RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03429
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20030825

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Fire Support Specialist, medically separated for “recurrent rhabdomyolysis” with a disability rating of 0%.   

CI CONTENTION:  The VA rated the CI higher.  The 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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20030711	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Recurrent Rhabdomyolysis	5099- 5021	0%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Recurrent Rhabdomyolysis.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s rhabdomyolysis (damage and breakdown of skeletal muscles) began in July 2001 when he was hospitalized for a total of five days, for severe muscle aches, elevated blood levels of muscle enzymes and dark urine.  Over the following 19 months, he had four additional episodes; each was associated with an infection (strep throat or skin infection) and/or increased physical activity.  The final episode prior to separation occurred in February 2003 and resulted in a very restrictive permanent profile that prohibited strenuous activity such as physical training, ruck marching, wearing MOPP (chemical warfare defense gear), Kevlar helmet, flack vest or being exposed to significant heat.  Each episode resolved and the CI was without symptoms between episodes.  
During the 14 January 2003 MEB examination (recorded on DD Forms 2807-1 and 2808), 7 months prior to separation, the CI reported multiple episodes of rhabdomyolysis but without current symptoms.  Physical examination revealed multiple scars on the right upper back and neck secondary to previous incision and drainage of abscesses.  Examination of all other body parts was marked as normal.  

The 9 June 2003 MEB NARSUM examination, 2 months prior to separation, noted no current complaints.  He was stable and denied any pain, discomfort or abnormal urine.  Physical examination referenced the 14 January 2003 MEB evaluation and added the CI had “a few furuncles (boils) on the arm and right shoulder.”  There was no VA examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the rhabdomyolysis 0%, analogously coded 5099-5021 (myositis), citing no limitation of motion.  The panel noted there were no residual complaints or examination findings between episodes or at separation and no medications were required for control.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the rhabdomyolysis.  

BOARD FINDINGS:  In the matter of the recurrent rhabdomyolysis and IAW VASRD §4.71a and §4.73, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends 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 20170317, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180008984, 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,					      
Enclosure