RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00672
BRANCH OF SERVICE:  MARINE CORPS	SEPARATION DATE:  20040215

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Fabric Repair Specialist, medically separated for “asthma” with a disability rating of 10%.

CI CONTENTION:  No specific contention made.  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 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 at the time of separation.  The panel has neither the role nor the authority to compensate for progression or complications of service-connected conditions after separation.  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 - 20040106	VARD - 20040401	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	30%	20040129	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:

Asthma.  According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s asthma condition began in 2002.  Initial pulmonary function tests (PFTs) were normal, but provocative testing (methacholine challenge) in September 2002 was consistent with the diagnosis of asthma.  He was prescribed Advair (an inhalational anti-inflammatory medication) and albuterol (an inhaled bronchodilator) in October 2002.  The STR consistently recorded use of both medications, as well as Singulair and theophylline (both oral bronchodilators) from that point through separation.  The CI was placed on 8 months of limited duty (LIMDU) on 15 December 2002, but symptoms continued.

The 16 September 2003 MEB NARSUM examination, 5 months prior to separation, noted the CI was taking Advair, albuterol, Singulair, and theophylline.  The CI noted his symptoms did not change with geographic location.  His lungs were clear on examination.  Additional PFTs were not performed.  Review of the STR revealed no evidence documenting the use of an oral or parenteral (injection) steroid for asthma during the year prior to separation, and no evidence that asthma exacerbations required monthly visits to a physician.

At the 29 January 2004 VA Compensation and Pension (C&P) evaluation, 2 weeks before separation, the CI reported weekly asthmatic attacks and the need to visit a physician to control the attacks as often as once a month (this history was not supported by the STR).  He claimed daily use of inhalational anti-inflammatory medication and daily oral and inhalational bronchodilators.  PFTs showed an FEV1 of 100% of predicted and an FEV1/FVC of 83%.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 10%, coded 6602 (asthma).  The VA rated the asthma condition 30%, also coded 6602, based on the C&P examination 2 weeks before separation.  A 30% rating is supported by the use of inhalational anti-inflammatory medication.  The record did not show monthly visits to a physician to treat exacerbations, nor intermittent (at least 3 per year) courses of systemic corticosteroids, nor PFT evidence to support the next higher 60% rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 30% for the asthma condition, coded 6602.

BOARD FINDINGS:  In the matter of the asthma condition, the panel unanimously recommends a disability rating of 30%, coded 6602 IAW VASRD §4.97.  There are no other conditions within the panel’s scope of review for consideration.

The panel recommends 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%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160914, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

MEMORANDUM FOR DEPUTY COMMANDANT (Manpower and Reserve Affairs)
COMMANDER, NAVY PERSONNEL COMMAND

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS

Ref: (a) DoDI 6040.44
        (b) PDBR ltr dtd 03 Jan 18 ICO XXXXXXXXXXXXXXXXXX        
        (C) PDBR ltr dtd 07 Jan 18 ICO XXXXXXXXXXXXXXXXXX
        (d) PDBR ltr dtd 22 Dec 17 ICO XXXXXXXXXXXXXXXXXX
        (e) PDBR ltr dtd 03 Jan 18 ICO XXXXXXXXXXXXXXXXXX
        (f) PDBR ltr dtd 03 Jan 18 ICO XXXXXXXXXXXXXXXXXX

1. Pursuant to reference (a), the recommendations of the Physical Disability
Board of Review set forth in references (b) through (f) are approved. The
official records of the following individuals are to be corrected as follows:

a. XXXXXXXXXXXXXXXXXX

b. XXXXXXXXXXXXXXXXXX, 

c. XXXXXXXXXXXXXXXXXX

d. XXXXXXXXXXXXXXXXXX

e. XXXXXXXXXXXXXXXXXX

2. Please take action to implement these decisions and provide notification
to the above individuals once those actions are complete.

XXXXXXXXXXXXXXXXXX
Acting