RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00656
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050520

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E4, Radio Operator-Maintainer, medically separated for “asthma” with a disability rating of 10%.

CI CONTENTION:  “Review all conditions.”  The CI’s complete submission is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited 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.  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 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 Veterans Affairs Schedule for Rating Disabilities (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:

SERVICE PEB - 20050406	NO VA CLAIM FILED	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma with Intermittent use of Inhaled Steroids…	6602	10%	N/A	
COMBINED RATING:  10%	N/A	

ANALYSIS SUMMARY:

Asthma.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s asthma condition began in September 2003.  The CI was treated with Advair™ (inhalational anti-inflammatory/steroid) and albuterol (inhaled bronchodilator) which led to some decrease in his symptoms.  Despite treatment, the asthma condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and he was referred for an MEB.  The MEB forwarded “asthma existed prior to service, aggravated” for PEB adjudication.  At the MEB specialty care consult dated 4 February 2005, 3 months before separation, the CI reported significant shortness of breath and was unable to run and pass his Army Physical Fitness Test.  The examiner indicated that the CI was using his Advair occasionally and Albuterol weekly.  Examination documented wheezing.  An inhaled steroids (Advair) was prescribed for twice a day use, as well as an inhaled bronchodilator (Albuterol) on an “as needed” basis.  Pulmonary function testing (PFT) on 4 February 2005 (3 months prior to separation) showed an FEV-1 of 97% of predicted and an FEV-1/FVC of 85% (essentially normal).  The NARSUM dated 8 March 2005, 2 months prior to separation, indicated the CI used (inhaled) medications of Advair and Albuterol.  Lung examination was normal with full breath sounds and no wheezing.  Review of the service treatment record (STR) showed several clinical encounters in evidence documenting the use of an inhaled steroid (anti-inflammatory) medication for asthma during the year prior to separation.  There was no evidence in the STR that asthma exacerbations were frequent enough to require monthly visits to a physician or at least three episodes of systemic corticosteroids in the last year.  There were no VA Compensation and Pension (C&P) examinations or VA rating decisions in the record.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 10% (coded 6602) citing intermittent use of inhaled steroids.  In its deliberations, the members considered the issue of whether the requirement for daily bronchodilator and/or routine anti-inflammatory therapy was met in this case, as that is the pivotal criteria between a 10% or 30% rating IAW VASRD §4.97.  A 30% rating stipulates “daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication.”  The 30% criteria do not stipulate a requirement for daily use of inhalational anti-inflammatory medication.  Board members considered that all of the examinations in evidence reported at least episodic use of inhalational anti-inflammatory medication (Advair/steroid).  Board members agreed that the VASRD §4.97 threshold for a 30% rating was reasonably satisfied in this case on the basis of inhalational anti-inflammatory medication use.  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, coded 6602.

BOARD FINDINGS:  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.

The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Asthma with Intermittent use of Inhaled Steroids…	6602	30%	
COMBINED	30%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150604, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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 XXXXXXXXXXXXXXXXXX, AR20160013339 (PD201500656)

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 re-characterize 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