RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  xxxxxxxxxxxxxxxxxxx	CASE:  PD-2017-05681
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20061101

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

CI CONTENTION:  “Asthma medications are expensive, and I go months without prescriptions due to the cost.  My career was ended due to developing asthma.”  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 - 20060912	VARD - 20070529	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	10%	20070329	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Asthma.  According to the information available in the MEB narrative summary (NARSUM), the CI’s asthma condition began following his return from deployment to Iraq in early 2006.  He reported difficulty breathing during physical therapy and at night for 5 months.  On 9 May 2006, 5 months prior to separation, pulmonary function testing (PFTs) showed an FEV-1 of 77% of predicted and an FEV-1/FVC of 72%.  PFTs also noted moderate obstructive lung defect with good response to bronchodilator treatment.   

While minimal service treatment records (STRs) were in evidence, the 17 July 2006 MEB NARSUM, 4 months prior to separation, noted that the CI was prescribed and used an Albuterol inhaler (inhaled bronchodilator) as needed at the time of the examination.  He was also started on Advair (inhalational anti-inflammatory) on 22 June 2006.  He still had symptoms with running and his medications were adjusted.  Physical examination revealed wheezing but no rhonchi, rales/crackles.  Respiratory movements were normal.  The examiner noted the CI had mild persistent asthma, fairly controlled on current medications.
At the 29 March 2007 VA Compensation and Pension (C&P) examination, 5 months after to separation, the examiner noted that the CI was taking Albuterol and Advair intermittently.  PFTs done the same day showed an FEV-1 of 82% of predicted and an FEV-1/FVC of 75%.  The CI reported after running, he had a cough and shortness of breath.  He reported wheezing with exercise.  Functional impairment was shortness of breath with exertion.  The CI had been working for the past 3 months and could perform activities of daily living.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB and VA both rated the asthma condition 10%, coded 6602.  The PEB cited general application of DoD and VASRD guidelines.  The VA cited “intermittent inhalation and bronchodilator therapy and the ratio of FEV-1 to forced vital capacity (FEV1/FVC) [of] 75.”  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.”  

An inhaled anti-inflammatory medication (Advair) was prescribed, as noted by the MEB NARSUM and C&P examiners.  Panel members agreed that the VASRD §4.97 threshold for a 30% rating was reasonably satisfied in this case on the basis of inhalational anti-inflammatory medication.  There was no STR evidence for respiratory failure, intermittent (at least three per year), daily use of systemic (oral or parenteral) corticosteroids, or monthly exacerbations requiring physician visits (criteria for VASRD ratings higher than 30%).  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.  

BOARD FINDINGS:  In the matter of the asthma condition, 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%	

Dear XXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05681.

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.