RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2016-00985
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20041208

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Ground Radar Systems Journeyman, medically separated for “asthma, exercise induced” with a disability rating of 10%.  

CI CONTENTION:  The condition was rated too low.  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 - 20040922	VARD - 20051128	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma, Exercise Induced	6602	10%	Exercise Induced Asthma	6602	0%	20050712	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Asthma, Exercise Induced.  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s asthma condition began in May 2004 after experiencing wheezing with running.  Spirometry done pre and post exercise on 26 July 2004, showed a decrease in the FEV1 after exercise of 14.4% which resulted in a diagnosis of exercise-induced bronchospasm.  She was prescribed albuterol (inhalational bronchodilator) and Singulair (oral bronchodilator) once daily.  Although her commander recommended retention, she was referred for PEB due to the diagnosis of asthma.  The 3 September 2004 MEB NARSUM examination, 3 months prior to separation, noted prescriptions of daily Singulair and albuterol, prior to exercise.  The NARSUM author and approving authority recommended retention. 
At a family practice appointment on 14 October 2004, 2 months before separation, the active medications listing included Singulair, 10mg to be taken daily, with 10 refills remaining and the last refill having occurred on 13 September 2004.  Albuterol was also prescribed for use before exercising and had not been refilled since 26 July 2004.  On the 5 November 2004 Report of Medical Assessment (recorded on DD Form 2697), one month prior to separation, the CI reported taking Singulair and albuterol, without mention of frequency.  

At the 12 July 2005 VA Compensation and Pension (C&P) evaluation, 7 months after separation, the examiner noted the CI was exercising regularly and rarely using her albuterol inhaler.  There was no mention of any other medications.  Pulmonary function test (PFT) was not completed because the CI failed to report for testing.  

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 0%, also coded 6602, citing a non-compensable evaluation because the CI had failed to report for a scheduled PFT.  A 30% rating stipulates “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.”  Panel members considered that the examinations prior to separation reported a current prescription of daily oral bronchodilators.  Panel members agreed that the VASRD §4.97 threshold for a 30% rating was reasonably satisfied in this case on the basis of daily oral bronchodilator 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 no 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, Exercise Induced	6602	30%	

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

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Dear Applicant:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-00985.

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.