviewed in all cases. The hypertension, sleep apnea and anxiety 
NOS posttraumatic stress disorder (PTSD) conditions requested for consideration and the 
unfitting SVT and/or arrhythmia conditions meet the criteria prescribed in DoDI 6040.44 for 
Board purview, and are accordingly addressed below. Lumbar strain and any conditions or 
contention not requested in this application, or otherwise outside the Board’s defined scope of 
review, remain eligible for future consideration by the Army Board for Correction of Military 
Records. 

 

 


RATING COMPARISON: 

 

Service PEB – Dated 20080604 

VA (2 Mos. Pre-Separation) – All Effective Date 20080817 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Supraventricular 
Tachycardia (SVT) 

7010 

10% 

Paroxysmal Supraventricular 
Tachycardia 

7010 

10% 

20080603 

Hypertension 

Not Unfitting 

Essential Hypertension 

7101 

10% 

20080603 

Hyperlipidemia 

Not Unfitting 

NO VA ENTRY 

 

Sleep apnea 

Not Unfitting 

Sleep Apnea 

6847 

50% 

20080603 

Anxiety not otherwise 
specified 

Not Unfitting 

NO VA ENTRY* 

 

.No Additional MEB/PEB Entries. 

Lumbar Strain 

5237 

0% 

20080603 

0% X 1 / Not Service-Connected x 0 

20080603 

Combined: 10% 

Combined: 60% 



* VARD 20110407 awarded 30% rating for PTSD (GAF 60) for a combined total of 70% effective 20110106. 

 

 

ANALYSIS SUMMARY: 

 

Supraventricular tachycardia (SVT) and/or Arrhythmia Condition. The narrative summary 
(NARSUM) notes the CI reported an episode of SVT in late 2002 just prior to deploying to Iraq. 
He continued to have several undocumented episodes per year. In March 2007 a cardiac 
echocardiogram showed no significant abnormalities. No structural heart valve abnormalities 
were noted and there was normal biventricular size and function. In April 2007, an event 
recorder captured one of his episodes and the diagnosis of SVT was made. A successful ablative 
procedure was performed in late September 2007. The CI noted episodes of arrhythmia in late 
November and December 2007, and a February 2008 a month event monitor did not detect any 
significant arrhythmia. Cardiology stated the CI had labile hypertension and history of 
palpitations, and even noted that his sleep apnea should be treated, and “perhaps an anti-
depressant agent or some other type of therapy could be more appropriate for his difficulty 
sleeping and his presumed diagnosis of PTSD.” In March 2008, permanent P3 profile was issued 
finding the CI unable to perform functional activities or Army Physical Fitness Test (APFT) other 
than run/walk at own pace, and noted he “Continues with abnormal heart rhythm after 
surgery”. On the weekend of 12 April 2008, the CI reported an “episode of tachycardia lasting 
approximately 2 minutes.” The commander’s statement at the end of April 2008 stated he 
could not perform the duties of his MOS or perform without an unreasonable number and 
duration of rest periods, “he easily becomes physically fatigued.” Additionally the Squad leader 
reported the CI interacted with healthcare team greater than 5 times per week, and the 
Platoon Sergeant marked his interaction rate at 3-5 times per week. 

 

At the MEB exam, the CI reported on DD Form 2808 that he had chest pain and palpitations 
associated with his arrhythmia in February 2007. The MEB physical examiner noted a regular 
rhythm without murmur, and cited cardiology notes January 2008 that no significant 
arrhythmias had been demonstrated. At the VA Compensation and Pension (C&P) exam 14 
weeks prior to separation, the CI reported to the examiner “ that he has not had any more SVT 
since the ablation” and that there were no (“none”) effects of the condition on the usual 
occupation or daily activities”. The Board noted the PEB coding of 7010, supraventricular 
arrhythmias, and disability rating of 10% for one to four episodes per year of SVT documented 
by electrocardiogram (ECG) or Holter monitor, and the same coding and rating applied by the 
VA. The relevant 10% criterion is for “one to four episodes per year of (… SVT) documented by 
ECG or Holter monitor.” Review of the service treatment record (STR) did not reveal any 
evidence that the SVT condition rose to the level of 30%, requiring more than four episodes of 
SVT per year documented by ECG or Holter monitor. 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 SVT and/or 


arrhythmia condition. The Board concluded therefore that this condition could not be 
recommended for additional disability rating. 

