RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01826
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060125

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Infantryman, medically separated from the Temporary Disability Retired List (TDRL) for “asthma,” with a disability rating of 0%.

CI CONTENTION:  “Review all conditions.”  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 panel 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 determinations 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 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 – 20020726/20051222	VARD - 20030313	
Condition	Code	Rating	Condition	Code	Rating
Proximate	
		TDRL
Placement	TDRL Removal			TDRL
Placement	TDRL
Removal	
Asthma	6602	30%	0%	Asthma	6602	10%	10%	
COMBINED RATING:  30% → 0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Asthma.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s asthma condition began in April 2002 after falling out while running during physical training.  A diagnosis of asthma was made based on pulmonary function testing (PFT) and clinical presentation.  Despite treatment, the asthma condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for MEB.  The MEB forwarded “mild intermittent asthma” for PEB adjudication.

According to the pulmonary clinic evaluation on 8 May 2002 (6 months prior to separation) the CI complained of shortness of breath.  The examiner noted that the CI was on Flovent and Albuterol; however, the frequency of medicine was not mentioned.  The examiner also noted that the CI had problems running most of the time and that he could not do his job as an Infantryman.  The CI had no symptoms at rest, no nocturnal symptoms, and no early morning congestion.  His lungs were clear to auscultation bilaterally.  The CI had a pulmonary function test (PFT) on 23 April 2008 that showed a forced expiratory volume in one second (FEV-1) of 77%, and a forced vital capacity (FVC) of 96%.  There was a 17% bronchodilator response.  

The MEB NARSUM examination on 24 June 2002, 5 months prior to separation, used the pulmonary evaluation and agreed with the diagnosis of mild intermittent asthma.  Review of the STR found no clinical encounters in evidence documenting the use of an oral or parenteral steroid 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.  There was no VA examination in evidence.  The CI failed to report for his scheduled VA Compensation and Pension (C&P) evaluations.  The CI was separated and placed on TDRL with a disability rating of 30%.  

The Board considered its recommendation for permanent disability rating at the time of removal from the TDRL.  The MEB NARSUM examination on 22 December 2005, 37 months after placement onto TDRL, noted that the CI reported that since returning to civilian life, he had been working as a security guard and was able to exercise at a local gym without symptoms.  He did note that his exercise was much less than what was previously required of him in the Army.  Physical examination noted that the CI was no longer taking medication for asthma.  A PFT was conducted that showed FVC of 103%, FEV- 1 of 83%, FEV-1/FVC of 81%.  After administration of albuterol FEV-1 was 98% and FEV-1/FVC was 80%.  

The PEB rated the asthma condition 0%, coded 6602, citing a FEV-1 of 98% posttreatment and the CI was not on medication.  There was no further VA rating decision in evidence, thus the VA maintained a rating of 10% for asthma.  The next higher 10% rating stipulates “FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy.”  In this case, there were no medications prescribed.  The PFT results in this case showed an FEV-1 greater than 80 percent predicted and an FEV-1/FVC greater than 80 percent.  Therefore, a 10% rating was not supported.  Board members agreed that the PEB’s 0% rating was properly adjudicated at the time of TDRL removal.  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 adjudications for the asthma at TDRL removal.

BOARD FINDINGS:  In the matter of the asthma condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication at TDRL removal.  There were no other conditions within the Board’s scope of review for consideration.  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 20150706, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

	
AR20170004072, XXXXXXXXXXXXXXXXXX

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XXXXXXXXXXXXXXXXXX
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Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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 been provided to the counsel you listed on your application, XXXXXXXXXXXXXXXXXX.

Sincerely,