RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00591
BRANCH OF SERVICE:  army	SEPARATION DATE:  20061215

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, UH-60 Helicopter Repairer, medically separated for “asthma” with a disability rating of 10%.

CI CONTENTION:  The CI requested review of additional conditions (reactive airway disease and sleep apnea) not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20060920	VARD - 20071023	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Reactive Airway Disease/Asthma; Obstructive Sleep Apnea	6847-6602	10%	20070907	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:

Asthma.  According to the service treatment record and MEB Narrative Summary (NARSUM), the CI’s asthma condition began in May 2003 as shortness of breath and cough after inhaling fire extinguisher chemicals during a convoy from Kuwait to Iraq.  Pulmonary function tests in evidence considered by the panel are summarized in the chart below.  

Pulmonary Examination	Pulmonary Lab
~16 Mos. Pre-Sep	MEB NARSUM
~4 Mos. Pre-Sep	VA C&P
~9 Mos. After-Sep	
FEV1 (% Predicted)	74% Predicted	79% Predicted	75.8% Predicted	
FEV1/FVC	59% Post	65% Post	62% Post	
Meds	Not Addressed	Advair, albuterol, Singulair	Albuterol as needed	
§4.97 Rating	10% (FEV)/30 (FEV1/FVC)	30%	10%/30%	

At a pulmonary disease examination on 27 July 2006, 5 months before separation, the active medications listed Singulair (oral indirect-acting bronchodilator) and Intal MDI (inhalational cromolyn) to prevent asthma attacks, both were last filled on 27 September 2005. The CI had also been prescribed Advair (inhaled anti-inflammatory medication) which was noted as last filled on 11 July 2005.  The CI reported good compliance with therapy.

The 18 August 2006 MEB NARSUM addendum, 4 months prior to separation, recorded current medications as Advair, albuterol (inhalational therapy), Singulair, and Intal MDI, but with no frequencies cited.  The MEB NARSUM on the same day recorded current medications as Advair, albuterol, Singulair and Intal MDI again with no frequencies cited.  The 3 April 2002 VA Compensation and Pension (C&P) examination, 9 months after separation, documented “albuterol use noted.”  Past therapy noted “was on Advair in Army and Intal and Singulair.”

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 10%, coded 6602 (asthma, bronchial), citing FEV-1 79% after inhaled bronchodilator and on intermittent inhalational bronchodilator therapy.  The VA rated the asthma condition 10%, coded 6602, based on the C&P examination, citing albuterol inhaler on an ‘as needed’ basis.  A 30% rating stipulates “FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational [albuterol] or oral bronchodilator therapy, or; inhalational anti-inflammatory medication [Advair].”  The panel agreed the MEB NARSUM pulmonary function test supports a 30% rating based on FEV-1/FVC at 65%.  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, that 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%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170217, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20190003505, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

I accept the recommendation of the Department of Defense Physical Disability Board of
Review (DoD PDBR) to re-characterize your separation as a disability retirement with the
combined disability rating of 30% effective the date of your medical separation for disability with
severance pay. Enclosed is a copy of the Board’s recommendation and record of proceedings
for your information.
The re-characterization of your separation as a disability retirement will result in an
adjustment to your pay providing retirement pay from the date of your original medical
separation minus the amount of severance pay you were previously paid at separation.
The accepted DoD PDBR recommendation has been forwarded to the Army Physical
Disability Agency for required correction of records and then to the U.S. Defense Finance and
Accounting Service to make the necessary adjustment to your pay and allowances. These
agencies will provide you with official notification by mail as soon as the directed corrections
have been made and will provide information on your retirement benefits. Due to the large
number of cases in process, please be advised that it may be several months before you
receive notification that the corrections are completed and pay adjusted. Inquiry concerning
your correction of records should be addressed to the U.S. Army Physical Disability Agency,
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557.
A copy of this decision has also been provided to the Department of Veterans Affairs.