RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2018-00483
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20060602

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Aircraft Fuel System Craftsman, 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 - 20060327	VARD - 20070207	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Asthma	6602	10%	Asthma 	6602	30%	20060820	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Asthma.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI first presented with acute respiratory distress in September 2005 and was ultimately diagnosed with asthma.  Provider entries in the STR amply corroborated compliant treatment with inhalational bronchodilator (albuterol) as needed and daily inhalational anti-inflammatory (Advair) medications.  There was one documented course of systemic corticosteroid (oral prednisone).  A pulmonary function test (PFT) in October 2005, after the condition was stabilized, documented post-bronchodilator measurements of FEV1 of 84% predicted and an FEV1/FVC ratio of 82%.  There was no STR evidence for respiratory failure, frequent (three or more courses yearly) or continuous corticosteroids, hospital admissions, or monthly exacerbations requiring physician visits which are all criteria for VASRD ratings higher than 30%.

The 7 February 2006 MEB NARSUM examination, 4 months prior to separation, documented the CI “has done well on Advair [and] has had no recurrence of his symptoms.”  The medication list confirmed treatment with albuterol as needed and daily Advair.  The examiner noted although earlier PFTs had normalized, more recent ones had worsened.  The source evidence for the latter, however, was not available in the STR.  Physical examination recorded clear lungs.  At the 20 August 2006 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported shortness of breath.  PFTs on 19 August 2006, the day prior, showed an FEV-1 of 81% of predicted and an FEV-1/FVC of 66%.  The examiner noted the CI was taking albuterol and Advair.  

The panel directed attention to its rating recommendation based on the above evidence. The PEB and VA both coded the condition 6602 (asthma, bronchial).  The PEB cited abnormal pulmonary function testing.  The VA based the rating on the C&P examination, citing the ratio of FEV-1 to forced vital capacity (FEV1/FVC) was between 56 to 70 percent.   The NARSUM, STR and C&P examinations all supported that the CI was prescribed Advair for daily use.  In addition to being an inhalational bronchodilator (salmeterol), Advair also contains an inhalational anti-inflammatory medication (fluticasone), and would therefore warrant a 30% rating.  The panel agreed a 30% rating was also supported by the FEV-1/FVC of 66 percent noted by the VA C&P examination.  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 §4.97.  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 XXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2018-00483.

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.