RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXX	CASE:  PD-2017-05584
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070611

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Aircraft Loadmaster, medically separated for “asthma” with a disability rating of 10%.  

CI CONTENTION:  No specific contention was made.  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 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 - 20070420	VARD - 20080505	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Exercise-Induced Bronchospasm with Underlying Asthma	6602	10%	20080207	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s sought care at the emergency from in August 2005 for complaints of a cough, chest pain and shortness of breath.  On 9 October 2006, pulmonary function testing (PFTs) showed an FEV-1 of 60% of predicted and an FEV-1/FVC of 61%.  At a flight medicine visit on 26 February 2007, 4 months prior to separation, the provider noted he was being treated with Advair (inhalational steroid/bronchodilator combination) with good results.  

The 7 March 2007 MEB NARSUM examination, 3 months before separation, also noted the CI was taking Advair, and the recommendation was to continue on his inhaler at the 100/50 dose with pre-exertion albuterol (inhalational bronchodilator) usage.  During the 8 May 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 1 month prior to separation, the CI reported taking Advair and albuterol.  

At the 7 February 2008 VA Compensation and Pension (C&P) examination, 8 months after separation, the examiner noted that he was taking Advair until August 2007 (2 months after separation) when he ran out of medication.  Chest X-rays revealed hyper-inflated lungs, possibly secondary to asthma, and PFTs showed an FEV-1 of 99% of predicted and an FEV-1/FVC of 77%.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma 10%, coded 6602 (asthma, bronchial).  The VA also rated the asthma 10%, coded 6602, based on the C&P examination, citing FEV-1 of 71 to 80%t of predicted; or FEV-1/FVC of 71 to 80%; or intermittent inhalational or oral bronchodilator therapy.  Panel members agreed that the VASRD §4.97 threshold for a 30% rating was reasonably satisfied for “inhalational anti-inflammatory medication use,” which was documented by all examinations noted above.  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 3 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, coded 6602.  

BOARD FINDINGS:  In the matter of the asthma, the panel recommends a disability rating of 30%, coded 6602 IAW VASRD §4.71a.  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%	

SAF/MRB
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

Dear XXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05584.

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 not in accordance with the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended your separation be re-characterized to reflect disability retirement, rather than separation with severance pay.

I have carefully reviewed the evidence of record and the recommendation of the Board.    I concur with that finding, accept the recommendation and determined that your records should be corrected accordingly.  The office responsible for making the correction will inform you when your records have been changed.

As a result of the aforementioned correction, you are entitled by law to elect coverage under the Survivor Benefit Plan (SBP).  Upon receipt of this letter, you must contact the Air Force Personnel Center at (210) 565-2273 to make arrangements to obtain an SBP briefing prior to rendering an election.  If a valid election is not received within 90 days from the date of this letter, you will not be enrolled in the SBP program unless at the time of your separation, you were married, in such a case, failure to render an election will result in automatic enrollment by law.