RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-04228
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20050515

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Unit Level Circuit Switch Operator/Maintainer, medically separated for “asthma” with a disability rating of 10%.

CI CONTENTION: Review 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 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 - 20050311	VARD - 20050927	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	0%	20050721	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Asthma. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI was diagnosed with asthma after he began to develop exertional wheezing in November of 2003. Pulmonary function tests (PFT) in January 2004 and December 2004 (most proximate to separation), recorded respective FEV-1 measurements of 88% and 78% predicted, and FEV-1/FVC ratios of 80% and 77%. There were multiple STR entries corroborating consistent treatment with a daily (or nearly so) inhalational bronchodilator (albuterol), daily oral bronchodilator (Singulair), and daily inhalational anti-inflammatory (Advair). There was one documented course of systemic corticosteroid (oral prednisone), but no evidence of respiratory failure, frequent (3 or more courses yearly) or continuous corticosteroids, hospital admissions, or monthly exacerbations requiring physician visits (criteria for VASRD ratings higher than 30%).

The 15 February 2005 MEB NARSUM examination, 3 months prior to separation, noted current “daily symptoms of cough and the need to use his albuterol daily up to 4 and 5 times a day,” and listed Advair and Singulair as daily medications, with all prescriptions further corroborated by the MEB’s DD Form 2807-1 medical history. The physical examination recorded diffuse wheezing.

The 21 July 2005 VA Compensation and Pension (C&P) examination, 2 months after separation, documented monthly asthma attacks and a requirement for a daily inhalational bronchodilator. Listed medications included Advair, Spiriva (daily oral bronchodilator), and Singulair. At that time the CI was also prescribed prednisone (20 milligrams daily), although there was no VA evidence indicating that this was a frequent or continuous requirement. The VA PFT results showed FEV- 1 of 93% predicted and an FEV-1/FVC ratio of 79.5% and the examiner noted clear lungs.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the asthma 10%, coded 6602 (specific to asthma). The VA conferred a 0% rating under code 6602, based on the C&P examination and citing failure to satisfy the minimum PFT criteria for a 10% rating (FEV-1 of 71 to 80 percent predicted, or FEV-1/FVC of 71 to 80 percent). Although the VA decision referenced the medication evidence from the C&P examination, it failed to address the associated VASRD §4.97 criteria for “intermittent inhalational or oral bronchodilator therapy” in addition to the PFT criteria. A 30% criteria stipulates “FEV-1 of [56-70%] predicted, or; FEV-1/FVC of [56-70%], or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication.” Panel members agreed that both the service and VA examinations provided clear evidence that a 30% rating, but no higher, was met for the medication criteria. 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%	

The following documentary evidence was considered:

2	PD-2017-04228

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO
6040
CORB:003 14 May 21

From: Director, Secretary of the Navy Council of Review Boards To:	XXXXXXXXXXXXXXXXXXXXX

Subj:	Physical Disability Board of Review Determination Ref:	(a) 6040.44(Series)
1.	The Physical Disability Board of Review (PBDR) reviewed your case in accordance with reference
(a) and forwarded their recommendation for action.

2.	On 23 April 2021 the Assistant Secretary of the Navy (Manpower and Reserve Affairs) accepted the PDBR’s recommendation of an increase in disability rating to 30% and placement on the Permanent Disability Retired List. This decision was then sent to Navy Personnel Command for appropriate action.

3.	The PDBR determination is final and not subject to appeal or review.