RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00476
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050218

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Basic Trainee, medically separated for “heat intolerance manifested by rhabdomyolysis,” with a disability rating of 0%.  

CI CONTENTION:  The CI contends his condition continues to affect his activities of daily living.  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is based upon a review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.

RATING COMPARISON:  

SERVICE PEB - 20050920	VARD - 20051013	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heat Intolerance Manifested by Rhabdomyolysis	7999-7900	0%	Rhabdomyolysis	5099-5025	0%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Heat Intolerance Manifested by Rhabdomyolysis.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI experienced a heat-related injury with an apparent brief loss of consciousness (LOC) while performing physical training on 25 July 2005.  Emergent evaluation revealed the CI’s heat condition had progressed to Rhabdomyolysis (severe form of muscle breakdown) and was treated accordingly.  The CI’s recovery was uneventful and he developed no medical complications from the condition.  He was placed on a P3 profile and referred for an MEB in September 2005.  

At the NARSUM examination, performed on 26 August 2005, (1 month prior to separation) the CI reported body “soreness,” but maintained the ability to “perform all range of motion and muscle activities of daily living.”  His physical examination (PE) was normal except for a pulse rate of 54 beats per minute (bradycardia).  His blood pressure was 126/77; equating to a normal pulse pressure of 49 ([126 minus 77 = 49] normal range = 40-60).  All prior abnormal laboratory parameters returned to normal.  He was not taking any form of continuous medication.  The provider noted that the CI “can do routine clerical work or routine in-door activities inside of air conditioning.”  There was no VA Compensation and Pension (C&P) examination contained in the case file and therefore, this Board’s final rating recommendation will be based upon the STR and MEB NARSUM documentation.  

The Board directed attention to its rating recommendation based on the above evidence.  Although utilizing different VASRD codes, both the PEB and VA analogously rated the condition at 0%.  The PEB’s primary code was 7900 (hyperthyroidism) whereas the VA used 5025 (fibromyalgia).  There is not a specific VASRD code for heat-related injury such as rhabdomyolysis; and, the PEB’s 7900 thyroid code is often analogized for such a condition.  Board members considered that in the absence of abnormal functional residuals, persistent abnormal vital signs, or the use of medication, the heat-related condition was of mild severity.  Board members agreed that the analogized VASRD 7900 code most accurately depicted the CI’s past condition.  The Board is unable to find any pathway to a higher rating than the PEBs 0%.  The 7900 at 10% criteria is not applicable in this case by the absence of a fast heartbeat; an associated tremor, or medication to control such symptoms.  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’s adjudication for the rhabdomyolysis heat-related condition.  

BOARD FINDINGS:  In the matter of the rhabdomyolysis condition and IAW VASRD §4.119, the Board unanimously or majority recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  The Board, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150601, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXXXXX, AR20170000140 (PD201500476)

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:

Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA