RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00231
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20020415

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Satellite, Wideband and Telemetry Systems Specialist, medically separated for “asthma” with a disability rating of 10%.  

CI CONTENTION:  Contended for a condition not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  The 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 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 – 20020131	VARD - 20020813	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Mild, Intermittent Asthma 	6602	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s asthma condition began in December 1999 while on a field exercise.  The CI had difficulty breathing, along with runny, watery, itchy eyes and nose for which he sought medical care.  He complained of shortness of breath with exertion and was prescribed a Proventil inhaler (inhaled bronchodilator).  In August 2000 the CI was prescribed, Flovent (inhalational anti-inflammatory medication), and Albuterol (inhalational bronchodilator) as needed.  A pulmonary function test (PFT) performed in September 2000 showed a forced expiratory volume in 1 second (FEV1) of 93% of predicted and an FEV-1/forced vital capacity (FVC) of 86% after bronchodilators.  

The 7 December 2001 MEB NARSUM examination, 5 months prior to separation, noted complaints of some occasional shortness of breath associated with his allergy symptoms.  Current medications were stated as “none.”  Physical examination showed a well-developed, well-nourished 21-year-old male in no apparent distress.  He was alert and active.  Nasal membranes were mildly congested and the oropharynx was clear.  The lungs were clear to auscultation without prolonged expiratory phase.  No crackles or wheezes were noted.  PFTs performed December 1999 revealed severe obstructive disease with minimal response to bronchodilator use.  PFTs were repeated in 2000, which revealed mild obstructive disease with reversibility with bronchodilator.  PFTs were repeated on 21 September 2001 and noted a very mild, small airways obstruction which was improved from the previous PFT and showed response to bronchodilators (FEV-1 of 82% of predicted and an FEV-1/FVC of 86%).  The examiner diagnosed “mild intermittent asthma that specifically occurs with allergic triggers.”  The physician recommended allergy medication on an ‘as needed’ basis.  

The 25 January 2002 primary care visit was for acute symptoms of fever, coughing and headache with shortness of breath only with coughing or running.  There was purulent nasal rhinorrhea and frontal sinus tenderness.  The diagnosis was acute sinusitis, and medications included Albuterol (inhaled bronchodilator) as needed.  There was no VA Compensation and Pension examination in evidence proximate to separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 10%, coded 6602 (asthma, bronchial).  The VA rated the asthma condition 0%, coded 6602 (asthma, bronchial), citing a non-compensable evaluation because the CI failed to report for the VA examination, and did not meet the 10% rating criteria.  

Review of the STR found no clinical encounters in evidence documenting the use of an oral or parenteral (injection) 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 evidence showing a requirement for daily use of systemic (oral or parenteral) high dose corticosteroids or immunosuppressive medication.  

The panel deliberated if the CI’s asthma condition warranted a rating above the 10% adjudicated by the PEB.  The next higher 30% rating requires 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.  There was no PFT evidence to support the next higher 30% rating.  Likewise, a 30% rating was not justified in the absence of daily inhalational or oral bronchodilator therapy, or inhalational anti-inflammatory medication.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the asthma condition.  

BOARD FINDINGS:  In the matter of the asthma condition and IAW VASRD §4.97, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160418, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-00231.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings