RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX	CASE:  PD-2013-01939
BRANCH OF SERVICE:  AIR FORCE	BOARD DATE:  20140724
Separation Date:  20050408

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SrA/E-4 (3P051/Security Forces Journeyman) medically separated for asthma.  The condition could not be adequately rehabilitated to meet the physical requirements of her Air Force Specialty or satisfy physical fitness standards.  She was issued a permanent P4 profile and referred for a Medical Evaluation Board (MEB).  The reactive airway disease, presently clinically asymptomatic condition, characterized as “medically unacceptable” and was forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123.  No other conditions were submitted by the MEB.  The Informal PEB adjudicated “asthma” as unfitting, rated 10% with cited application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.

CI CONTENTION:  The CI elaborated no specific contention in her application.

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; no additional conditions are within the DoDI 6040.44 defined purview of the Board.  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 Military Records.

RATING COMPARISON:

Service IPEB – Dated 20050131	VA - (4 Mos. Post-Separation)  -or- based on Service Treatment Records (STR)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	10%	20050820	
Other x 0 (Not in Scope)	Other x1 (Not in Scope)		
Combined:  10%	Combined:  10%	
Derived from VA Rating Decision (VARD) dated 20051027 (most proximate to date of separation)

ANALYSIS SUMMARY:

Asthma Condition.  The CI was diagnosed with asthma in June 2002 when she had an episode of shortness of breath (SOB) with wheezing while performing gate security.  She was taken via ambulance to the base emergency room (ER) and given an Albuterol nebulizer treatment.  The next day she was working at the gate and had a repeat SOB episode that did not resolve with use of the Albuterol inhaler.  The CI was treated at the ER again; she was given another albuterol nebulizer treatment and oral prednisone for 5 days.  The CI had a pulmonary function test (PFT) which demonstrated an FEV1-82.2% predicted and a FEV1/FVC 82%.  The pulmonologist diagnosed borderline obstructive airway disease.  A methacholine challenge test taken on 23 June 2004, demonstrated significant bronchial hyper–reactivity which was consistent with the diagnosis of asthma.  The MEB narrative summary examination (approximately 5 months prior to separation), documented that the CI had no further episodes of SOB or wheezing since 14 June 2002.  The lung examination was normal, with good air movement bilaterally and no wheezes.  The Albuterol inhaler was used only on an as needed basis and the CI was not prescribed any other asthma medication.  The examiner diagnosed asymptomatic reactive airway disease.  The commander’s statement noted that the CI was able to perform her duties despite her medical condition.  The VA Compensation and Pension examination (approximately 5 months post-separation), documented that the CI complained of chest tightness, wheezing and SOB which would last for less than 2 hours, approximately 6 times per month and occurred with exertion.  The symptoms would resolve with Albuterol inhaler use.  There were no PFT’s done at this exam.

The Board directs attention to its rating recommendation based on the above evidence.  The PEB and the VA chose the same disability code 6602 (asthma) and both rated the condition at 10%.  The CI was prescribed only Albuterol inhaler to use on an as needed basis and never required any additional asthma medication.  The PFT’s were an FEV1 pf 82% and an FEV1/FVC of 82%, and the CI required only intermittent inhalational or oral bronchodilator therapy; meeting the 10% rating criteria.  Considering the totality of the evidence and mindful of VASRD §4.3 (reasonable doubt), members agreed that a disability rating of 10% for the asthma condition was appropriately adjudicated by the PEB.

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 and IAW VASRD §4.97, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.

RECOMMENDATION:  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 20131024, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

SAF/MRB

Dear XXXXXXXXXXXXXXXXX:

	Reference your application submitted under the provisions of DoDI 6040.44 (Title 10 U.S.C. § 1554a), PDBR Case Number PD-2013-01939

	After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

	I have carefully reviewed the evidence of record and the recommendation of the Board.    I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Attachment:
Record of Proceedings