RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  xxxxxxxxxxxxxxxxxxxxxxx	CASE:  PD-2017-03996
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20051104

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Information Management Journeyman, medically separated for “asthma” with a disability rating of 10%. 

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 - 20050919	VARD - 20060608	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	10%	20060103	
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 complained of chest pain and shortness of breath in May 2005.  Pulmonary function testing (PFT) in June 2006 showed normal baseline spirometry (FEV-1 of 79% and FEV-1/FVC of 85%), but a methacholine challenge test was positive (consistent with asthma). The 21 July 2005 MEB NARSUM examination, 4 months prior to separation, noted “some shortness of breath and some intermittent substernal chest discomfort especially with exertion.”  The examiner started the CI on daily Advair (inhalational anti-inflammatory) and as-needed albuterol (inhalational bronchodilator).  Physical examination showed “lungs clear to auscultation bilaterally without any rales, rhonchi or wheezing present.”  At the 3 January 2006 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported taking Advair on a daily basis, but had only used the albuterol inhaler twice since separation.  Physical examination showed “lungs clear with adequate excursion.”  The 12 January 2006 PFT showed normal spirometry (FEV-1 of 82% and FEV-1/FVC of 88%) with “mild bronchodilator response at low flow rates.”

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma 10%, coded 6602 (bronchial asthma).  The VA also rated the asthma 10%, coded 6602, based on the C&P examination, citing “intermittent inhalational therapy.”  Although there was post-separation evidence showing the CI stopped using Advair in 2006, panel members noted that she was definitively taking it at separation and for at least 2 months after separation as documented on the NARSUM and C&P examinations.  Thus, the panel agreed that the VASRD §4.97 threshold for a 30% rating was reasonably satisfied in this case on the basis of inhalational anti-inflammatory medication use.  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; 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	
Asthma	6602	30%	

SAF/MRB
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

Dear Ms. xxxxxxxxxxxxx:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-03996.

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 in accordance with 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 the 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 to make arrangements to obtain an SBP briefing prior to rendering an election.  If a valid election is not received within 90 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, in such a case, failure to render an election will result in automatic enrollment by law.