DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 

IN REPLY REFER TO

1850
CORB:003
27 Feb 20

From:
To:

Director, Secretary of the Navy Council of Review Boards 
PD-2017-04128

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr of 18 Jul 19

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 21 February 2020, the Assistant General Counsel 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 Navy Personnel Command for appropriate changes to your personnel records and notification to you upon completion.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE: PD-2017-04128 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20051021

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Gunner’s Mate, medically separated for “mild increase in airway hyperresponsiveness” with a disability rating of 0%.

CI CONTENTION: “Review all conditions.” Review was also requested 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 - 20050830	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Mild Increase In Airway Hyperresponsiveness	6699-
6602	0%	No VA Examination Proximate to Separation in Evidence	
Posttraumatic Right Chest and Liver Gunshot Injury	Cat III		
COMBINED RATING: #%	COMBINED RATING OF ALL VA CONDITIONS: NA	
	
ANALYSIS SUMMARY:

Mild Increase in Airway Hyperresponsiveness. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s respiratory condition began in November 2004 after receiving a gunshot wound to the thoracoabdominal region. The liver, right diaphragm and lung were injured. Surgical procedures affecting the lungs resulted in some compromise of pulmonary function. Studies of the lungs showed some scarring of the right lower lobe and a limited entrapment of the lung at the right lung base.       Pulmonary function tests (PFTs) were normal,

showing normal ventilator capability. A methacholine test showed a minor degree of airway hyperresponsiveness that would normally not be associated with any restriction in exercise capability. He had reported exercise-induced bronchospasm. The CI was referred to a rehabilitation program and given albuterol (inhaled bronchodilator) before exercise, Advair twice a day, and Flonase. After 3 months, he failed to improve his effort tolerance to pass his physical readiness test. He was referred for psychological assessment due to suspicion of psychogenic origin of his ventilation impairment. The psychologist found some element of post-traumatic stress disorder, but no specific treatment was initiated. Despite monthly meetings with the examiner and limited duty (LIMDU), the CI was not motivated to follow a more aggressive rehabilitation schedule.

The 14 July 2005 MEB NARSUM examination, 3 months prior to separation, noted complaints of shortness of breath. The examiner noted this was due to a mild increase in airway hyperresponsiveness and was disproportionate to permanent lung damage from injury. The CI was to continue Flonase at bedtime and albuterol 1-2 puffs before exercise. The MEB physical examination showed some postsurgical scars on the left and right chest. 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 respiratory condition 0%. The VASRD does not have a specific code for this diagnosis, thus the Medical [EPSS] recommends an analogous code, 6699-6602. The panel noted the PFTs were normal and a diagnosis of asthma was not made, but methacholine challenge testing was mildly positive (indicating asthma should be considered). According to the NARSUM, continued use of a bronchodilator was recommended. A 10% rating stipulates “intermittent inhalational or oral bronchodilator therapy.” After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the airway hyperresponsiveness condition, coded 6699-6602.

Contended PEB Condition: Post-traumatic Right Chest and Liver Gunshot Injury. The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting. The non-medical assessment noted the contended condition that resulted in a LIMDU period was a result of a gunshot wound to the abdomen. No specific LIMDU was in evidence. The contended conditions did not 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 mild increase in airway hyperresponsiveness condition, the panel recommends a disability rating of 10%, coded 6699-6602, IAW VASRD §4.100. In the matter of the contended post-traumatic right chest and liver gunshot injury conditions, the panel recommends no change from the PEB determinations as not unfitting. 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	
Mild Increase In Airway Hyperresponsiveness	6699-6602	10%	

The following documentary evidence was considered: