RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00953
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051022

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E6, Unit Supply Specialist, medically separated for “exertional rhabdomyolysis…” (breakdown of skeletal muscle fibers with leakage of muscle contents into the circulation) with a disability rating of 0%.  

CI CONTENTION:  The CI requested consideration of all conditions and included an attached memo indicating continued fatigue, malaise and muscle soreness without exertion.  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 on 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 - 20051003	VARD - 20140616	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Exertional Rhabdomyolysis	5099-5021	0%	Rhabdomyolisis	7599-7502	NSC	STR	
Low Back Pain	Not Unfitting	Lumbar Spine Condition	5237	NSC	STR	
Headache	Not Unfitting	No VA Placement	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NSC	

ANALYSIS SUMMARY:  

Exertional Rhabdomyolysis.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s rhabdomyolysis condition began in June 2005 while deployed to Kuwait.  There was no specific trauma, exceptional exercise exposure, or other heat injury symptoms, but the CI noted brown urine.  Evaluation showed elevated creatine kinase (CK) levels indicating muscle breakdown and the CI was medically evacuated from theater.  The MEB forwarded “rhabdomyolysis” for PEB adjudication.  

The MEB NARSUM examination on 1 August 2005, 3 months prior to separation, noted a chief complaint of rhabdomyolosis.  Physical examination showed that CK levels had declined and urinalysis was normal.  The CI had a normal gait with normal muscle strength and no abnormal findings relatable to rhabdomyolosis.  The physician stated the CI had completely recovered from his rhabdomyolysis, but that if the CI were placed back in an environment with significant heat stress that he would likely experience another episode of exertional rhabdomyolosis.  

The CI did not attend a VA Compensation and Pension (C&P) evaluation proximate to separation.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the exertional rhabdomyolysis condition 0%, coded 5099-5021 (myositis).  The VA denied the CI’s claim for service connection of the rhabdomyolysis condition, coded it 7599-7502 (chronic nephritis) based on STRs, citing there was no indication of a current disability.  The record did not demonstrate any permanent residuals from the rhabdomyolysis condition and there was no renal, muscular or other permanent residual on examination.  There was no pathology for alternative rating under code 7999-7900 (hyperthyroidism [Table of analogous codes recommendation for heat injuries]).  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 exertional rhabdomyolysis condition.  

Contended PEB Conditions:  Low Back Pain and Headache(s).  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  None of the conditions were profiled or implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions and so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the exertional rhabdomyolysis condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the contended low back pain and headache(s) 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.  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 20150605, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander

08 MAR 2017

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20170000893 (PD201500953)

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