RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX  	CASE:  PD-2018-00006
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20041108

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Air Traffic Control Journeyman, medically separated for “asthma” with a disability rating of 10%.  

CI CONTENTION:  “Was medically discharged for asthma (0% rating).  Disability rating is for chronic octitis (ear infections).”  The CI requested review of an additional condition not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20040825	VARD - 20050428	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma	6602	0%	20050312	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI began experiencing shortness of breath and a sensation of burning and pressure on her chest when running during squadron physical training in February 2004.  On 15 May 2003, pulmonary function testing (PFT) showed an FEV-1 of 67% predicted and FEV-1/FVC of 68%.  The clinical diagnosis was asthma and a 2-week trial of Advair (inhalational steroid/bronchodilator combination) was recommended.  At a pulmonary evaluation on 25 February 2004, the CI reported shortness of breath, chest tightness, bronchitis, and wheezing every couple of months.  On 12 March 2004, PFT results showed an FEV-1 of 107% predicted and FEV-1/FVC of 84% with a significant response to bronchodilator medication.  At follow-up pulmonary visits, she reported was using her rescue inhaler less since on Advair and did not have as many attacks.  

The 16 April 2004 MEB NARSUM examination, 7 months prior to separation, noted complaints of shortness of breath when running.  Physical findings referenced the 24 March 2004 pulmonary consultation that noted the CI was taking Advair, which reduced attacks and decreased the need for albuterol (inhalational bronchodilator).  At a 26 May 2004 primary care appointment, 5 months before separation, the CI was taking Advair and albuterol.  On 16 August 2004, PFT’s showed an FEV-1 of 88% and FEV-1/FVC of 72%.  No post-bronchodilator test was performed, and the examiner’s interpretation was possible early obstructive pulmonary impairment.  

At the 12 March 2005 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported shortness of breath caused by exertion.  The examiner documented that the CI was taking no medications.  Cough expectoration and shortness of breath were absent at rest and no wheezing was noted.  On 24 March 2005, PFTs showed an FEV-1 of 93% of predicted and an FEV-1/FVC of 84% with a significant change in FEV-1 post-bronchodilator medication (13%).  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the asthma 10%, coded 6602 (asthma).  The VA rated the asthma 0%, coded 6602, based on the C&P examination.  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 use.  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, coded 6602.  

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

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2018-00006.

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.