SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05208.

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.

						

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX		CASE: PD-2017-05208 BRANCH OF SERVICE: AIR FORCE	SEPARATION DATE: 20050926

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Aircraft Structural Maintenance, medically separated for “asthma” with a disability rating of 10%.

CI CONTENTION: The condition has continued to worsen and affects activities of daily living. 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 - 20050609	VARD - 20060829	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	10%	STR	
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 multiple visits to the emergency room for “breathing problems,” and at the last visit in August 2004, he was prescribed prednisone (corticosteroid) and an albuterol (bronchodilator) inhaler as required. At a pulmonary clinic visit on 3 November 2004, pulmonary function tests (PFTs) showed an FEV-1 of 71% of predicted and FEV-1/FVC of 93%; “consistent with moderate obstructive defect.” At a pulmonology appointment on 16 December 2004, 9 months before separation, the examiner diagnosed persistent  asthma  and  prescribed  use  of  QVAR  (beclomethasone  dipropionate),  an inhaled

corticosteroid (two puffs twice daily), and continued use of albuterol as needed. At a family practice visit the next day, the CI reported no shortness of breath and no issues that month. Claritin (anti-histamine) had helped symptoms and he used albuterol once every 2-3 weeks. No overnight shortness of breath was annotated. The examiner documented mild to moderate persistent asthma and recommended continued use of the inhaled corticosteroid for maintenance and albuterol as required.

The 21 January 2005 MEB NARSUM examination, 8 months prior to separation, listed QVAR (2 puffs twice daily), albuterol (as required) and Claritin daily with a final diagnosis of “mild to moderate asthma, stable on medications” that could impact military speciality performance with extended exposure to cold temperatures. The examiner cited PFT’s from November 2004 as noted above.

A letter to the CI’s primary care physician on 24 January 2005 reiterated the same information from the 16 December 2004 pulmonology appointment. At a family practice visit on 18 March 2005, 5 months before separation, the examiner noted mild intermittent asthma symptoms and that the CI had not used albuterol since November 2004 and did not use the QVAR prescription; continued use of the albuterol as needed was recommended. On 25 March 2005, PFTs revealed in an FEV-1 of 75% of predicted and FEV-1/FVC of 88%. There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The formal PEB rated the asthma 10%, coded 6602 (asthma, bronchial). The VA also rated the asthma condition 10%, coded 6602, based on the STR, citing intermittent inhalational or oral bronchodilator therapy. A 30% rating stipulates “FEV-1 of 56- to 70-percent predicted, or; FEV- 1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication.” Although inhaled anti-inflammatories were prescribed, as noted by the pulmonary and NARSUM examiners, the CI denied use. 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.

The following documentary evidence was considered: