RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  ARMY 
SEPARATION DATE:  20061031 

 
NAME:  XXXXXXXXXXXXXXX 
CASE NUMBER:  PD1200442 
BOARD DATE:  20121119 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty SSG/E-6 (11B30 / Infantryman), medically separated 
for a generalized seizure disorder.  The condition began in 2005 while deployed to Iraq and was 
not the result of an identifiable cause.  The CI’s medical condition was incompatible with the 
physical requirements of his Military Occupational Specialty.  He was issued a permanent P3 
profile  and  referred  for  a  Medical  Evaluation  Board  (MEB).    The  MEB  forwarded  idiopathic 
generalized epilepsy to the Physical Evaluation Board (PEB) as medically unacceptable IAW AR 
40-501.    No  other  conditions  appeared  on  the  MEB’s  submission.    The  PEB  adjudicated  the 
generalized seizure disorder condition as unfitting, rated 10% with application of the Veteran’s 
Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals, and was medically 
separated with a 10% disability rating. 
 
 
CI CONTENTION:  “When I was separated from the military I was rated at 10% for only epilepsy. 
However, the VA has rated me at 40% for seizure disorder, grand mal.  Additionally, I am rated 
40% for traumatic brain injury and 10% for PTSD for an overall combined rating of 70%.” 
 
 
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.  Ratings for unfitting conditions will be reviewed 
in all cases.  The seizure disorder condition as requested for consideration meets the criteria 
prescribed in DoDI 6040.44 for Board purview and is addressed below.  The other requested 
traumatic  brain  injury  and  posttraumatic  stress  disorder  (PTSD)  conditions,  or  any  other 
conditions rated by the Department of Veterans’ Affairs (DVA) at the time of separation, are 
not within the Board’s purview.  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 the Correction of Military Records. 
 
 
RATING COMPARISON:   
 

VA (2 Mos. Pre-Separation) – All Effective Date 20061101 

Service PEB – Dated 20060828 
Condition 

Code 
8910 

Rating 
10% 

Generalized Seizure Disorder 

No Additional MEB/PEB Entries 

Combined:  10% 

Condition 

Seizure Disorder, Grand Mal 
Tinnitus 

Code 
8910 
6260 

Rating 
40% 
10% 

Exam 

20060824 
20060828 
20060824 

*VA decision 20100529 added traumatic brain injury at 40% and PTSD at 10%, effective 20091211; combined 70% 
 
 
 

 

0% X 1 / Not Service-Connected x 1 

Combined:  50%* 

ANALYSIS SUMMARY: 
 
Generalized  Seizure  Disorder  Condition.    On  23  August  2005  while  deployed  to  Iraq  the  CI 
experienced his first generalized seizure.  A post-ictal state characterized by several minutes of 
somnolence  and  confusion  ensued,  and  the  CI  had  no  memory  of  recent  days  or  of  events 
surrounding  the  seizure.    On  31  August  2005,  after  medical  evacuation  to  Kuwait,  a  second 
witnessed  generalized  seizure  occurred  and  anti-seizure  medication  was  begun.    Laboratory 
evaluation,  head  CT  scan  and  brain  magnetic  resonance  imaging  (MRI)  were  negative.    A 
subsequent electroencephalogram (EEG) showed abnormal brief bursts of epileptiform activity 
in the frontal regions during onset of drowsiness and hyperventilation testing.  In October 2005 
the CI stopped his medication, and in January 2006 he experienced an unwitnessed episode of 
loss of consciousness.  Anti-seizure medication was re-instituted on 5 January 2006, but due to 
side effects this medication was subsequently changed.  On 9 February 2006, during the period 
of  medication  transition,  a  witnessed  generalized  seizure  occurred  during  sleep.    At  the 
narrative summary (NARSUM) examination on 8 June 2006, 5 months prior to separation, the CI 
reported a 2-3 year history of very brief episodes of a fleeting “jolting” sensations lasting 1-2 
seconds,  and  that  these  episodes  continued  while  on  medication.    Their  frequency  was  not 
described and the examiner was not certain if they represented simple myoclonic jerks or were 
a manifestation of an absence-type seizure.  Examination revealed entirely normal neurologic 
findings.  In a memo to the PEB dated 23 August 2006, the NARSUM examiner stated that the 
last witnessed generalized seizure occurred on 9 February 2006.  The Department of Veterans’ 
Affairs (DVA) Compensation and Pension (C&P) examiner on 24 August 2006, 2 months before 
separation, referenced the grand mal seizures: “over the last 2 years, he has had 5 attacks in 
total,  averaging  1  each  month.”    The  dates  of  these  events  were  not  specified.    The  CI  also 
referred to episodes of momentary “mental black-outs” without associated falling or physical 
problems,  but  the  frequency  of  these  was  also  not  clarified.    The  CI  did  not  keep  a  diary  of 
events.  The neurologic and mental status examinations were normal. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and VA both used the 8910 code (epilepsy, grand mal), but assigned different ratings.  The 
Board must correlate the above clinical data with the VASRD §4.124 rating criteria which, for 
convenience, is excerpted below: 
 

Note (1): When continuous medication is shown necessary for the control of epilepsy, 
the minimum  evaluation will be 10 percent. This rating  will not be combined with any other rating for 
epilepsy. 
 
