RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE: PD-2015-00537
BRANCH OF SERVICE:  Marine Corps	SEPARATION DATE:  2008-05-15

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty Marine Corps  Recruit, medically separated for “Obstructive Lung Process” with a  disability rating of 10%.  

CI CONTENTION:  The CI made no specific contention.  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned to those conditions determined by the Physical Evaluation Board (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 or non-compensable.  Any conditions outside the panel’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 Records.  Furthermore, the panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition(s) at the time of separation.  The panel 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 panel 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:  

SERVICE PEB - 20080325	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Obstructive Lung Process	6699-6602	10%		
Left Sided Plural Effusion	Cat II	No VA Exam in Evidence	
Status Post Chest Tube Insertion			
Status Post Pneumonia			
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Obstructive Lung Process:  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s obstructive lung process condition began in July 2007 following a 17-day hospitalization for treatment and complications of pneumonia.  Primary Care Clinic (PCC) notes, as early as October 2007, contained in the CI’s file documented that the CI was prescribed the use of 2 inhalation/bronchodilator medications, which were Salmeterol Xinafoate 50 mcg + Fluticasone Propionate 100 mcg for daily use, twice per day and Albuterol Sulfate HFA Aerosol Powder 90 mcg Inhalation as needed.
The 14 January 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of chronic dyspnea following pneumonia.  The CI stated that he wheezed, had shortness of breath and used an inhaler daily.  The CI reported that he was unable to complete the running phase of the IST, despite a 5 month period of re-conditioning.  The CI stated that he developed shortness of breath at approximately ¼ mile and had minimal nocturnal shortness of breath.  Pulmonary Function Testing (PFT), performed on 13 November 2007, continued to demonstrate obstructive pattern.  Physical auscultation of the lungs was normal.  Radiography of the chest, performed 10 December 2007, showed increased markings of both lower lung field and blunting and thickening of the left costophrenic sulcus (unchanged pleural effusion versus scarring).  The examiner opined “obstructive lung process, status post pneumonia left sided pleural effusion with chest tube insertion.”  There was no VA examination in evidence proximate to separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the obstructive lung process condition 10% coded 6699-6602 (Asthma, bronchial).  The panel considered the CI was prescribed daily use of at least one bronchodilator which met criteria for a rating of 30% but not higher due to the use of an inhalation or bronchodilator daily.  The CI did not meet criteria fora rating higher, 60%, for an FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 30% for the obstructive lung process condition, coded 6699-6602.  

BOARD FINDINGS:  In the matter of the obstructive ling process condition, the panel unanimously recommends a disability rating of 30% coded 6699-6602 IAW VASRD §4.97.  There were no other conditions within the panel’s scope of review for consideration.  

The panel 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 the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Obstructive Lung Process	6699-6602	30%	
COMBINED	30%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 4/24/2020 w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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

Ref:  (a) DoDI 6040.44
	(b) PDBR ltr dtd 23 May 17 XXXXXXXXXXXXXXXXXX 
	(c) PDBR ltr dtd 26 May 17 XXXXXXXXXXXXXXXXXX
	(d) PDBR ltr dtd 15 Jun 17 XXXXXXXXXXXXXXXXXX 
	(e) PDBR ltr dtd 08 Jun 17 XXXXXXXXXXXXXXXXXX
      (f) PDBR ltr dtd 16 May 17 XXXXXXXXXXXXXXXXXX

1.  Pursuant to reference (a), the recommendations of the Physical Disability Board of Review set forth in references (b) through (f) are approved.  The official records of the following individuals are to be corrected to reflect the stated disposition below:

     a. XXXXXXXXXXXXXXXXXX, former USMC: Placement on the Permanent Disability Retired List with a 30 percent rating (increased from 10 percent) effective date of discharge.

     b. XXXXXXXXXXXXXXXXXX, former USMC: Entitlement to disability separation pay with a 20 percent disability rating (increased from 10 percent) effective date of discharge.

     c. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 20 percent disability rating (increased from 10 percent) effective date of discharge.

     d. XXXXXXXXXXXXXXXXXX, former USMC: Placement on the Permanent Disability Retired List with a 30 percent rating (increased from 10 percent) effective date of discharge.

     e. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 20 percent disability rating (increased from 10 percent) effective date of discharge.   
     
3.  Please ensure all necessary actions are taken to implement these decisions including notification to the former members once those actions are complete.