RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02233
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070610

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a National Guard E4, Combat Engineer, medically separated for “Guillain-Barre Syndrome,” with a  disability rating of 10%.  

CI CONTENTION:  The CI made no specific contention.  His 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 - 20070425	VARD – No VA Claim	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Guillain-Barre Syndrome	8099-8011	10%	No VA Claim	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: N/A	

ANALYSIS SUMMARY:  

Guillain-Barre Diagnosis.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s Guillain-Barre condition began in June 2005 after suffering heat exhaustion during an active duty training period.  The CI was admitted to the hospital where his condition worsened, resulting in paralysis.  He was discharged to outpatient rehabilitation in mid-August.  In May 2006, the CI was released back to work; however, in 2-3 weeks, after working outside, his symptoms recurred.  The CI was placed on a profile, but by September 2006 he had no further improvement and it was determined he had reached maximal medical improvement.  A nerve conduction study showed a very slight residual lower extremity demyelinating neuropathy.  The MEB forwarded “Guillain-Barre” for PEB adjudication.  At the 31 July 2006 physical medicine evaluation (performed by a physician who specializes in rehabilitation from nerve injuries), 10 months before separation, the CI reported some residual hip flexor weakness and heat intolerance.  Physical examination revealed minimal bilateral hip flexor muscle weakness and on-going fatigability.  The examiner opined that he was unfit for duty, military or civilian.  At the MEB examination (recorded on DD Forms 2807 and 2808) dated 30 January 2007, 5 months prior to separation, the CI reported no specific current complaints.  Physical examination revealed full range of motion (ROM) and strength in his upper and lower extremities.  The CI’s gait, sensory examination, and reflexes were normal.  The MEB NARSUM examination on 6 February 2007, 4 months prior to separation, noted complaints of recurring symptoms of heat exhaustion when required to work outside in a hot environment.  There was no VA Compensation and Pension (C&P) evaluation within the evidence.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the Guillain-Barre condition 10%, analogously coded 8099-8011 (poliomyelitis, anterior), citing minimal right lower extremity demyelinating neuropathy.  The CI did not file a VA claim, therefore the Guillain-Barre condition was not rated by the VA.  The Board noted that the 8011 code has a minimum rating of 10% and allows for the rating of residuals.  The residuals of the CI’s Gillian-Barre condition were heat intolerance and right lower extremity weakness; however as noted, lower extremity strength had been found to be normal and a rating for heat intolerance analogous to 7900 (hyperthyroidism) would not have resulted in a higher than 10% rating.  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 Guillain-Barre condition.  

BOARD FINDINGS:  In the matter of the Guillain-Barre condition and IAW VASRD §4.71a, 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 20150727, 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, AR20160018777  (PD201502233)

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