RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-06165
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20050601

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

CI CONTENTION:  “Turns out the problem was cancer (lymphoma), not asthma.  Review all conditions.”  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 - 20050330	VARD - 20060118	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	10%	20051018	
History of Tobacco Abuse	Cat III	No VA Placement	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  100%	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI experienced intermittent shortness of breath, coughing and wheezing in November 2004, and on 2 January 2005, a pulmonary function test (PFT) showed an FEV-1 of 90% of predicted and an FEV-1/FVC of 106%.  The 2005 MEB NARSUM examination (undated), documented a current prescription of Advair (inhalational steroid/bronchodilator combination) twice a day for chronic asthma, and also albuterol (inhalational bronchodilator), as needed, for wheezing, cough, and shortness of breath.  The examiner noted the CI had been compliant with his medication.  During a 7 April 2005 primary care visit, 2 months prior to separation, he was prescribed daily use of Advair and given a 90-day supply of medication.  Review of the STR found no clinical encounters in evidence documenting the use of at least three courses per year of an oral or parenteral (injection) steroid for asthma during the year prior to separation; or asthma exacerbations frequent enough to require monthly visits to a physician.  At the 13 October 2005 VA Compensation and Pension (C&P) examination, 4 months after separation, the examiner noted that the CI was using Advair and albuterol with no further elaboration.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma 10%, coded 6602 (asthma), citing mild and intermittent symptoms.  The VA also rated the asthma 10%, coded 6602, based on the STR and C&P examination, citing a history of the asthma with inhaler use as needed, and the January 2005 service PFT which was well within normal limits.  Panel members agreed that the CI’s use of Advair met criteria for a 30% rating which 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.”  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.  

Contended PEB Condition:  History of Tobacco Abuse.  In accordance with DoDI 1332.38, E4.13.1.4 and E5, tobacco abuse does not constitute a physical disability, and is therefore not compensable. 

BOARD FINDINGS:  In the matter of the asthma, the panel recommends a disability rating of 30%, coded 6602 IAW VASRD §4.97.  In the matter of the contended history of tobacco abuse, 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%	

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-06165.

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.