RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-05470
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20040227

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Fire Controlman, medically separated for “asthma” with a disability rating of 10%.

CI CONTENTION: Should be awarded a higher rating based off CFR rating criteria. The complete submission is at Exhibit A.

SCOPE OF REVIEW: The panel’s scope of review is defined in Do DI 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 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 – 20040107	VARD - 20040409	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Moderate Persistent Asthma	6602	10%	Asthma	6602	10%	20031231	
Severe Obstructive Sleep Apnea	Cat III	Sleep Apnea	6847	50%		
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 70%	

ANALYSIS SUMMARY:

Asthma. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI was evaluated June 2003 by pulmonary medicine for dyspnea and chest tightness. He was healthy up until 1998 and then he developed a chest cold which required breathing treatment for dyspnea and chest tightness. His condition progressively worsened with symptoms of dyspnea associated with nighttime and morning cough. He described his breathing as labored. He took albuterol approximately three times a day.

At 12 June 2003 pulmonary evaluation, 8 months prior to separation, the CI complained of dyspnea and chest tightness. The examiner noted pulmonary function tests (PFTs) revealed air flow obstruction consistent with moderate obstructive lung disease and the CI was diagnosed with moderate persistent asthma, placed on limited duty (LIMDU), and started on an Advair inhaler 250/50, one puff twice a day. Upon his return to the pulmonary clinic on 6 August 2003, 6 months prior to separation, the examiner increased his Advair prescription to 500/50.

The 18 September 2003 MEB NARSUM examination, 5 months prior to separation, noted complaints of dyspnea and chest tightness. Physical examination revealed lungs were clear to auscultation bilaterally with no wheezes or rhonchi appreciated. His upper airway examination had a crowded posterior pharynx with a Mallampati III airway. There was no sinus tenderness, and no oropharyngeal lesions were noted.

A 9 June 2003 PFT revealed a pre-bronchodilator FVC of 4.31 (which was 76% of predicted,) an FEV1 of 3.02 (which was 65% of predicted,) and an FEV1 to FVC ratio of 70 (with a predicted value of 82.) Post bronchodilator FEV1 was 4.14 (or 89% predicted, which was a 37% increase from his baseline,) and his FVC was 5.80 (or 103% of predicted, which was a 35% increase from his baseline). The NARSUM examination noted referral to the PEB based on persistent exercise intolerance and moderate persistent asthma.

At the 31 December 2003 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported wheezing and difficulty breathing. Physical examination revealed PFTs were within normal limits but mildly depressed FEV1 and FEF 25-75 were both improved by bronchodilator, consistent with asthma.

The panel directed attention to its rating recommendation based on the above evidence. The PEB and VA both rated the asthma condition 10%, analogously coded 6602 (bronchial asthma). The VA rating was based on the C&P examination. Inhaled anti-inflammatories were prescribed, as noted by the pulmonary clinic, MEB and VA examiners. Panel members agreed that the VASRD
§4.97 threshold for a 30% rating was reasonably satisfied in this case on the basis of bronchodilator and/or inhalational anti-inflammatory medication use as well as FEV-1 of 56 to 70% predicted. A 60% rating was not justified in the absence of at least monthly visits to a physician for required care of exacerbations, or intermittent (at least three per year) courses of systemic corticosteroids. 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 condition, coded 6602.

Contended PEB Condition: Severe Obstructive Sleep Apnea (OSA). The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting. The contended condition was not noted on LIMDU forms, implicated in the non-medical assessment, and 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 asthma condition, the panel recommends a disability rating of 30%, coded 6602 IAW VASRD §4.97. In the matter of the contended severe obstructive sleep apnea condition, the panel recommends no change from the PEB determination 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; 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%	
	COMBINED	30%	

The following documentary evidence was considered:

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,
1850
CORB:003 12 Oct 20

From: To:

Subj:

Ref:

Director, Secretary of the Navy Council of Review Boards 

PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)
(a) DoDI 6040.44
(bl PDBR ltr of 3 Jan 20

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy for appropriate action.

2.	On 7 October 2020, the Assistant Secretary of the Navy took action in your case by accepting the correct recommendation of the PDBR.	Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Physical Evaluation Board from 10 to 30 percent with assignment to the Permanent Disability Retired List.

3.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, was sent to the Navy Personnel Command, for correction of your records as stated above.	You will be notified once those changes are complete.