RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE: PD-2017-05126 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20050201

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Chemical, Biological, Radiological, and Nuclear Specialist, medically separated for “asthma” with a disability rating of 10%.

CI CONTENTION: Review requested of all conditions as well as 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 - 20041022	VARD - 20050819	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	30%	20050317	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Asthma. According to the service treatment record and MEB narrative summary (NARSUM), the CI experienced an asthma attack in October 2003 and presented to the emergency room on    15 November 2003 with complaints of chest pain, difficult breathing and wheezing. Albuterol (bronchodilator) was prescribed, and a medication profile indicated this prescription was filled again in 2004 on 14 March, 26 April, 25 June, and 15 September, each with a quantity of one inhaler. Singulair (oral bronchodilator) and triamcinolone (inhalational steroid) were both filled one time on 26 April 2004, with no refills authorized.

On 5 May 2004, 9 months prior to separation, the CI’s pulmonary function test (PFT) revealed an FEV-1 of 97% predicted and an FEV-1/FVC of 81%. During the 7 June 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), the CI reported current use of albuterol and no other medications, and the examiner noted respiratory wheezing. At the 20 August 2004 primary care clinic appointment, 5 months before separation, the current medication list showed that a prescription for albuterol was last filled on 25 June 2004 (quantity of 1). During the MEB NARSUM examination the same day, the CI reported flare-ups during exercise or when exposed to animal

dander, and continued to use albuterol. The respiratory focused physical examination was unremarkable, and the examiner noted that a PFT completed in May 2004 indicated moderately severe, persistent asthma, which responded well to bronchodilator therapy.

At the 17 March 2005 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported daily use of albuterol as a recue inhaler and the lung examination was normal. The VARD listed evidence from a PFT on 4 April 2005 which showed an FEV-1 of 95% predicted and an FEV-1/FVC of 97%.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the asthma 10%, coded 6602 (asthma, bronchial), citing intermittent inhaled bronchodilator or steroid use. Utilizing the same code, the VA rated the asthma 30%, based on the C&P examination, citing daily use of albuterol as well as PFT findings. Panel members agreed that there were no reported PFT-derived parameters which supported a compensable impairment rating under code 6602. Non-PFT derived criteria include: “intermittent inhalational or oral bronchodilator therapy” for 10%; “daily inhalational or oral bronchodilator therapy, or; non-daily inhalational anti-inflammatory medication” for 30%; and, “intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids” for 60%. The CI was never placed on oral corticosteroids, and thus the panel deliberated over whether his condition supported the 30% criteria level. Although he did receive prescription treatment from both an inhaled corticosteroid and daily use oral bronchodilator, the record clearly showed that such treatments were a single recommendation which occurred 10 months prior to separation and only in a prescribed amount to last the duration of 1 month. Therefore, absent current use of inhaled corticosteroids, daily use of an oral bronchodilator or other newly prescribed medications, there was no support for a rating higher than that adjudicated by the PEB. 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.

2	PD-2017-05126

XXXXXXXXXXXXXXXX. 

Dear XXXXXXXXXXXXXXXX:

	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.