RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-01457
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070316

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Survival Equipment Craftsman, medically separated for “exercise-induced anaphylaxis” with a disability rating of 20%.  

CI CONTENTION:  No specific contention was made.  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 - 20070129	VARD - 20070926	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Exercise-Induced Anaphylaxis	7199-7118	20%	Anaphylaxis-Induced Bronchospasm	7899-7827	0%	20070622	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Exercise-Induced Anaphylaxis.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s anaphylaxis began in August 2006 after an itchy rash on his skin developed during exercise.  Two weeks later, while running in the same area, he developed the same rash, had difficulty breathing and throat swelling, and passed out.  Pulmonary function tests were normal, and he was diagnosed with exercise-induced anaphylaxis.  

The 22 November 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of rash, but no difficulty breathing with exercise. The CI was prescribed Claritin (antihistamine) prior to exercise and an Epipen as needed.  Physical examination was normal.  

At the 22 June 2007 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported 10-12 episodes of exercise induced hives since August 2006 and two episodes of anaphylactic bronchospasm.  The throat, lung and skin evaluations were normal, but there was a left wrist scar noted.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the anaphylaxis condition 20%, analogously coded 7199-7118 (angioneurotic edema).  The VA rated the anaphylaxis condition 0%, analogously coded 7899-7825 (urticaria), based on the STR and C&P examination, citing a noncompensable evaluation.  Members noted there was no evidence of attacks without laryngeal involvement lasting 1-7 days or longer and occurring more than 8 times a year, or; attacks with laryngeal involvement of any duration occurring more than twice a year for a 40% rating analogous to 7118.  Additionally, there was no evidence of recurrent debilitating episodes of urticaria occurring at least 4 times during the past 12-month period, and; requiring intermittent systemic immunosuppressive therapy for control for a 30% rating analogous to 7825.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the anaphylaxis.  

BOARD FINDINGS:  In the matter of the exercise-induced anaphylaxis and IAW VASRD §4.104, the panel recommends no change in the PEB adjudication.  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.  

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-01457.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.