RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01736
BRANCH OF SERVICE:  MARINE CORPS	SEPARATION DATE:  20070801

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Motor Vehicle Operator, medically separated for “asthma” with a disability rating of 0%.  

CI CONTENTION:  “No rating through the VA.”  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 – 20070330	VARD – NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	0%	No VA Examination Proximate to Separation in Evidence	
Chest wall pain, right sided	Cat II		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s asthma condition began in November 2005 while deployed.  At the internal medicine clinic on 29 September 2006, 11 months prior to separation, the CI complained of exertional dyspnea and wheezing.  Prescribed medications included fluticasone/salmeterol (inhalation anti-inflammatory) and salbutamol (bronchodilator).  The examiner reported the exercise challenge showed a 22% decrease in FEV1 after 7 minutes of running on a treadmill.  The impression was a normal baseline pulmonary function test (PFT) with evidence of inducible obstructive pattern and recovery with bronchodilator treatment that was consistent with exercise-induced asthma.  

At the pulmonary disease clinic, on 25 January 2007, 7 months prior to separation, the CI complained of continued dyspnea (shortness of breath) and chest pain with exertion.  Prescribed medications included fluticasone/salmeterol and salbutamol.  The PFT showed an FEV-1 of 86% and an FEV-1/FVC of 81%.  The examiner stated the CI’s condition did not respond to the respiratory medications.  At the 23 February 2007 MEB NARSUM examination, 6 months prior to separation, the CI reported symptom worsening.  Medications included fluticasone/salmeterol and salbutamol.  Chest X-rays were normal.  Physical examination showed normal air exchange and no wheezing.  Carbon monoxide diffusion testing was normal.  PFT showed an FEV-1 of 85% and an FEV-1/FVC of 81%.  There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 0%, coded 6602 (asthma, bronchial).  Members agreed the category II, chest wall pain, was properly subsumed in the rating of the unfitting asthma condition.  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 noted the examinations in evidence showed prescription and use of daily bronchodilators and inhaled anti-inflammatories.  Panel members agreed that the VASRD §4.97 threshold for a 30% rating was reasonably satisfied in this case on the basis of daily bronchodilator and/or 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 (oral or parenteral) corticosteroids.  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	6602	30%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161112, w/atchs
Exhibit B.  Service Treatment Record

MEMORANDUM FOR DEPUTY COMMANDANT (Manpower and Reserve Affairs)
		   COMMANDER, NAVY PERSONNEL COMMAND	
	                          
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS          

Ref:  (a) DoDI 6040.44
	(b) PDBR ltr dtd 12 Feb 18 ICO XXXXXXXXXXXXXXXXXX 
	(c) PDBR ltr dtd 17 Feb 18 ICO XXXXXXXXXXXXXXXXXX
	(d) PDBR ltr dtd 18 Feb 18 ICO XXXXXXXXXXXXXXXXXX
	(e) PDBR ltr dtd 12 Feb 18 ICO XXXXXXXXXXXXXXXXXX
	(f) PDBR ltr dtd 17 Feb 18 ICO XXXXXXXXXXXXXXXXXX
	(g) PDBR ltr dtd 17 Feb 18 ICO XXXXXXXXXXXXXXXXXX    
	(h) PDBR ltr dtd 17 Feb 18 ICO XXXXXXXXXXXXXXXXXX
	(i) PDBR ltr dtd 12 Feb 18 ICO XXXXXXXXXXXXXXXXXX

1.  Pursuant to reference (a), the recommendations of the Physical Disability Board of Review set forth in references (b) through (i) are approved.  The official records of the following individuals are to be corrected as follows:

     a. XXXXXXXXXXXXXXXXXX, former USMC: Entitlement to disability separation pay with a 10 percent disability rating (increased from 0 percent) effective date of discharge.

     b. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 20 percent disability rating (increased from 10 percent) effective date of discharge.

     c. XXXXXXXXXXXXXXXXXX, former USMC: Placement on the Permanent Disability Retired List with a 30 percent rating (increased from 0 percent) effective date of discharge.     

     d. XXXXXXXXXXXXXXXXXX, former USN: Placement on the Permanent Disability Retired List with a 40 percent rating (increased from 20 percent) effective date of discharge.   

     e. XXXXXXXXXXXXXXXXXX, former USMC: Placement on the Permanent Disability Retired List with a 30 percent rating (increased from 10 percent) effective date of discharge.   

     f. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 20 percent disability rating (increased from 10 percent) effective date of discharge.

     g. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 20 percent disability rating (increased from 10 percent) effective date of discharge.

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS

     e. XXXXXXXXXXXXXXXXXX, former USN: Placement on the Temporary Disability Retired List at time of discharge for six months with a 50 percent rating followed by a permanent rating of 10 percent with entitlement to disability severance pay. 
     
3.  Please take action to implement these decisions and provide notification to the above individuals once those actions are complete.

                                  XXXXXXXXXXXXXXXXXX
                                  Acting