RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXX	CASE:  PD-2013-01265
BRANCH OF SERVICE: NAVY	BOARD DATE:  20140422
SEPARATION DATE:  20040730

SUMMARY OF CASE:  The evidence of record indicates this covered individual (CI) was an active duty E03 (Equipment Operator) who was medically separated for asthma.  Symptoms began in late 2002 after the run portion of his Physical Readiness Test (PRT) and he was issued an Albuterol metered dose inhaler which improved his symptoms.  Later, though, he began to again have difficulty breathing when running.  This condition could not be adequately rehabilitated to meet the requirements of his rating or physical fitness standards, so he was referred for a Medical Evaluation Board (MEB), which forwarded the case to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E; no other conditions were submitted by the MEB.  The Informal PEB (IPEB) adjudicated “asthma” as unfitting, rated 10%; the CI made no appeals and was medically separated.

CI CONTENTION:  “I have a 10% rating on my back.  It has gotten worse; also, I won my social security benefits because of my back.”

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI.  The rating for the unfitting asthma condition is addressed below, but the contended back condition is not within the DoDI 6040.44 defined purview of the Board because it was not identified by the PEB.  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 Board for Correction of Naval Records.

RATING COMPARISON:

Service IPEB – Dated 20040621	VA - (4 Mos. Post-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	30%	20041104	
No Additional MEB/PEB Entries	Other x 3		
Combined:  10%	Combined:  30%	
Derived from VA Rating Decision (VARD) dated 20041215.

ANALYSIS SUMMARY:

Asthma Condition.  Available treatment records indicate exercise induced asthma was first documented in 2002.  Treatment notes from 2002 also reveal the CI was a smoker and was being taken through a smoking cessation regimen.  The CI continued to report shortness of breath despite Albuterol (corticosteroid) inhaler use as need.  In 2003, the CI failed the run portion of PRT and underwent pulmonary function tests (PFT) which were suggestive of small airway disease.  In February and March 2004, the CI had acute asthma exacerbations (not associated with physical activities) requiring albuterol nebulizer treatment and systemic steroids.  His asthma medications were documented as Flovent and Albuterol twice daily and Albuterol as needed.  The narrative summary dated 12 April 2004 notes the diagnosis of exercise induced asthma.  The examiner noted the CI had difficulty breathing (especially with running) despite Albuterol inhaler use.  The pulmonary examination was normal.  At the VA Compensation and Pension examination performed 4 months after separation, the CI reported a one and one half year history of asthma characterized as wheezing, shortness of breath and coughing.  His medications were listed as a steroid inhaler (Flovent) twice daily and Albuterol as needed.  He reported using Albuterol 2-3 times per day.  His pulmonary examination was normal.  A PFT dated 4 November 2004 documented an FEV1 of 59%.

The Board directs attention to its rating recommendation based on the above evidence. The IPEB adjudicated asthma as unfitting with a disability rating of 10%.  The VA rated the asthma condition at 30% for FEV1 of 59% and daily inhalational bronchodilator therapy.  Board members agreed the treatment records indicated daily use of a bronchodilator (at the time of separation) for supporting a 30% disability rating; no evidence was found to contradict this conclusion.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 30% for the asthma condition.

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 asthma condition, the Board unanimously recommends a disability rating of 30%, coded 6602 IAW VASRD §4.97.  There were no other conditions in the Board’s scope of review for consideration.

RECOMMENDATION:  The Board recommends that the CI’s prior determination be modified as follows, and that the discharge with severance pay be recharacterized to reflect permanent disability retirement effective the date of medical separation:

UNFITTING CONDITION	VASRD CODE	RATING	
Asthma	6602	30%	
COMBINED	30%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20130909, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

				
MEMORANDUM FOR COMMANDER, NAVY PERSONNEL COMMAND
		   DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS
	                          
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS          

Ref:   (a) DoDI 6040.44
       (b) PDBR ltr dtd 8 Dec 14 ICO XXXXXXXXXXXXXXX
	 (c) PDBR ltr dtd 15 Dec 14 ICO XXXXXXXXXXXXXXX 
	 (d) PDBR ltr dtd 10 Dec 14 ICO XXXXXXXXXXXXXXX
	 (e) PDBR ltr dtd 24 Dec 14 ICO XXXXXXXXXXXXXXX
       (f) PDBR ltr dtd 18 Dec 14 ICO XXXXXXXXXXXXXXX
       (f) PDBR ltr dtd 18 Dec 14 ICO XXXXXXXXXXXXXXX
	 (h) PDBR ltr dtd 12 Feb 15 ICO XXXXXXXXXXXXXXX
          
1.  Pursuant to reference (a) I approve the recommendations of the Physical Disability Board of Review set forth in references (b) through (h).

2.  The official records of the following individuals are to be corrected to reflect the stated disposition:

     a. XXXXXXXXXXXXXXX, former USMC: Placement on the Permanent Disability Retired List with a 40 percent disability rating effective date of discharge.

     b. XXXXXXXXXXXXXXX, former USN: Placement on the Permanent Disability Retired List with a 30 percent disability rating effective date of discharge.

     c. XXXXXXXXXXXXXXX, former USN: Placement on the Permanent Disability Retired List with a 40 percent disability rating effective date of discharge.

     d. XXXXXXXXXXXXXXX, former USMC:  Placement on the Permanent Disability Retired List with a 30 percent disability rating effective date of discharge. 

     e. XXXXXXXXXXXXXXX, former USMC: Placement on the Permanent Disability Retired List with a disability rating of 40 percent effective date of discharge.

     f. XXXXXXXXXXXXXXX, former USMC: Placement on the Permanent Disability Retired List with a disability rating of 40 percent effective date of discharge.

     f. XXXXXXXXXXXXXXX, former USMC: Disability separation with final disability rating of 20 percent (increased from 10%) effective date of discharge.

3.  Please ensure all necessary actions are taken to implement these decisions, including the recoupment of disability severance pay, if warranted, and notification to the subject members once those actions are completed.