RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00801
BRANCH OF SERVICE:  ARMY	SEPARATION DATE:  20040404

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Trainee, medically separated for “exercise induced respiratory distress” with a disability rating of 0%.  

CI CONTENTION:  “Ongoing respiratory issues.  Difficulty in excursion.”  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(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 - 20040225	VARD - 20040528	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Exercise Induced Respiratory Distress	6699-6600	0%	Status Post Multilobar Pneumonia	6699-6601	0%	20040127	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Exercise Induced Respiratory Distress.  According to the service treatment record and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s respiratory condition began in May 2003 when he was diagnosed with multilobar pneumonia and admitted to the hospital for 2 days of treatment.  Albuterol (inhalational bronchodilator) was prescribed as needed for 1 week.  Despite treatment, he continued to experience chest tightness, shortness of breath (SOB) and near syncope.  A 29 October 2003 pulmonary evaluation revealed normal pulmonary function tests (PFT) and a negative methacholine challenge.  

During the 15 December 2003 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months before separation, the CI reported wheezing, SOB, dizziness/unconsciousness and burning chest pain.  The examiner noted normal echocardiogram, exercise tolerance test, PFT and methacholine challenge results. 

The 6 January 2004 MEB NARSUM examination, 3 months prior to separation, recorded CI complaints of cough, and chest tightness with SOB during exercise or exertion.  Physical examination noted chronic cough but no other significant findings.  

At the 27 January 2004 VA Compensation and Pension (C&P) evaluation, 2 months before separation, the CI reported difficulty breathing with prolonged exertion.  Chest X-rays indicated no active chest disease.  Physical examination revealed symmetric breath sounds, with no rattling, and expiratory phase within normal limits.  PFT results before bronchodilator use were forced expiratory volume in 1 second (FEV-1) of 111% predicted and an FEV-1/forced vital capacity (FVC) of 101%.  Post-bronchodilator testing was not performed because pre-bronchodilator testing was within normal limits.  No medications were listed and the examiner stated there were no complications secondary to pulmonary disease.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the exercise induced respiratory distress condition 0%, coded 6699-6600 (bronchitis, chronic), citing normal spirometry (PFTs) and negative methacholine challenge.  The VA rated the respiratory condition 0%, coded 6699-6601, (brochiectasis), based on the C&P examination 2 months before separation, citing normal chest X-rays and PFTs and no complications secondary to the multilobar pneumonia.  Members considered criteria for a higher 10% rating which requires “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, PFTs were normal and there were no medications prescribed to justify a 10% rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the respiratory condition.  

BOARD FINDINGS:  In the matter of the exercise induced respiratory 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.  The panel, therefore, 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 20160914, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20170017989, XXXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	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.  

Sincerely,					      
						      					
Enclosure