 

Note (2): In the presence of major and minor seizures, rate the predominating type. 

 
The Board notes that although the CI described episodes suggestive of possible minor seizures 
(“…  a  brief  interruption  in  consciousness  or  conscious  control…”),  these  events  were  of 

General Rating Formula for Major and Minor Epileptic Seizures: 
 
Averaging at least 1 major seizure per month over the last year………..…100 
Averaging at least 1 major seizure in 3 months over the last year;  

or more than 10 minor seizures weekly………………..…………………..80 

Averaging at least 1 major seizure in 4 months over the last year;  

or 9-10 minor seizures per week……………………………………………….60 

At least 1 major seizure in the last 6 months or 2 in the last year; 

or averaging at least 5 to 8 minor seizures weekly…………………….40 

At least 1 major seizure in the last 2 years; or at least 2 minor seizures 

in the last 6 months……………………………………………………………………20 
A confirmed diagnosis of epilepsy with a history of seizures …………………..10 
 
 

frequency. 

  The  Board  therefore  must  premise 

uncertain  etiology  and 
its  rating 
recommendation on the frequency of major seizures (i.e. generalized tonic-clonic convulsions 
with unconsciousness).  The PEB’s 10% rating appeared to be based on a conclusion that the 
condition  was  controlled  with  medication.    Although  the  VA  assumed the  occurrence  of  five 
seizures  during  the  year  prior  to  the  VA  examination,  this  frequency  was  not  deemed  to 
average “at least 1 major seizure in 4 months over the last year,” and thus did not justify a 60% 
rating.    A  rating  higher  than  the  VA’s  assigned  40%  required  “more  accurate  recording”  of 
witnessed events, in reference to the fact the CI did not keep a seizure diary.  The record shows 
that  the  first  two  seizures,  which  occurred  in  August  2005  while  deployed,  preceded  any 
treatment, were more than a year prior to separation.  There were two remaining generalized 
seizures reported.  The first of these was unwitnessed and occurred in January 2006 while the 
CI was not taking prescribed anti-seizure medication.  The second was witnessed and occurred 
in February 2006 while the CI was being transitioned from one medication to another.  This was 
the last generalized seizure in evidence and occurred greater than 6 months prior to the PEB 
and 9 months prior to separation.  The Board agreed that, during the year prior to separation, 
there  was  one  seizure  in  evidence  that  constituted  a  ratable  event  (February  2006)  under 
§4.124a.  Because the event reported to have occurred in January 2006 took place 2 months 
after discontinuing medication and was unwitnessed, members debated at length its value in 
the rating.  In this regard the Board was cognizant of §4.121 which, when determining seizure 
frequency, emphasizes the importance of lay testimony that notes convulsive activity and post-
convulsive  characteristics.    Furthermore, the  Board  concluded that  a  rating  recommendation 
should  be  premised  on  compliance  with  appropriate  treatment.    After  due  deliberation, 
considering  all  of  the  evidence  and  mindful  of  VASRD  §4.3  (reasonable  doubt),  the  Board 
recommends a disability rating of 20% for the generalized seizure 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.    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  generalized  seizure  disorder  condition,  the  Board 
unanimously recommends a disability rating of 20%, coded 8910 IAW VASRD §4.124a.  There 
were no other conditions within the Board’s scope of review for consideration. 
 
 
RECOMMENDATION:  The Board recommends that the CI’s prior determination be modified as 
follows, effective as of the date of his prior medical separation: 
 

UNFITTING CONDITION 

VASRD CODE  RATING 

Generalized Seizure Disorder 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120523, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 

8910 

COMBINED 

20% 
20% 

 
 
 
 
 

           XXXXXXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

 
 

 
 
 

 
 
 

 
 
 

 
 
 

 
 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB /  ), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for XXXXXXXXXXXXXXXXXXXXXXX, AR20120021440 (PD201200442) 
 
 
1.  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 to modify the individual’s disability rating to 20% without recharacterization 
of the individual’s separation.  This decision is final.   
 
2.  I direct that all the Department of the Army records of the individual concerned be corrected 
accordingly no later than 120 days from the date of this memorandum.    
 
3.  I request that a copy of the corrections and any related correspondence be provided to the 
individual concerned, counsel (if any), any Members of Congress who have shown interest, and 
to the Army Review Boards Agency with a copy of this memorandum without enclosures. 
 
 BY ORDER OF THE SECRETARY OF THE ARMY: 
 
 
 
 
Encl 
 
 
 
CF:  
(  ) DoD PDBR 
(  ) DVA 
 
 

     XXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)