 

Contended PEB Conditions. The contended conditions adjudicated as not unfitting by the PEB 
were hyperlipidemia, hypertension, sleep apnea and anxiety NOS (PTSD). The Board’s first 
charge with respect to these conditions is an assessment of the appropriateness of the PEB’s 
fitness adjudications. The Board’s threshold for countering fitness determinations is higher 
than the VASRD §4.3 (reasonable doubt) standard used for its rating recommendations, but 
remains adherent to the DoDI 6040.44 “fair and equitable” standard. Hyperlipidemia is a lab 
abnormality and not a physical disability condition, and is not compensable. 

 

The Board considered if the hypertension condition met the requirements of an unfitting 
condition. The Board noted that the condition was not profiled or included in the commander’s 
statement. The Board noted the C&P exam 14 weeks prior to separation carried high probative 
value for the blood pressure with citation of “average BP now runs about 150/95”, and was 
treated by daily medications. The hypertension condition was reviewed by the action officer 
and considered by the Board. There was no indication from the record that the CI’s treated 
hypertension significantly interfered with satisfactory duty performance nor was there any STR 
evidence that the medications to treat hypertension caused any significant unfitting condition. 
Specifically, the CI’s treatment with 25-75 mg of Toprol XL, and other medications, from March 
2007 until separation are without implication of side effects in any part of the record. 

 

Next the Board considered whether the sleep apnea condition by itself could be unfitting. Due 
to the timing of the CI’s treatment, and resolution of his symptoms by the C&P exam date, the 
C&P exam carried a high probative value that the CI’s sleep apnea had been adequately treated 
with continuous positive airway pressure (CPAP) at the time of separation as evidence by the 
C&P exam history 14 weeks prior to separation, and multiple STR notes as cited above. The 
Board noted the sleep apnea condition was not profiled, and was adequately treated months 
prior to the commander’s statement. The Board agreed with the PEB that the treated sleep 
apnea was not unfitting at the time of separation according to the record. 

 

The Board turned its attention to the anxiety NOS (PTSD) condition as discussed above. The 
Board noted that the anxiety NOS condition was not profiled and was considered not 
disqualifying by the psychiatric addendum and as meeting retention standards by the MEB. 
However, there was a reference in the April 2008 commander’s statement that the CI could not 
perform without an unreasonable number and duration of rest periods, and “he easily becomes 
physically fatigued” cited as one of two reasons for commander noted “medical impairments 
that may render them unfit for further military service.” The daytime fatigue and sleep issues 
had improved on additional treatment prior to separation. The Board opined that the anxiety 
NOS (PTSD) could not be tied directly to any symptoms that made the CI unfit. The Board noted 
that the anxiety NOS (PTSD) condition continued to improve by evidence of better sleep with 
treatment from May 2008 until separation according to the record. The Board opined that the 
CI’s mental health in and around the time of discharge would not have made him unfit at the 
Board level of preponderance of the evidence required to counter a not unfitting PEB 
determination. Hence the Board agreed with the PEB that the anxiety NOS (PTSD) was not 
unfitting. 

 

 

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 SVT and/or arrhythmia condition and IAW VASRD §4.104, the Board 
unanimously recommends no change in the PEB adjudication. In the matter of the contended 
hyperlipidemia, hypertension, sleep apnea and anxiety NOS (PTSD) conditions, the Board 
unanimously recommends no change from the PEB determinations as not unfitting. There were 
no other conditions within the Board’s scope of review for consideration. 

 

 

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 

Supraventricular tachycardia (SVT) and/or arrhythmia 

7010 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120503, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxxxxxxx, AR20130009572 (PD201200400) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)