RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-03549
BRANCH OF SERVICE:  air force	SEPARATION DATE:  20070417

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Missile and Space Facilities Maintenance Journeyman, medically separated for “moderate persistent asthma” with a disability rating of 10%.

CI CONTENTION:  In addition to the asthma and GI issues, the CI also requested review of additional 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 - 20070302	VARD - 20071024	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Moderate Persistent Asthma	6602	10%	Asthma	6602	10%	20070829	
GERD	Not Unfitting	GERD with Sliding Hiatal Hernia	7399-7346	10%	20070829	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Asthma.  According to the service treatment record and MEB Narrative Summary (NARSUM), the CI was diagnosed with asthma in 2006 after experiencing shortness of breath and wheezing associated with exercise.  The 26 June 2006 cardiopulmonary consultation documented use of Advair (inhalational anti-inflammatory), Singulair (oral bronchodilator) and albuterol (inhalational bronchodilator).  Pulmonary function testing (PFT) showed FEV1 of 84% predicted and FEV-1/FVC of 72% post-bronchodilator, with expiratory wheezing with FVC.  The PFTs were consistent with reactive airway disease with a significant reversible component.  Chest X-rays were normal.  

The 10 January 2007 MEB NARSUM, 3 months prior to separation, recorded current medication use of daily Advair, daily Singulair and intermittent albuterol.  The examiner noted the CI had been treated with systemic steroids in July and September 2006 and symptoms resolved with treatment.  Physical examination documented normal chest and lung findings.  

The 29 August 2007 VA Compensation and Pension (C&P) examination, 4 months after separation, documented current medication use of Advair, daily Singulair and intermittent albuterol.  The chest examination was normal.  PFTs from the day prior recorded FEV1 of 93% of predicted and FEV1-FVC of 79% post-bronchodilator.  

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 also rated the asthma condition 10%, coded 6602, based on the C&P examination, citing “medication for intermittent control.”  

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.”  The panel agreed that the MEB NARSUM and C&P examinations, as well as the preponderance of treatment notes, showed the continued use of Advair proximate to separation to support a 30% rating for inhalational anti-inflammatory medication.  A higher 60% rating was not justified in the absence of PFT findings, at least monthly visits to a physician for required care of exacerbations or intermittent (at least three per year) courses of systemic corticosteroids.  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 condition, coded 6602.  

Contended PEB Condition:  GERD.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was not profiled, implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the asthma condition, the panel recommends a disability rating of 30%, coded 6602 IAW VASRD §4.97.  In the matter of the contended GERD condition, the panel agrees it cannot recommend it for additional disability rating.  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, that the discharge with severance pay be re-characterized to reflect permanent disability retirement, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Moderate Persistent Asthma 	6602	30%	

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

XXXXXXXXXX
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XXXXXXXXXX

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-03549.

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.