RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2016-00929
BRANCH OF SERVICE:  AIR FORCE 	SEPARATION DATE:  20040723

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Munitions Systems Craftsman, 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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20040518	VARD - 20041130	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	10%	20041001	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20% 	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s asthma condition began in February 2002 after presenting to the emergency room following mowing the lawn.  The CI underwent a full allergy evaluation and immunotherapy was initiated in July 2003.  At a 25 March 2004 allergy clinic appointment, pulmonary function testing (PFT) showed an FEV-1 of 109% of predicted and an FEV-1/FVC of 74%.  

The 28 April 2004 MEB NARSUM examination, 3 months prior to separation, noted complaints of asthma.  The CI was able to perform physical training without limitation and passed his physical fitness test without difficulty.  The asthma symptoms consisted of a dry cough and mild shortness of breath, which were exacerbated by mowing the lawn.  Medication history noted the CI’s use of Flovent (inhaled anti-inflammatory) and albuterol (inhaled bronchodilator) as needed.  

At a 9 June 2004 allergy/immunology clinic, the CI was taking Flovent and albuterol.  The CI complained of continued daily chest tightness usually with exertion and with mowing the lawn one to two times per week.  The CI reported compliance with medications and denied nighttime symptoms.  The examiner changed the treatment to Advair (combined anti-inflammatory and long-acting bronchodilator) and continued albuterol as needed.  

At the 1 October 2004 VA Compensation and Pension (C&P) evaluation, 3 months after separation, the CI reported frequent asthma symptoms.  The CI had to quit his first post-separation civilian job because he was working outside and it caused an increase in his asthma symptoms.  Reported medications included Advair and albuterol.  PFTs showed an FEV-1 of 109% of predicted and an FEV-1/FVC of 77%.  

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 also rated the asthma condition 10%, coded 6602, based on the C&P examination, citing forced expiratory volume.  Panel members agreed the VASRD §4.97 threshold for a 30% rating was reasonably satisfied in this case on the basis of inhalational anti-inflammatory medication use.  A 60% rating was not justified in the absence of at least monthly visits to a physician for required care of exacerbations, or intermittent (at least three per year) courses of systemic corticosteroids.  There was also no PFT evidence to support the next higher 60% rating.  After due deliberation, considering all 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 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, the discharge with severance pay be re-characterized to reflect permanent disability retirement, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Asthma	6602	30%	

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

XXXXXXXXXX
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Dear XXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-00929.

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 not appropriate under the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended your separation be re-characterized to reflect disability retirement, rather than separation with severance pay.

I have carefully reviewed the evidence of record and the recommendation of the Board.    I concur with that finding, accept their recommendation and determined that your records should be corrected accordingly.  The office responsible for making the correction will inform you when your records have been changed.

As a result of the aforementioned correction, you are entitled by law to elect coverage under the Survivor Benefit Plan (SBP).  Upon receipt of this letter, you must contact the Air Force Personnel Center at (210) 565-2273 to make arrangements to obtain an SBP briefing prior to rendering an election.  If a valid election is not received within 30 days from the date of this letter, you will not be enrolled in the SBP program unless at the time of your separation, you were married or had an eligible dependent child, in such a case, failure to render an election will result in automatic enrollment.