RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00687
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20070301

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

CI CONTENTION:  “Look at all conditions.”  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 - 20061221	VARD - 20070620	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma  	6602	10%	Bronchial Asthma	6602	30%	20070428	
Plantar Fasciitis	Not unfitting	Plantar Fasciitis and Extensor Tendonitis, Right Foot	5020-5311	0%	20070428	
		Plantar Fasciitis, Left Foot	5020-5312	0%	20070428	
Low Back Pain	Not unfitting	Chronic Lumbar Strain	5237-5010	10%	20070428	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  50% 	

ANALYSIS SUMMARY:  

Asthma.  According to service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s asthma was diagnosed by a pulmonologist in September 2006 after returning from Iraq.  
According to the allergy clinic evaluation on 14 September 2006, 6 months prior to separation, the examiner noted that the CI was unable to pass his physical training test or wear a protective mask.  A pulmonary function test (PFT) showed an FEV-1 of 107% of predicted and an FEV-1/FVC of 83%.  Medication for asthma control was prescribed with Advair (inhaled corticosteroid [anti-inflammatory]) daily and albuterol (inhaled bronchodilator) as needed.  The 9 November 2006 MEB NARSUM examination, 4 months prior to separation, noted shortness of breath with exercise and climbing stairs.  A physical examination documented the CI was taking albuterol before, during and after exercise.  The CI could not wear the protective mask due to shortness of breath and was unable to complete his physical training while on albuterol.  PFTs showed an FEV-1 of 107% of predicted and an FEV-1/FVC of 83%.  The CI was prescribed Advair daily and albuterol as needed.  He was diagnosed with mild persistent allergic asthma.  

At the 28 April 2007 VA Compensation and Pension (C&P) evaluation, 1 month after separation, the CI continued to endorse exercise induced asthma.  Repeat PFTs revealed an FEV-1 of 88% of predicted and an FEV-1/FVC of 77% with a good response after bronchodilator use.  The examiner stated the CI was currently on Xopenex (inhaled bronchodilator) and Advair.  Diagnosis was bronchial asthma.  

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 intermittent inhaler use as noted in the medication profile.  The VA rated the asthma condition 30%, coded 6602, based upon the C&P examination, citing daily inhalational or oral bronchodilator therapy; or inhalational anti-inflammatory medication.  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 agreed the CI was prescribed and taking inhaled anti-inflammatory medication near the time of separation and therefore, further agreed that the VASRD §4.97 threshold for a 30% rating was reasonably satisfied in this case.  There was no STR evidence for respiratory failure, hospital admissions, continuous requirement for systemic corticosteroids, or monthly exacerbations requiring physician visits (criteria for VASRD ratings higher than 30%).  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.  

Contended PEB Conditions:  Plantar Fasciitis and Low Back Pain.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  Neither of the conditions were profiled, implicated in the commander’s statement nor judged to fail retention standards.  There was no performance-based evidence from the record that either of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB’s fitness determination for either of the two contended conditions and so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the asthma condition, the panel recommends a disability rating of 30%, coded 6602 IAW VASRD §4.97.  In the matter of the contended plantar fasciitis and low back conditions, the panel unanimously recommends no change from the PEB’s determinations as not unfitting.  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, undated and received 20170228, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180004736, 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 
Sincerely,					      
Enclosure