RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01947
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20091123

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Health Service Management Journeyman, medically separated for “exercise induced asthma” with a disability rating of 10%.  

CI CONTENTION:  The CI requested review of conditions 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 - 20090811	VARD - 20100511	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Exercise Induced Asthma 	6602	10%	Mild Intermittent Exercise-Induced Asthma	6602	0%	20100323	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Exercise Induced Asthma.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s asthma condition began in childhood with the first military diagnosis in April 2009 after running.  He was seen by an allergist for allergy type symptoms where it was noted he had pulmonary function testing (PFT) consistent with exercise induced asthma.  A follow-up provocative (methacholine challenge) test was positive for asthma.  The FVC was 110% expected and FEV1 94% expected with an FEV1/FVC ratio of 71.8.  X-rays of the chest were normal.  He was prescribed daily loratidine for his allergies and Proventil (albuterol) inhaler, a bronchodilator, as needed for shortness of breath.  The asthma was determined to be exercise induced.  

The 28 May 2009 MEB NARSUM examination, 6 months prior to separation, noted complaints of shortness of breath and wheezing while running.  Physical examination showed mild to intermittent asthma referencing the PFT results on 4 May 2009, showing methacholine challenge test with 20% drop in FEV1 and positive bronchodilator response.  This was consistent with asthma.  The CI was taking the above medications which controlled his symptoms.  Although his symptoms were exercise-induced, he had been able to pass his physical fitness test in the past.  

At the 23 March 2010 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported that since leaving the service there had been no change in his symptoms.  He still used the albuterol prior to physical exertion.  He did not have asthma attacks and did not required treatment with oxygen or oral or inhaled steroids.  The VA examiner referenced the material already provided above from the MEB NARSUM examination and STR.  Pulmonary function testing was scheduled, but the CI apparently did not report for these.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 10%, coded 6602 (asthma, bronchial).  The VA rated the asthma condition 0%, coded 6602, based on the failure to report for scheduled PFTs.  Panel members agreed that the PEB’s 10% rating was justified by the intermittent use of inhaled bronchodilator therapy reflected in the MEB NARSUM and STR evaluations and by the PFTs (FEV1/FVC of 71-80 % predicted).  There was no evidence to support the next higher 30% rating.  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 asthma condition.  

BOARD FINDINGS:  In the matter of the asthma condition and IAW VASRD §4.96, 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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170218, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

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

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-01947.

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.

						Sincerely,

		

								

Attachment:
Record of Proceedings