RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00940
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20070110

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

CI CONTENTION:  Review of all conditions requested. 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 - 20061003	VARD - 20070517	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Exercise-Induced Asthma	6602	10%	20070123	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record and the MEB narrative summary (NARSUM), the CI was initially diagnosed with exercise-induced asthma in 2005.  Her pulmonary function tests (PFT) suggested an obstructive pattern and she was initially treated with albuterol, but subsequently was prescribed Advair, an inhaled corticosteroid.  The PFTs on 8 February 2006 were normal, with an FEV1 of 100% of predicted and an FEV1/FVC of 86%.  The record shows the CI was initially using Advair incorrectly, but was advised on the correct use (daily) at a civilian pulmonary evaluation on 13 March 2006, where PFTs showed an FEV1 of 57% of predicted and an FEV1/FVC ratio of 99%.  

The 11 September 2006 MEB NARSUM examination, 4 months prior to separation, noted the CI was taking Advair twice daily and Albuterol as needed.  The final PFT results prior to separation were normal with an FEV1 of 116% of predicted and an FEV1/FVC of 89%.  On examination her lungs were clear and she was not in respiratory distress.  At a 21 September 2006 primary care appointment, completed after the MEB (and likely not available to the PEB), the provider noted the CI was not under good control and increased the dosage of the Advair.  

At the 23 January 2007 VA Compensation and Pension (C&P) examination, 2 weeks after separation, the examiner noted the CI was taking Advair and Albuterol without specifying frequency of use.  On examination her lungs were clear and she was not in respiratory distress.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 10%, coded 6602 (asthma), citing normal spirometry and intermittent use of inhalational bronchodilator therapy.  The PEB noted the medication profile showed the CI had not received Advair or Albuterol refills since 31 March 2006 (6 months before PEB findings).  The VA also rated the asthma condition 10%, coded 6602, (asthma), based on the C&P examination, citing normal PFTs and use of intermittent inhalational or oral bronchodilator therapy.  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.”  The examinations in evidence showed current use of inhaled anti-inflammatory medication and the VASRD §4.97 threshold for a 30% rating was reasonably satisfied in this case.  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 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 20170221, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180005692, 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), XXXXXXXXXXXXXXXXXX.
	
Sincerely,					      
Enclosure