RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03288
BRANCH OF SERVICE:  AIR FORCE	BOARD DATE:  20141009
SEPARATION DATE:  20040809 

SUMMARY OF CASE:  The available evidence of record reflects that this covered individual (CI) was an active duty SRA/E-4 (2A551L/Aerospace Maintenance Journeyman) medically separated for an asthma condition.  The condition could not be adequately rehabilitated to meet the requirements of his Air Force Specialty or physical fitness standards.  He was issued a temporary P4 profile and referred for a Medical Evaluation Board (MEB).  Asthma was forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123.  No other conditions were submitted by the MEB.  The Informal PEB (IPEB) adjudicated asthma as category I (unfitting) rated 10% with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  Additionally, the IPEB adjudicated seasonal allergic rhinitis as category II (unfitting, but not compensable or ratable) and tobacco abuse as category III (not separately unfitting and not compensable or ratable).  The CI did not appeal and was medically separated.

CI CONTENTION:  “Please consider all conditions.”

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 category I asthma condition and contended category II allergic rhinitis are addressed below; while the category III tobacco abuse condition does not constitute a physical disability and is not compensable or ratable.  Any condition or contention not requested in this application, or otherwise outside the Board’s defined scope of review, remains eligible for future consideration by the Board for Correction of Military Records.

IAW DoDI 6040.44, the Board’s authority is limited to making recommendations on correcting disability determinations.  The Board’s role is thus confined to the review of medical records and all evidence at hand to assess the fairness of PEB rating determinations, compared to VASRD standards, based on ratable severity at the time of separation.

RATING COMPARISON:

Service IPEB – Dated 20040518	VA* - (4 Yrs. Post-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	0%	20080717	
Seasonal Allergic Rhinitis	Category II	No VA Entry	
Tobacco Abuse	Category III	No VA Entry	
Other x 0 (Not in Scope)	Other x 3 	
Rating:  10%	Rating:  0%	
*Derived from original VA Rating Decision (VARD) dated 20080904 (most proximate to the date of separation (DOS))

ANALYSIS SUMMARY:

Asthma Condition.  According to the MEB narrative summary (NARSUM) on 9 April 2004, the CI was diagnosed with asthma and treated with an inhaled bronchodilator medication as needed.  The NARSUM noted that exposure to jet fuels seemed to trigger his symptoms which were easily alleviated with inhaled bronchodilator.  The CI reported using the inhaled bronchodilator approximately twice per week.  He was not treated with inhaled anti-inflammatory medication or oral bronchodilator medications.  Pulmonary function tests on 16 February 2004, were normal (FVC 106% of predicted normal, FEV1 107% of predicted normal, and FEV1/FVC ratio of 80%).  There was no VA Compensation and Pension (C&P) examination until 17 July 2008, 4 years after separation.

The Board directs attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 10% (coded 6602, bronchial asthma).  The VA rated the asthma 0%, based on the C&P examination 4 years after separation.  At the time of separation, the CI’s asthma condition met the VASRD guidelines (6602) for the 10% rating based on intermittent inhalational bronchodilator therapy as well as the FEV1/FVC ratio.  The spirometry results and treatment did not support a rating higher than the 10% adjudicated by the PEB.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the asthma condition.

Contended PEB Condition.  The Board’s main charge is to assess the fairness of the PEB’s determination that the allergic rhinitis condition was not unfitting.  The Board’s threshold for countering fitness determinations requires a preponderance of evidence and is higher than the VASRD §4.3 (reasonable doubt) standard used for its rating recommendations, but remains adherent to the DoDI 6040.44 “fair and equitable” standard.  The allergic rhinitis condition was noted to be present since age seven.  Review of service treatment records do not reflect symptoms that were severe enough to interfere with duties.  The allergic rhinitis condition was not profiled or implicated in the commander’s statement and was not referred by the MEB (although it was listed by the PEB).  The contended condition was reviewed and considered by the Board.  There was no performance-based evidence from the record that the condition interfered with satisfactory duty performance.  After due deliberation, and in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the allergic rhinitis.  The Board concluded therefore that this condition could not be recommended for additional disability rating.

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.  In the matter of the asthma condition, and IAW VASRD §4.97, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the contended allergic rhinitis condition, the Board unanimously recommends no change from the PEB determinations as not unfitting.  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 20140701, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

		
XXXXXXXXXXXXXXXXXX
President
DoD Physical Disability Board of Review

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

Al XXXXXXXXXXXXXXXXXX

Dear XXXXXXXX:

	Reference your application submitted under the provisions of DoDI 6040.44 (Title 10 U.S.C. § 1554a), PDBR Case Number PD-2014-03288.

	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.

			Sincerely,

XXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings