RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-02424
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20010915

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Intelligence Specialist, medically separated for “mild to moderate persistent asthma” with a disability rating of 10%.

CI CONTENTION: Asthma should have been rated 30%. 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 - 20010725	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Asthma. According to the service treatment record and MEB narrative summary (NARSUM), the CI was initially evaluated in April 2001 for a recent history of recurrent shortness of breath and difficulty with exercise, and a suspected diagnosis of asthma was made based on the clinical presentation. She was prescribed a prednisone (oral steroid) taper for 5 days, Flovent (inhalational steroid), and Proventil (inhalational bronchodilator) as needed. At a pulmonology evaluation on 24 April 2001, the provider noted continued use Flovent among other medications with no use of an oral steroid; Advair (inhalational steroid/bronchodilator combination) was prescribed for mild to moderate asthma. The CI had an asthma attack on 25 April 2001 when attempting to run in cold weather and was treated with Solumedrol (steroid), and on 9 May 2001,

she was again prescribed Flovent and Proventil. At a pulmonary clinic visit on 23 May 2001, symptoms were noted to have improved with treatment, and lungs were clear to auscultation.

The 23 May 2001 MEB NARSUM examination, 4 months prior to separation, documented CI complaints of persistent asthma symptoms despite taking Flovent, Serevent (inhalational bronchodilator), and Proventil. The examiner noted that pulmonary function tests (PFTs) showed mild obstruction with improvement post-bronchodilator, and PFTs at the time of the NARSUM were improved. During the 6 June 2001 MEB examination (recorded on Forms SF-88 and SF-93), the CI reported continued use of Flovent, and no wheezes were noted on examination. At a 3 July 2001 allergy clinic appointment, 2 months prior to separation, the provider noted the CI was taking Flovent. A CT scan of the sinuses showed minimal thickening involving the frontal sinuses. Initial allergy screening revealed a couple of borderline reactions and skin testing was recommended. On 19 July 2001, PFTs showed an FEV-1 of 87% of predicted and an FEV-1/FVC of 99% of predicted. There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the asthma 10%, coded 6602. Panel members noted the one 5-day course of an oral steroid, and one injection of Solumedrol in the year prior to separation, but no evidence showing a requirement for daily use of systemic (oral or parenteral) high dose corticosteroids or immunosuppressive medication. Additionally, there were no asthma exacerbations frequent enough to require monthly visits to a physician. 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,” and the panel agreed that the threshold for this rating was reasonably satisfied on the basis of inhalational anti-inflammatory medication use recorded on all examinations proximate to separation. A 60% rating was not justified in the absence of at least monthly visits to a physician for required care of exacerbations, intermittent (at least three per year) courses of systemic corticosteroids, or PFT evidence. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 30% for the asthma, coded 6602.

BOARD FINDINGS: In the matter of the asthma, 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, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Mild to Moderate Persistent Asthma	6602	30%	

2	PD-2017-0242

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

I?I REPLY REFER TO:
1850
CORB:003
12 Oct 20

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

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr of 11 Jun 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy for appropriate action.
2.	On s October 2020, the Assistant Secretary of the Navy took action in your case by accepting the correct recommendation of the PDBR.	Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Physical Evaluation Board from 10 to 30 percent with assignment to the Permanent Disability Retired List.

3.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, was sent to the Office of the Deputy Commandant (Manpower and Reserve Affairs), for correction of your records as stated above.	You will be notified once those changes are complete.