RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02880
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20050916

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

CI CONTENTION:  “Review all conditions.”  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 - 20050801	VARD - 20060526	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma with Reactive Airway Disease	6602	10%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record and MEB narrative summary (NARSUM), the CI was first seen on 24 January 2005 for shortness of breath while running.  During a pulmonary medicine visit on 8 March 2005, he reported that he did not smoke or have a prior history of asthma; the physical examination was unremarkable.  Pulmonary function tests (PFTs) showed an FEV1 of 77% and an FEV1/FVC ratio of 75% and provocative testing was positive.  The provider diagnosed mild asthma and started the CI on Pulmicort (inhaled steroid) twice daily and albuterol (inhaled bronchodilator) as needed.  When seen one week later, he reported only using Motrin for medications.  

The 21 April 2005 MEB NARSUM examination, 5 months prior to separation, noted CI complaints of shortness of breath and chest tightness while running for the prior few months.  He denied any cough, nocturnal symptoms, or emergency room visits and reported use of both prescribed medications.  The physical examination was unremarkable.  

On 3 May 2005, he only reported the use of albuterol, and during a follow-up in pulmonary medicine on 20 May 2005, he was again advised to use both medications.  The examination was normal and he stated that he was doing well, but had not done any vigorous exercise.  On 2 June 2005, he again reported the use of albuterol and Motrin, but did not report the use of the Pulmicort.  At a dental appointment on 31 August 2005, 2 weeks prior to separation, he only noted the use of the albuterol.  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 condition 10%, coded 6602 (asthma, bronchial), citing inequities in deployment and remote assignment obligations.  The VA also rated the asthma condition 10%, coded 6602, based on the STR and noting that the CI failed to report for a scheduled C&P examination.  Members agreed the 10% rating adjudicated by the PEB and VA is supported by either the use of intermittent medications, an FEV1 of 71-80%, or an FEV1/FVC ratio of 71-80%.  .  A higher 30% rating is supported by the use of daily bronchodilator therapy, inhalational anti-inflammatory therapy, an FEV1 of 56-70%, or an FEV1/FVC ratio of 56-70%.  While PFT criteria did not meet this threshold, the panel considered whether medication use did.  The CI was placed on a daily inhaled steroid by the pulmonologist.  However, the medical records following the final pulmonary evaluation, 4 months prior to separation, all indicate that the CI did not use it.  The albuterol was prescribed for use as needed.  The CI did endorse its use, but there was no record supporting daily use.  The panel determined that the criteria for a 30% rating were not satisfied at separation.  After due deliberation, considering all of 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 §4.100, 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 20170210, 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-2017-02880.

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,

	

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings