RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-00700 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20050331

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E1, Basic Marine, medically separated for “left lower lobe lingular bronchiectasis” with a disability rating of 10%.

CI CONTENTION: “Been in and out of Medical Faculty for past ten years and presently rated at 60% for condition.”  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 - 20050204	VARD - 20060523	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Lower Lobe Lingular Bronchiectasis	6899-6824	10%	Bronchiectasis	6600-6601	10%	20060414	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	
	
ANALYSIS SUMMARY:

Left Lower Lobe (LLL) Lingular Bronchiectasis. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s LLL bronchiectasis (chronic inflammation of airway and lung tissue) began in September 2004 when he was treated for symptoms of shortness of breath, chest pain, chills and fever. A diagnosis of LLL pneumonia was rendered and he was placed on antibiotics and a respiratory inhaler. However, his symptoms persisted as did X-ray evidence of pneumonic findings. Over a period of time, multiple studies were completed, and in

December 2004 a diagnosis of LLL and lingular lobe pneumonia (partially resolved) was determined. A chest CT revealed bronchiectasis and continued lung infiltrate (area density greater than air), and it was felt that some type of genetic variant might have had a role in the condition not fully resolving.

The 4 January 2005 MEB NARSUM examination, 3 months prior to separation, noted CI complaints of a chronic cough, fatigue, shortness of breath and continued difficulty breathing with mild exercise, such as walking up stairs. Physical examination was unremarkable and the diagnosis remained unchanged.

At the VA Compensation and Pension (C&P) examination, 10 months after separation, the CI reported an intermittent productive cough associated with wheezing and generalized weakness and fatigue. Physical examination was normal and a repeat chest X-ray noted “no active disease.” The CI’s diagnosis remained as bronchiectasis.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the bronchiectasis 10%, analogously coded 6899-6824 (chronic lung abscess) and listed the chronic LLL pneumonia as a Category II condition (contributes to the unfitting condition, but no separately ratable). The VA also rated the lung condition 10%, dual coded 6600-6601 (chronic bronchitis-bronchiectasis), based on the C&P examination, citing acute infection requiring a course of antibiotics at least twice a year. Members first agreed that the greatest degree of probative value be apportioned to the MEB examination due to its proximity to separation. Upon extensively deliberating over the etiologic pathology that caused the chronicity of the CI’s symptoms, the panel concluded that although radiographic evidence of various lung densities (infiltrate) remained near the time of separation, it was clearly the condition of bronchiectasis that continued to produce adverse symptoms. Such findings are identified under VASRD code of 6601 (bronchiectasis) which has 4 rating levels of 10% though 100%. All rating levels greater than 10% required episodes of incapacitation as described by VASRD guidelines, however no such periods of incapacitation were documented. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB’s adjudication for the lung condition.

Other PEB Condition. Chronic LLL pneumonia was adjudicated by the PEB as related Category II condition. The panel agreed that this condition was related and included in the discussion above, and further concluded that there was insufficient cause to recommend a change in the PEB’s adjudication, so no additional disability rating is recommended.

BOARD FINDINGS:     In the matter of the left lower lobe lingular bronchiectasis and IAW VASRD
§4.197-128, the panel recommends no change in the PEB adjudication. In the matter of the chronic LLL pneumonia condition, the panel agreed that it cannot recommend it for an additional impairment rating. 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.

 	 

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN   REPLY  REFER  TO :
1850
CORB: 003 20May20

From: Director, Secretary of the Navy Council of Review Boards

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW  (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 29 Oct 18

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation  Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.