RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01543
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20040521

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Information Management Apprentice, medically separated for “asthma” with a disability rating of 10%.  

CI CONTENTION:  “Over the years my asthma has gotten worse due to my allergies.”  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 - 20040304	VARD - 20050125	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Bronchial Asthma	6602	10%	20040711	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record and MEB narrative summary (NARSUM), the CI first reported periodic episodes of chest tightness and shortness of breath in October 2003.  She was noted to have a family history of asthma and advised to stop smoking.  Pulmonary function testing (PFT) was performed on 17 October 2003, and while baseline values (FEV-1 of 90% predicted) were normal, a provocative test (methacholine challenge) showed a reversible decrease consistent with mild asthma.  She was treated with an albuterol (inhalational bronchodilator) as needed.  

The 21 January 2004 MEB NARSUM examination, 4 months prior to separation, noted complaints of asthma symptoms exacerbated by exercise and that also awoke her at night about once a month.  She continued to smoke 1-2 cigarettes a day and used albuterol as needed.  The examiner documented clear lungs and referred to the October 2003 PFT results noting that “FEV1 as well as other parameters returned to baseline values” after bronchodilator administraton.  

At the 11 July 2004 VA Compensation and Pension (C&P) evaluation, 2 months after separation, the CI reported that she was 31 weeks pregnant and used an albuterol inhaler about twice a week.  On examination, her lungs were clear and PFTs showed an FEV-1 of 73% predicted and FEV-1/FVC 89% predicted after a bronchodilator was administered.  She was noted to have borderline restrictive disease, but the provider observed the PFT changes were consistent with an intra-uterine pregnancy and not reflective of the underlying asthma.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma 10%, coded 6602 (asthma, bronchial).  The VA also rated the asthma 10%, coded 6602, based on the C&P examination, citing intermittent use of a bronchodilator and PFT results.  Members determined that the MEB PFT results were more probative for rating purposes than the VA results, which may have been affected by the CI’s pregnancy.  Although the PFTs did not meet the criteria for an FEV-1 or FEV-1/FVC between 71% and 80%, a 10% rating, but no higher, is supported by intermittent use of a bronchodilator.  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.  

BOARD FINDINGS:  In the matter of the asthma and IAW VASRD §4.97, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration. Therefore, the panel 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 20161019, w/atchs  
Exhibit B.  Service Treatment Record  
Exhibit C.  Department of Veterans Affairs Record    

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

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-01543.

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.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have 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.  Accordingly, I accept their recommendation that your application be denied.

						Sincerely,

		

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings