RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04436
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20030321

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Aviation Operations Specialist, medically separated for “spontaneous pneumothorax” with a disability rating of 0%.

CI CONTENTION:  The rating should be changed.  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’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 - 20030110 	VARD - 20030829 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Spontaneous Pneumothorax 	6843	0%	Spontaneous Pneumothorax	6843	10%	20030708 	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:

Spontaneous Pneumothorax.  According to the service treatment record and MEB narrative summary (NARSUM), the CI had three-left lung episodes of spontaneous pneumothorax (small air sacs in lung tissue that rupture, causing air to leak).  The first episode occurred in May 1999 and resulted in the placement of a chest tube.  The second episode was in July 2001 for which he underwent a pleurodesis (membranes stick together to prevent fluid buildup) and in July 2002 he underwent another pleurodesis.

The 3 December 2002 MEB NARSUM examination, 4 months prior to separation, noted complaints of constant pleuritic chest pain exacerbated by lifting or deep breathing.  He could not perform most airfield operations duties, run or take the physical fitness test.  Physical examination was normal.  His bilateral lungs were clear and no abnormalities were noted.  A chest X-ray showed minimal left costaphrenic angle blunting most likely due to scarring from the pleurodesis.  The 3 January 2003 pulmonary function test, 3 months before separation, showed FEV-1 of 138%, FEV-1/FVC of 81% and DLCO of 126%.

At the 8 July 2003 VA Compensation and Pension (C&P) evaluation, 5 months after separation, the CI reported that he avoided regular exercise due to fear of what could happen and denied shortness of breath with walking or going up/down stairs.  He had residual scarring due to the procedures that were performed.  He stated that the scars were uncomfortable and tender when touched.  Occasionally he had tenderness and tingling along the left sternal border.  He took no medications and was unemployed.  He was able to walk greater than one mile, go up/down stairs without difficulty and could perform activities of daily living without assistance.  Physical examination showed a mild pleuritic rub generalized to left lung fields, was clear to percussion and respirations were normal.  A chest X-ray was normal.  Pulmonary function test showed FEV-1 of 94%, FEV-1/FVC of 78% and DLCO of 113%.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the spontaneous pneumothorax 0%, coded 6843 (traumatic chest wall defect, pneumothorax), citing normal FVC, FEV1 and DLCO.  The VA rated the spontaneous pneumothorax condition 10%, coded 6843, based on the C&P examination, citing a ratio of FEV-1/FVC of 78 percent.

The panel agreed the spirometry readings of 3 January 2003, closest to separation, did not meet the requirements for a 10% disability and there was no evidence to support a higher rating under restrictive lung disease.  After due deliberation, considering all of 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 spontaneous pneumothorax.

BOARD FINDINGS:  In the matter of the spontaneous pneumothorax 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.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170427, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180006646, XXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,					      
Enclosure