RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01879
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070908

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, UN-60 Helicopter Repairman, medically separated 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 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 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 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 - 20070523	VA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	0%	No VA Claim Filed	
Hypertension	Not Unfitting		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

ANALYSIS SUMMARY:

Asthma.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s asthma condition began as recurrent bronchitis during Basic and Advanced Individual Training.  In March 2006 the CI reported the onset of shortness of breath.  He was diagnosed with asthma in November 2006.  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 an MEB.  The MEB forwarded “asthma” moderate for PEB adjudication.  

A spirometry examination on 08 January 2007, 8 months before separation, revealed pulmonary function test (PFT) results of FEV-1 91.62% and FEV-1/FVC ration of 104.76%.  At a pulmonary evaluation, the same day, the CI reported persistent severe shortness of breath.  The examiner noted a 2-week trial of prednisone without symptom improvement.  The lung examination was normal.  

The MEB NARSUM addendum examination on 09 January 2007, 8 months prior to separation, noted the PFT dated 8 January 2007 contained an FEV-1 91% and FEV-1/FVC ratio of 104.76%.  Asthma medications included Salmeterol twice daily and Levalbuterol four times daily (both bronchodilator therapies).  

The MEB NARSUM examination on 01 May 2007, 4 months prior to separation, noted the aforementioned PFT dated 8 January 2007.  The examiner documented the CI regularly takes Levalbuterol and was prescribed Advair (anti-inflammatory) as inhaled medications.  There were no subsequent STRs in evidence after the MEB NARSUM examination.  

There was no VA Compensation and Pension examination for this Board to review as the CI did not file a VA disability claim.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 0%, coded 6602 (asthma, bronchial).  A 30% rating stipulates “FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication.”  A 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.”  The Board agreed there were no STR PFTs to support the minimum 10% rating.  The Board next considered that the inhaled anti-inflammatory medication (Advair) was not regularly taken by the CI as documented by the MEB NARSUM examiner 4 months before separation.  The Board next considered that daily inhalational or oral bronchodilator therapy was taken by the CI as documented by the preponderance of evidence in the STR.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board majority recommends a disability rating of 30% for the asthma condition, coded 6602.  

Contended PEB Conditions:  Hypertension.  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The contended condition was not profiled or implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the asthma condition, the Board majority recommends a disability rating of 30%, coded 6602 IAW VASRD §4.97.  The single voter for dissent submitted the appended minority opinion.  In the matter of the contended hypertension condition, the Board unanimously agrees that it cannot recommend it for additional disability rating.  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; 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	
Asthma	6602	30%	
COMBINED	30%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150615, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

Minority Opinion.

The single voter for dissent strongly recommends modification of the CI’s permanent disability rating to no higher than 10%. The PEB rated the asthma condition 0%, and the VA did not rate this asthma condition because the CI did not file a VA disability claim.  A 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.”  The recorded PFTs did not support the minimum criteria for 10% rating.  However, the CIs overall medical picture supported by the STR and the prescribed inhaled anti-inflammatories medication reasonably supports a 10% rating.

SAMR-RB									

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

06 MAR 2017

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20160018768, (PD201501879)

1.  I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a, I reject the Board’s recommendation and accept the Board’s minority opinion to modify the individual’s disability rating to 10% without recharacterization of the individual’s separation.  This decision is final.  

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.   

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:
 
Enclosures						     

CF: 
(  ) DoD PDBR
(  ) DVA