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

XXXXXXXXX
XXXXXXXXX
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Dear Applicant:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-02437.

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 not appropriate under the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended your separation be re-characterized to reflect disability retirement, rather than separation with severance pay

I have carefully reviewed the evidence of record and the recommendation of the Board.    I concur with that finding, accept their recommendation and determined that your records should be corrected accordingly.  The office responsible for making the correction will inform you when your records have been changed.

As a result of the aforementioned correction, you are entitled by law to elect coverage under the Survivor Benefit Plan (SBP).  Upon receipt of this letter, you must contact the Air Force Personnel Center at (210) 565-2273 to make arrangements to obtain an SBP briefing prior to rendering an election.  If a valid election is not received within 30 days from the date of this letter, you will not be enrolled in the SBP program unless at the time of your separation, you were married or had an eligible dependent child, in such a case, failure to render an election will result in automatic enrollment.

						Sincerely,

Attachment:
Record of Proceedings 

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXX	CASE:  PD-2017-02437
BRANCH OF SERVICE:  AIR fORCE 	SEPARATION DATE:  20050726

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Pavement and Construction Equipment Craftsman, medically separated for “asthma” with a disability rating of 10%.   

CI CONTENTION:  No specific contention 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 - 20050610	VARD - 20060327	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Sleep Apnea with Asthma	6602-6847	50%	20060111	
Obstructive Sleep Apnea	6847	Cat II					
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  90%	

ANALYSIS SUMMARY:  

Asthma.  According to service treatment record and MEB narrative summary (NARSUM), the CI’s asthma was initially noted in September 2004 when he performed a spirometry test for an annual occupational examination.  The test revealed a mild to moderate reduced respiratory volume, and he was referred to pulmonology for an albuterol challenge test which showed no significant changes.  Chest X-rays were unremarkable except for thoracic kyphosis.  In December 2004, a methacholine challenge revealed bronchial hyper-responsiveness, and he was diagnosed with asthma and prescribed albuterol (inhalational bronchodilator) and Pulmicort (inhalational steroid) inhalers.  Pulmonary function testing (PFT) on 31 May 2005 showed an FEV-1 of 83% and was interpreted as mild obstruction.  An 11 January 2006 PFT showed an FEV-1 of 98%.
The 26 May 2005 MEB NARSUM examination, 1 month prior to separation, noted no episodes of shortness of breath with mild exertion and good control of asthma symptoms with Pulmicort and albuterol inhalers.  Physical examination showed lungs clear to auscultation bilaterally.  

At the 27 March 2006 VA Compensation and Pension (C&P) evaluation, 8 months after separation, the CI reported chest pains and shortness of breath with exertion.  Physical examination showed the chest clear on auscultation and percussion.  The examiner cited a post-bronchodilator FEV-1/FVC that was 83% but did not attribute this to a specific testing date.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma condition 10%, coded 6602 (asthma), citing limitations on career progress and inequities in deployment/remote assignments.  The VA combined the asthma and sleep apnea conditions under a single rating of 50% coded 6602-6847 (asthma–sleep apnea) based on the C&P evaluation, citing post bronchodilator FEV1/FVC of 83%.  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.”  Members considered whether the requirement for daily bronchodilator and/or routine anti-inflammatory therapy was met in this case, as that is the pivotal criteria between a 10% or 30% rating IAW VASRD §4.97.  Examinations in evidence reported current prescriptions and use of daily bronchodilator and inhaled anti-inflammatories (Pulmicort), and therefore the panel agreed the threshold for a 30% rating was reasonably satisfied.  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 §4.71a.  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, the discharge with severance pay be re-characterized to reflect permanent disability retirement, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Asthma	6602	30%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170302, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record