RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00549
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060105

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

CI CONTENTION:  The CI requested a higher rating for the condition.  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 - 20051208	VARD - 20060224	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Heat Exhaustion with Rhabdomyolysis	7999-7900	0%	Rhabdomyolysis	5099-5025	0%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Heat Exhaustion with Rhabdomyolysis.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s rhabdomyolysis (breakdown of skeletal muscle fibers with leakage of muscle contents into the circulation) condition began in September 2005 while in boot camp.  The CI had muscle aches and pains and reported passing out twice.  The CI was hospitalized with elevated creatine kinase (CK) levels indicating muscle breakdown.  Diagnostic imaging of the brain was normal and there was no significant renal or hepatic compromise.  CK levels declined and the CI’s condition was stable with a plan for gradual reconditioning, but with a restriction from vigorous activity of more than 15 minutes and a one year restriction from running the APFT or wearing MOPP equipment.  
The CI could not return to training and was referred for MEB for “inability to complete physical training in accordance with regulations designed to prevent further injury should he stay in the Army.”  The MEB forwarded “rhabdomyolysis” for PEB adjudication.  The MEB NARSUM examination on 1 November 2005, 2 months prior to separation, noted the CI’s history of rhabdomyolysis and activity restrictions.  Physical examination was normal.  There was no VA Compensation and Pension evaluation in evidence.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the heat exhaustion with rhabdomyolysis condition 0%, coded analogous to 7900 (Hyperthyroidism [Table of analogous codes recommendation for heat injuries]), citing no renal compromise, normal imaging, normal lab values (CK), and normal exam.  The VA rated the rhabdomyolysis condition 0% coded analogous to 5025 (fibromyalgia [fibrositis, primary fibromyalgia syndrome]), based on the STRs.  The CI had no symptoms or permanent residuals from his episode of heat exhaustion with rhabdomyolysis, and there was no renal, muscular or other permanent residual on examination.  There was no tachycardia, tremor, or continuous medication required for control.  There was therefore no avenue to any higher rating than the 0% awarded by the PEB.  

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 heat exhaustion with rhabdomyolysis condition.  

BOARD FINDINGS:  In the matter of the heat exhaustion with rhabdomyolysis condition and IAW VASRD §4.71a, §4.73, and §4.119, the Board unanimously 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 re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150603, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20160018752 (PD201500549)

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