RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01649
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20071107

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Multichannel Transmission Systems Operator-Maintainer, medically separated for “exertional rhabdomyolysis” with a disability rating of 0%.

CI CONTENTION:  The CI is “seeking service connection for rhabdomyolysis and HIV-related progressive multifocal leukoencephalopathy.”  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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(s) at the time of separation.  The panel 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 panel 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 - 20070823	VARD - 20150611	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Exertional Rhabdomyolysis	7999-7900	0%	Rhabdomyolysis	7599-7540	NSC	20150609	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  100%	

ANALYSIS SUMMARY:  

Rhabdomyolysis.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI had a possible heat injury in basic training in 1997 and another while deployed in 2003.  In August 2005, the CI sustained heat stroke and rhabdomyolysis (a break-down in skeletal muscle and a complication of a heat injury).  He recovered from the heat injury, but was not able to return to full activities due to recurrent symptoms with significant exertion in a hot environment.  The CI reported intolerance to ambient temperatures over 80 degree Fahrenheit.  The MEB NARSUM examination on 8 August 2007, 3 months prior to separation, noted that the CI remained asymptomatic if his activities were severely curtailed; these limitations were not compatible with military service.  The physical examination was unremarkable.  Laboratory studies showed resolution of the heat injury and subsequent rhabdomyolysis.  The VA compensation and pension (C&P) examination was not performed until almost 8 years after separation and is too remote to be probative for rating at separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the exertional rhabdomyolysis condition 0%, coded 7999-7900 (analogous to hyperthyroidism).  The VA determined that the rhabdomyolysis condition was not service-connected, coded 7599-7540 (disseminated intravascular coagulation), based on the VA examination remote from separation.  The panel observed that there is not a specific code for either heat stroke or rhabdomyolysis in the VASRD.  While the CI was limited in his activities, there was no evidence found of residual physical impairment or laboratory findings at separation.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the exertional rhabdomyolysis condition.  

BOARD FINDINGS:  In the matter of the exertional rhabdomyolysis condition and IAW VASRD §4.73 and §4.119, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, 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 20150610, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170008733, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,