RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW
SEPARATION DATE: 20030728
NAME: XXXXXXXXXXX BRANCH OF SERVICE: ARMY
CASE NUMBER: PD1200904
BOARD DATE: 20121219
SUMMARY OF CASE: Data extracted from the available evidence of record reflects that the
covered individual (CI) was an Army National Guard PFC/E‐3 (63W0/Wheel Vehicle Mechanic),
medically separated for “rhabdomyositis post episode of rhabdomyolysis, with chronic back and
chest pain, without limitation of motion.” During the first week of basic training, the CI
collapsed in his bay after completing physical training and was hospitalized. Inpatient testing
revealed an assessment of rhabdomyolysis. The CI was issued a permanent P3 profile and
referred for a Medical Evaluation Board (MEB). In accordance with AR 40‐501, chapter 3‐46b,
the MEB found the CI’s condition medically unacceptable for service in the US Army. He was
then referred to a Physical Evaluation Board (PEB). In its referral, the MEB annotated back and
chest pain, secondary to the CI’s rhabdomyositis, for the PEB’s consideration. The PEB found
the CI’s condition unfitting for his “rhabdomyositis post episode of rhabdomyolysis, with
chronic back and chest pain, without limitation of motion.” The PEB rated the CI’s condition at
0%, with application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The CI
made no appeals, and was medically separated with a 0% disability rating.
CI CONTENTION: The application simply states, with no elaboration: (sic) “Because I have
reoccurring problems and symptoms with the condition that affect my job and home life. Most
employers won’t hire me because of this. That affects my family and living expenses.”
SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI
6040.44 (Enclosure 3, paragraph 5.e.(2) is limited to those conditions which were determined
by the PEB to be specifically unfitting for continued military service; and, when requested by
the CI, those condition(s) “identified but not determined to be unfitting by the PEB.”
Accordingly, the rating for the single specified unfitting condition of rhabdomyositis is
addressed below. Any conditions or contention not requested in this application, or otherwise
outside the Board’s defined scope of review, remain eligible for future consideration by the
Army Board for Correction of Military Records.
RATING COMPARISON:
Service PEB – Dated 20030529
Code
Rating
Condition
VA All Effective Date 20030729
Code
Rating
Exam
Condition
Rhabdomyositis Post
Episode of
Rhabdomyolysis, with
Chronic Back and Chest
Pain, Without Limitation
Of Motion
Combined: 0%
5099‐5021
0%
Rhabdomyositis
5099‐5025
0%
STR
Combined: 0%
ANALYSIS SUMMARY.
Rhabdomyositis Condition. During the first week of basic training the CI was admitted for “a
two day history of fatigue, dizziness, muscle aching particularly the chest and upper extremities
along with cramps in his lower extremities.” He was found to have an elevated creatinine
kinase level over 12,000 and was diagnosed with rhabdomyolysis. He was treated and
discharged. Seven months after the rhabdomyolysis episode, he continued to complain of
chest and lower back pain worse with motion. He was diagnosed with rhabdomyositis. At the
MEB exam performed 3 months prior to separation, the CI reported continued back and chest
pain with generalized headaches. The MEB physical exam noted that the CI was “standing and
walking without difficulty but showing signs of pain while standing from a sitting position.” The
exam was significant for tenderness to palpation at the lower back and sacral area with full
forward flexion, lateral flexion, and rotation. There were no abnormal cardiac or pulmonary
findings. The MEB radiographic evaluations were normal. There was no VA exam.
The Board directs attention to its rating recommendation based on the above evidence. The
PEB coded rhabdomyositis post‐rhabdomyolsis as 5099‐5021, analogous to myositis at 0%.
Myositis, is rated per the 5003 rating criteria which allows for compensation of pain limited
range‐of‐motion (ROM) that does not reach a compensable level under other limitation of
motion VASRD codes. The VA coded rhabdomyositis as 5099‐5025 at 0%, analogous to
fibromyalgia for widespread musculoskeletal pain, not requiring constant medication based on
the service treatment records. The Board deliberated if the examiner’s statement of showing
signs of pain when moving from a sitting to standing position indicated adequate evidence of
painful motion IAW VASRD §4.59 (painful motion). After due deliberation, considering all of the
evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability
rating of 10% for the rhabdomyolysis, with chronic back and chest pain condition, rated
analogously to 5099‐5021, myositis, for painful motion.
BOARD FINDINGS: IAW DoDI 6040.44, provisions of DoD or Military Department regulations or
guidelines relied upon by the PEB will not be considered by the Board to the extent they were
inconsistent with the VASRD in effect at the time of the adjudication. The Board did not
surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD
were exercised. In the matter of the rhabdomyositis post episode of rhabdomyolysis, with
chronic back and chest pain condition, the Board unanimously recommends a disability rating
of 10%, coded 5099‐5021 IAW VASRD §4.71a. There were no other conditions within the
Board’s scope of review for consideration.
RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as
follows, effective as of the date of his prior medical separation.
VASRD CODE RATING
10%
5099‐5021
COMBINED
10%
UNFITTING CONDITION
Rhabdomyositis post episode of rhabdomyolysis, with chronic back
and chest pain, without limitation of motion
2 PD1200904
The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20120608, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record
SFMR‐RB
XXXXXXXXXXXXX, DAF
President
Physical Disability Board of Review
MEMORANDUM FOR Commander, US Army Physical Disability Agency
(TAPD‐ZB / XXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA 22202‐3557
SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXX, AR20130000112 (PD201200904)
1. 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 to modify the individual’s disability rating to 10% without recharacterization
of the individual’s separation. This decision is final.
2. I direct that all the Department of the Army records of the individual concerned be corrected
accordingly no later than 120 days from the date of this memorandum.
3. I request that a copy of the corrections and any related correspondence be provided to the
individual concerned, counsel (if any), any Members of Congress who have shown interest, and
to the Army Review Boards Agency with a copy of this memorandum without enclosures.
BY ORDER OF THE SECRETARY OF THE ARMY:
Encl
XXXXXXXXXXX
Deputy Assistant Secretary
(Army Review Boards)
CF:
( ) DoD PDBR
( ) DVA
3 PD1200904
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