RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-02840 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20090730

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Construction Wireman, medically separated for “bronchiectasis without acute exacerbation” with a disability rating of 0%.

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 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 - 20090527	VARD - 20090825	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bronchiectasis without Acute Exacerbation	6845-6601	0%	Bronchiectasis without Acute Exacerbation	6845-6601	0%	20090121	
Chronic Sinusitis	CAT II	Chronic Sinusitis	6513	0%	20090121	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 0%	
	
ANALYSIS SUMMARY:

Bronchiectasis without Acute Exacerbation. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI developed a productive cough in June 2004 after developing community acquired pneumonia. In October 2007, pulmonary function tests (PFTs) revealed results suggesting a mild obstructive respiratory defect. Radiographic imaging performed in late 2007 revealed bronchiectasis (widening and thickening of the airways) as well as mucous plugging within the lungs. Despite multiple treatment modalities, the CI’s chronic cough and repeated bouts of pneumonia continued. The CI was treated with a course of antibiotics (Amoxicillin), last filled on 4 December 2008.

The 7 January 2009 MEB NARSUM examination, 7 months prior to separation, noted complaints of “shortness of breath on exertion…resulting in decreased exercise tolerance due to chronic cough with sputum production.”  Physical examination was unremarkable.

At the 21 January 2009 VA Compensation and Pension (C&P) examination, 6 months prior to separation, the CI reported no new or additional symptoms. Physical examination was unremarkable. Repeat chest X-ray and PFTs were normal. The STR showed the CI was treated with a course of antibiotics (Bactrim) prescribed on 24 February 2009.

The panel directed attention to its rating recommendation based on the above evidence. Both the PEB and VA rated the bronchiectasis 0%, dual coded 6845-6001 (chronic pleural effusion or fibrous and bronchiectasis) citing the absence of intermittent productive cough with acute infection requiring a course of antibiotics at least twice a year, respectively. The PEB additionally listed chronic sinusitis as a Category II diagnosis which panel members agreed was intrinsic to the rated primary pulmonary condition and therefore, separate ratings could not be supported without pyramiding (VASRD §4.14). Therefore, the sinusitis was appropriately subsumed under the bronchiectasis rating.

A 10% rating under code 6601 requires the presence of symptoms and evidence of at least two courses of antibiotics per year. A higher rating requires evidence of “incapacitating episodes.” After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel agreed that the absence of incapacitating episodes coupled with evidence of antibiotic use twice within a year prior to separation supported a 10% rating. Therefore, the panel recommends a disability rating of 10% for the bronchiectasis, coded 6601.

BOARD FINDINGS: In the matter of the bronchiectasis, the panel recommends a disability rating of 10%, coded 6601 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	
Bronchiectasis without Acute Exacerbation	6601	10%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20170429, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

2	PD-2017-02840

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

IN REPLY REFER TO

1850
CORB:003
9 Jun 20

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

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

Ref:   (a) DoDI 6040.44
(b) PDBR ltr of 29 Oct 18

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy for appropriate action.

2.	On 4 June 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) took action in your case by accepting the recommendation of the PDBR. Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEB) from 0% to 10% without re-characterization of your discharge.

3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement to additional compensation.

4.	The Assistant Secretary’s determination, which represents final action in your case by the Department of the Navy, has been forwarded to the office of the Deputy Commandant, Manpower and Reserve Affairs, for appropriate changes to your personnel records and notification to you upon completion.