RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201536 SEPARATION DATE: 20020315 

BOARD DATE: 20130226 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty Soldier, PFC/E-3(73C/Finance Specialist), medically 
separated for conversion disorder manifested by subjective left lower extremity weakness and 
sensory deficits. The CI’s symptoms began in February 2001 upon her arrival in Korea. She was 
subsequently air evacuated to Ft. Sam Houston. The CI did not improve adequately with 
treatment to meet the physical requirements of her Military Occupational Specialty (MOS) or 
satisfy physical fitness standards. She was issued a permanent S4 profile and referred for a 
Medical Evaluation Board (MEB). The MEB forwarded conversion disorder with moderate 
deficit, S&I slight; and common migraine as medically unacceptable IAW AR 40-501. The MEB 
forwarded no other conditions for Physical Evaluation Board (PEB) adjudication. The PEB 
adjudicated the conversion disorder manifested by subjective left lower extremity weakness 
and sensory deficits as unfitting, rated 10%. The PEB adjudicated the common migraine as not 
unfitting. The CI made no appeals, and was medically separated with a 10% disability rating. 

 

 

CI CONTENTION: The CI elaborated no specific contention in her application. 

 

 

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. 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 20020109 

VA – All Effective Date -- N/A 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Conversion Disorder; Subjective 
Left Lower Extremity Weakness 

9424 

10% 

Conversion Disorder; Left Lower 
Extremity Weakness 

8520-9410 

NSC 

STRs 

Common Migraine 

Not Unfitting 

No VA Entry 

 

 

 

.No Additional MEB/PEB Entries. 

0% X 0 / Not Service-Connected x 0 

STRs 

Combined: 10% 

Combined: 



*The CI had no VA C&P Exams, initial VARD is approximately 8 years post-separation. 

 

 

ANALYSIS SUMMARY: 

 

Conversion Disorder. The narrative summary (NARSUM) notes the CI was evacuated from 
overseas in May 2001 secondary to left leg weakness. The CI had a first episode of muscle 
weakness in February 2001 when she noted decreased sensation of left arm and leg lasting 
one-two hours with total remission of symptoms. A few days later she had another episode of 


left arm and leg weakness and numbness. The left arm symptoms resolved immediately, 
however the left leg weakness and numbness persisted since that time, with unchanged quality 
or intensity. Magnetic resonance imaging (MRI) of the brain was performed immediately after 
each episode but on both occasions was normal, with no evidence of a causative abnormality. 
Conservative management was initiated but the CI complained she could not move her left leg, 
ambulated with a cane and eventually was sent back to the United States for further 
investigation and treatment. Despite thorough medical investigation, no objective physical 
cause for her symptoms was found. Eventually a psychiatric evaluation was recommended and 
the CI endorsed symptoms including sadness, crying spells, decreased energy, frustration and 
lack of interest in previous activities. However, the mental status exam (MSE) noted a full 
affect, without feeling of sadness or anxiety. Despite detailed questioning no specific bio-
psycho-social stressors were identified. No specific treatment or follow up was recommended 
and the Global Assessment of Functioning (GAF) was 75 (slight impairment). The psychiatrist 
gave the CI a provisional diagnosis of conversion disorder and recommended psychological 
testing to validate the diagnosis. Results of the testing confirmed the CI’s tendency to convert 
psychological distress into somatic symptoms. It was also noted the CI had a rigid personality, 
intellectual functioning in the low to normal range, and narcissistic and histrionic personality 
disorder traits. Individual therapy was not considered a treatment option due to CI resistance 
and poor response to treatment. The CI received a permanent S4 profile and the MEB was 
initiated. The MEB NARSUM physical exam on 4 December 2001 noted normal muscular 
strength and tone, normal gait and deep tendon reflexes (DTRs). Sensory was intact except a 
patchy decreased pin prick on the left lateral calf without a sensory level. There was no VA 
Compensation and Pension (C&P) examination proximate to separation, and VA records 
indicate the CI did not file a claim with the VA until November 2009, 8 years after separation. 
The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the conversion disorder manifested by subjective left lower extremity weakness and 
sensory deficits, 10% (considering mild social and industrial impairment) under code 9424. The 
Board analyzed the social and occupational impairment secondary to CI conversion disorder 
symptoms and agreed with the 10% rating attributed by the PEB. The mental health specialists 
attributed the CI’s symptoms to psychological stress and poor coping mechanisms, considered 
her impairment for social and industrial adaptability “slight” and assigned the CI a GAF of 75. 
The MEB physical examination recorded resolved conversion symptom with recovered leg 
strength with normal gait. A higher rating of 30% would require mood symptoms like 
suspiciousness, panic attacks, and chronic sleep impairment which were not evidenced 
throughout the treatment records. 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 conversion disorder condition. 

 

 

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. In the matter of the 
conversion disorder manifested by subjective left lower extremity weakness and sensory 
deficits condition and IAW VASRD §4.130, the Board unanimously recommends no change in 
the PEB adjudication. 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 

Conversion Disorder 

9424 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120728, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxxxxxxxx, AR20130005363 (PD201201536) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)