RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX  	CASE:  PD-2017-04060
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20050711

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

CI CONTENTION:  Review requested of asthma, as well as an additional condition 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 - 20050510	VARD - 20051216	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Moderate Persistent Asthma	6602	10%	Asthma	6602	10%	20051025	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Moderate Persistent Asthma.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI was initially evaluated in March 2004 and clinically found to have asthma.  Although he had been prescribed Advair (inhalational anti-inflammatory) and Singulair (oral bronchodilator), he had “not been using his Advair, Singulair or Zyrtec for the past several months because…he didn't notice a difference when he was on them.”  Pulmonary function testing (PFT) showed FEV-1 of 114% and FEV-1/FVC of 84%. 

The 11 April 2005 MEB NARSUM examination, 3 months prior to separation, noted nocturnal symptoms of coughing, shortness of breath, and wheezing which occurred twice a week.  The CI also indicated that cold, aeroallergens and exercise exacerbated symptoms, but that albuterol (inhalational bronchodilator) provided relief.  Physical examination showed him to be in no acute distress with unlabored breathing, and lungs clear to auscultation bilaterally without wheezing.  The examiner restarted the Advair, noting no significant reduction in his occupational productivity as an electrician on the flight line.  A 19 April 2005 STR entry documented active prescriptions including albuterol as need and daily use Advair.  However, on the 15 June 2005 Report of Medical Assessment, 1 month before separation, the CI reported only using albuterol.

At the 25 October 2005 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported coughing and wheezing, but improvement in symptoms with albuterol treatment (frequency not listed).  Physical examination showed lungs clear to auscultation bilaterally.  Three days later, PFT results showed FEV-1 of 131% and FEV-1/FVC of 102%.  Chest X-rays were normal and showed clear lungs.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma 10%, coded 6602 (asthma).  The VA also rated the asthma 10%, coded 6602, based on the C&P examination, citing intermittent use of an inhalational bronchodilator.  Panel members noted that a 10% rating stipulates “intermittent inhalational or oral bronchodilator therapy,” and agreed that the PEB’s rating was justified by the intermittent use of inhaled bronchodilator therapy reflected in the NARSUM and C&P examinations.  There was no PFT evidence to support the next higher 30% rating.  Likewise, a 30% rating was not justified in the absence of daily inhalational or oral bronchodilator therapy, or inhalational anti-inflammatory medication.  After due deliberation, considering all 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.  

BOARD FINDINGS:  In the matter of the asthma and IAW VASRD §4.97, 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.  

 

SAF/MRB

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-04060.

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.