RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	 CASE:  PD-2015-01946
BRANCH OF SERVICE:  AIR FORCE 	 SEPARATION DATE:  20040820

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3, Security Forces Apprentice, medically separated for “asthma, exercise induced,” with a disability rating of 10%.

CI CONTENTION:  The CI contended that she had no prior history of asthma before her military service.  Her 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 - 20040317	VA – No VA Claim or Rating	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma, Exercise Induced	6602	10%	No VA claim or rating 	
COMBINED RATING: 10%	No Rating  	

ANALYSIS SUMMARY:

Asthma, Exercise Induced.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI initially presented in June 2003 for complaints of shortness of breath and wheezing which affected her ability to perform physical activity.  She reported a history of allergic rhinitis as a child; however, she had no history of asthma or sinus problems prior to entering the military.  Initial treatment included antibiotics, an inhaled bronchodilator (albuterol) and a 2-week course of oral corticosteroids in July 2003, a year prior to separation.  There were no subsequent courses of treatment with oral or systemic corticosteroids or immunosuppressive medications.  Evaluation with pulmonary function testing demonstrated the presence of reversible airways obstruction consistent with asthma.  Bronchoscopy and sleep studies in October 2003 were normal.  The CI’s asthma was treated with Singular, albuterol inhaler prior to exercise, and Advair (inhaled corticosteroid, twice daily).  Pulmonary function testing 4 November 2003 was normal (FEV1 at 92% predicted, FEV1/FVC ratio 90%).  According to the NARSUM on 18 December 2003, the CI was symptom-free on the above listed medications; however her medication treatment was recommended to be long term.  At the time of a 22 January 2004 clinic appointment the CI presented for refill of her asthma medications.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 10%, coded 6602 (asthma) citing that the medical condition prevented the CI from performing the duties of her office, grade, and rank.  There was no VA claim or service-connected VA rating in evidence in the available records.  A 30% rating stipulates “daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication.”  Board members considered the evidence of the STR and the MEB NARSUM which reported the use of inhaled anti-inflammatory medication.  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.  There was no oral or systemic corticosteroid treatment for the year prior to separation to support a higher rating.  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; and, that the discharge with severance pay be re-characterized to reflect permanent disability retirement, effective as of the date of her prior medical separation:  

CONDITION	VASRD CODE	RATING	
Asthma, Exercise Induced	6602	30%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150710, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

PDBR PD-2015-01946

MEMORANDUM FOR THE CHIEF OF STAFF

	Having received and considered the recommendation of the Physical Disability Board of Review and under the authority of Title 10, United States Code, Section 1554a (122 Stat. 466) and Title 10, United States Code, Section 1552 (70A Stat. 116) it is directed that:

	The pertinent military records of the Department of the Air Force relating to XXXXXXXXXXXXXXXXXXXXX, be corrected to show that:

	a.  The diagnosis in her finding of unfitness for Exercise Induced Asthma, VASRD code 6602, was rated at 30% rather than 10%.

	b.  She was not discharged on 20 August 2004 with entitlement to disability severance pay; rather, on that date, she was released from active duty and on 21 August 2004, her name was placed on the Permanent Disability Retired List.  

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Air Force Review Boards Agency