RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01299
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20041217

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

CI CONTENTION:  Requests review of conditions not identified by either the MEB or 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 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 - 20040826	VARD - 20050817	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Exercise-Induced Asthma	6602	0%	20050804	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was first diagnosed with acute bronchitis and reactive airway disease in January 2004.  On 8 March 2004, 9 months prior to separation, pulmonary function testing (PFTs) showed an FEV-1 (forced expiratory volume in 1 second) of 104% of predicted and an FEV-1/FVC (forced vital capacity) of 85%, confirming the asthma condition.  On 5 May 2004, 7 months prior to separation, PFTs showed an FEV-1 of 100% of predicted.  A formal diagnosis of asthma was established by a pulmonologist in July 2004 and an inhaled bronchodilator (albuterol) was prescribed on an “as needed” basis.  

The 13 July 2004 MEB NARSUM examination, 5 months prior to separation, documented that the CI was taking albuterol before exercise and as needed.  Review of the STR found no clinical encounters documenting the use of an oral or parenteral steroid for asthma during the year prior to separation.  Additionally, there was no evidence of asthma exacerbations frequent enough to require monthly visits to a physician.  

At the 22 February 2005 VA Compensation and Pension (C&P) evaluation, 2 months after separation, the CI denied any dyspnea on exertion and could walk as far as she wanted; however she experienced shortness of breath and cough after running two laps on a track.  She denied additional treatment with oxygen, mechanical ventilation, or hand-held nebulizer therapy; and she had not been incapacitated or prescribed bed rest.  She reported that exacerbations resolved quickly, and the examiner noted she was prescribed albuterol but did not record frequency of use.  PFTs were normal with a normal diffusing capacity; post-bronchodilator results were not recorded.  A 4 August 2005 2005 C&P pulmonary evaluation, 8 months after separation, was not available; however, the 17 August 2005 VA Rating Decision referenced normal PFTs (FEV-1 of 106% of predicted and an FEV-1/FVC of 81%) and normal diffusing capacity.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 10%, coded 6602.  The VA rated the asthma condition 0%, coded 6602, citing normal PFTs and diffusing capacity.  A 10% rating stipulates “intermittent inhalational or oral bronchodilator therapy.”  Members agreed that the PEB’s 10% rating was justified by the intermittent use of inhaled bronchodilator therapy reflected in the STR.  There was no PFT evidence (i.e. FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent) 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 §4.100, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends 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 20161003, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-01299.

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.  The Board recommended no re-characterization or modification of your separation.

I 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.  I accept their recommendation that your application be denied. 

						Sincerely,

		

Attachment:
Record of Proceedings