RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01028
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050526

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3 Air Traffic Control Operator Specialist Trainee, medically separated for “shortness of breath on exertion,” with a disability rating of 0%.

CI CONTENTION:  The CI contends a shoulder condition not adjudicated by the MEB or PEB.  The CI’s 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 - 20050518	VARD – N/A	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Shortness of Breath on Exertion	6699-6602	0%	No VA Examination in Evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

ANALYSIS SUMMARY:  

Shortness of Breath on Exertion.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI had a history of childhood allergies for which he took an inhaler, but did not use medications at the time of accession.  In February 2004, 4 months after accession and while in advanced infantry training, the CI developed shortness of breath on exertion following an upper respiratory infection.  He was issued a bronchodilator inhaler (Albuterol), but this was not sufficient.  His symptoms persisted despite resolution of the infection.  Pulmonary function tests (PFTs) on 6 July 2004 were normal although there was a mild response to a bronchodilator.  A methacholine challenge test was then done on 14 July 2004 and was normal.  The CI was then referred to mental health to evaluate for possible anxiety.  No Axis I diagnosis was given.  However, there were Axis II traits consistent with those found in malingering although there was no conclusive evidence of this.  It was recommended that his medical diagnosis be reconsidered.  A chest X-ray on 8 September 2004 was normal.  The CI was then evaluated in pulmonary medicine on 10 November 2004.  His examination was unremarkable and repeat PFTs were normal.  The diagnosis of asthma could not be made.  The CI was referred for an MOS medical retention board (MMRB) , but then returned to duty to complete his evaluation as there was no diagnosis to explain the shortness of breath (a symptom, not a diagnosis).  On 6 January 2005, the CI requested convalescent leave to pursue his own work out schedule.  The request was denied.  Repeat spirometry on 8 April 2005 showed a minimal obstructive defect as shown by a bronchodilator response.  The FVC and FEV1/FVC were nonetheless normal at 114% and 89, respectively, after bronchodilators (the pre-bronchodilator values were also normal).  A repeat chest X-ray a few days later was also normal.  

During the MEB examination (recorded on DD Forms 2807 and 2808) dated 12 May 2005, 2 months prior to separation, the CI reported trouble breathing since he had pneumonia.  The physical examination was normal.  The MEB NARSUM examination on 2 May 2005, 1 month prior to separation, noted that the CI was taking Albuterol as needed.  The panel observed that a medication profile dated 21 march 2005 indicated that the last time this had been filled was on 28 September 2004 when he was issued 2 inhalers.  The above history was summarized.  It was noted that no etiology for his shortness of breath with mild exertion had been found.  The panel observed that the 66 inch CI weighed 176 pounds, a decrease from the accession weight of 187, but an 8 pound increased from the air traffic control physical in June 2004.  His physical examination was otherwise normal.  He was noted to have shortness of breath without a specific diagnosis.  There was not a VA Compensation and Pension (C&P) examination in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the shortness of breath on exertion condition 0%, coded 6699-6602 (analogous to asthma) noting normal spirometry and a normal methacholine challenge test.  There was no VA rating in evidence.  The panel considered the evidence.  It noted that the CI initially requested an MEB in order to separate from the US Army, the concern for malingering by the mental health examiner, and the negative methacholine challenge test.  The pulmonologist stated that the diagnosis of asthma could not be made.  The panel also observed that the 66 inch CI weighed 176 pounds suggesting that deconditioning might explain the shortness of breath with exertion, at least in part.  However, the PEB analogously used the code for asthma and an inhaled bronchodilator was prescribed for use as needed.  This supported a 10% rating IAW VASRD §4.100.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the shortness of breath with exertion condition, coded 6699-6602.  

BOARD FINDINGS:  In the matter of the shortness of breath with exertion condition, the panel recommends a disability rating of 10%, coded 6699-6202 IAW VASRD §4.71a.  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, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Shortness of Breath with Exertion	6699-6602	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150609, w/atchs
Exhibit B.  Service Treatment Record

	

AR20170007379, XXXXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,	
Enclosure