ARECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-00073
BRANCH OF SERVICE:  Army  	SEPARATION DATE:  20060904

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-5 (Mental Health Specialist) medically separated for asthma.  This condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty.  He was issued a permanent P3U2 profile and referred for a Medical Evaluation Board (MEB).  “Asthma” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  The MEB also identified and forwarded one medically acceptable condition (right shoulder pain) for PEB adjudication.  The Informal PEB adjudicated asthma as unfitting rated 10%, with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The PEB did not specifically address the right shoulder condition, presumably because it did not fail retention standards and was profiled U2.  The CI submitted a rebuttal to the PEB regarding his asthma condition only.  The PEB affirmed the original findings and recommendation; the CI concurred and was medically separated.  

CI CONTENTION:  The applicant makes no specific contention in his application.  His complete submission is at Exhibit A.

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 20060719	VA* - (~10 Mos. Post-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	30%	20070612	
Other MEB/PEB Conditions x 1 (Not In Scope)	Other X 9 	
RATING:  10%	COMBINED RATING:  50%	
*Derived from VA Rating Decision (VARD) dated 20070920 (most proximate to date of separation (DOS)).  

ANALYSIS SUMMARY:  
Asthma.    At a pulmonary function test evaluation dated 29 June 2006 noted that the CI was diagnosed with asthma in 2004 via a positive response to bronchodilators.  At this evaluation the CI reported night time asthma symptoms 1-2 times per week requiring the use of albuterol (inhaled corticosteroid) and continued daily use of preventive medications (Advair [inhaled corticosteroid/anti-inflammatory/bronchodilator], Singulair [prevents bronchoconstriction]) with good control.  Pre and post bronchodilator pulmonary function tests were normal.  The narrative summary (NARSUM) noted a diagnosis of severe persistent reactive airway disease treated with daily Advair and as need albuterol.  The pulmonary examination was normal.  

The VA Compensation and Pension examination performed 10 months after separation, noted a diagnosis of asthma and continued use of bronchodilator and inhaled anti-inflammatory medications.     

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition at 10% citing that the medication profile was consistent with intermittent use of a bronchodilator, coded 6602 (Asthma).  VA rated the condition at 30%, coded 6602.  The Board considered whether the evidence supported a higher than 10% rating.  The NARSUM and VA examinations documented daily use of an inhalational bronchodilator therapy or inhalational anti-inflammatory medication which met criteria for a 30% rating.  There was no evidence of systemic corticosteroid use or asthma exacerbation requiring monthly medical visits for a higher rating.  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.  

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 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 re-characterized to reflect permanent disability retirement, effective as of the date of his prior medical separation:  

CONDITION	VASRD CODE	RATING	
Asthma	6602	30%	
RATING	30%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20131223, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB																		

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation 
for XXXXXXXXXXXXXXXXX, AR20160001836 (PD201400073)

1.  Under the authority of Title 10, United States Code, section 1554(a), I approve the enclosed recommendation of the Department of Defense Physical Disability Board of Review (DoD PDBR) pertaining to the individual named in the subject line above to recharacterize the individual’s separation as a permanent disability retirement with the combined disability rating of 30% effective the date of the individual’s original medical separation for disability with severance pay.  

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:

	a.  Providing a correction to the individual’s separation document showing that the individual was separated by reason of permanent disability retirement effective the date of the original medical separation for disability with severance pay.

	b.  Providing orders showing that the individual was retired with permanent disability effective the date of the original medical separation for disability with severance pay.

	c.  Adjusting pay and allowances accordingly.  Pay and allowance adjustment will account for recoupment of severance pay, and payment of permanent retired pay at 30% effective the date of the original medical separation for disability with severance pay.

	d.  Affording the individual the opportunity to elect Survivor Benefit Plan (SBP) and medical TRICARE retiree options.

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:

			      
						      					
Enclosure
					
CF: 
(  ) DoD PDBR
(  ) DVA