RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-00018
BRANCH OF SERVICE:  AIR FORCE	BOARD DATE:  20150611
Separation Date:  20060127

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-5, Fighter Aircraft Maintenance Journeyman medically separated for asthma.  The condition could not be adequately rehabilitated to meet the physical requirements of his Air Force Specialty or satisfy physical fitness standards.  He was issued a temporary L4 profile and referred for a Medical Evaluation Board (MEB).  The “asthma” was forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123.  No other condition was submitted by the MEB.  The Informal PEB adjudicated “asthma” as unfitting, rated 10%, citing application of Department of Defense Instruction (DoDI) 1332.39/Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.

CI CONTENTION:  “Due to service-connected disabilities I am now rated at 80% by the V. A.  Since separation from the Air Force I have been seen almost monthly for over 8 years by various doctors and specialists.  My service-connected disabilities that resulted in my being discharged have severely impacted nearly all aspects of my life.”

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 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/Naval 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 confined to review of medical records and all available evidence for application of the 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:

IPEB – Dated 20051213	VA* - (~3 Mos. Post-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	30%	20060413	
Overweight	Category III	Other x 1	
RATING: 10%	RATING:  50%	
*Derived from VA Rating Decision (VARD) dated 20060901 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:

Asthma Condition.  The CI was diagnosed with asthma in 2005 after developing wheezing and difficulty breathing.  He was initially started on an inhaled bronchodilator (Albuterol) as needed.  A provocholine challenge pulmonary function test (PFT) confirmed the diagnosis of asthma in October 2005 with otherwise normal PFT values.  The CI was started on Advair™ (an inhalational anti-inflammatory and bronchodilator medication; fluticasone/salmeterol) twice daily in November 2005.

The MEB narrative summary exam, approximately 2 months prior to separation, documented that the CI had some mild exacerbations when he worked with composite fiber materials and when he exercised (with occasional symptoms at rest).  He used his inhaled Advair as prescribed and needed to use his Albuterol inhaler approximately once daily.  The examiner noted that the CI was incompletely controlled on his current treatment regimen.  The examiner increased the strength of the CI’s Advair to increase the CI’s control of symptoms.

The VA Compensation and Pension exam approximately 3 months after separation documented that the CI’s treatment regimen was Advair twice daily and Albuterol as needed.  Chest exam was normal and the exam referenced normal PFTs performed in March 2006.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB coded the asthma condition as 6602 and rated at 10%.  The VA coded the asthma condition as 6602 and rated at 10%.  All evidence proximate to separation documented that the CI was compliant with his daily use of inhalational anti-inflammatory medication (Advair) and used Albuterol (as needed) approximately daily.

The Board agreed that the CI’s use of daily Advair met the 30% rating criteria of use of “inhalational anti-inflammatory medication.”  The CI had not been hospitalized, had not required courses of systemic steroids, or required at least monthly visits to a physician for required care of exacerbations that may have supported any rating higher than 30%.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 30% for the asthma condition IAW §4.100.

Contended PEB Conditions.  The contended condition adjudicated as not unfitting by the PEB was “Overweight.”  The Board’s first charge with respect to this condition is an assessment of the appropriateness of the PEB’s adjudication.  The Board’s threshold for countering fitness determinations is preponderance of the evidence but remains adherent to the DoDI 6040.44 “fair and equitable” standard.  IAW DoDI 1332.38, E5, Obesity (overweight) is not a condition constituting a physical disability and is not compensable or ratable.  The Board adjudged that the condition was appropriately indicated as a Category III 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.  As discussed above, PEB reliance on DoDI 1332.39 for rating the asthma condition was operant in this case and the condition was adjudicated independently of that instruction by this Board.  In the matter of the asthma condition, the Board unanimously recommends a disability rating of 30%, coded 6602 IAW VASRD §4.100.  In the matter of the contended overweight condition, the Board unanimously recommends no change from the PEB determination as not unfitting.  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; and, that the discharge with severance pay be recharacterized to reflect permanent disability retirement, effective as of the date of his prior medical separation:

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

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20131218, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

XXXXXXXXXXXXXXXXXXXX
President
Physical Disability Board of Review

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

Dear XXXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2014-00018.

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 not appropriate under the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended your separation be re-characterized to reflect disability retirement, rather than separation with severance pay.

I have carefully reviewed the evidence of record and the recommendation of the Board.    I concur with that finding, accept their recommendation and determined that your records should be corrected accordingly.  The office responsible for making the correction will inform you when your records have been changed.

As a result of the aforementioned correction, you are entitled by law to elect coverage under the Survivor Benefit Plan (SBP).  Upon receipt of this letter, you must contact the Air Force Personnel Center at (210) 565-2273 to make arrangements to obtain an SBP briefing prior to rendering an election.  If a valid election is not received within 30 days from the date of this letter, you will not be enrolled in the SBP program unless at the time of your separation, you were married or had an eligible dependent child, in such a case, failure to render an election will result in automatic enrollment.

Sincerely,

XXXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings

cc:
SAF/MRBR
DFAS-IN