RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXX BRANCH OF SERVICE:  AIR FORCE

CASE:  PD-2020-0007 4
SEPARATION DATE: 20040120

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (Cl) was an active duty E4, Special Purpose Vehicle and Equ ipm ent Maintenance Journeyman, medically separated for "asthma" with a disability rating of 10%.

Cl CONTENTION: " At 10% I should have been able to stay active duty or at least entered the Reserves or Guard." 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 Cl, those conditions identified by the Medical Evaluation Board (M EB), 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.

RATINGCOMPARISON:

SERVICE PEB		20030930	VARD· NA	
	Condition	I	Code	I   Rating	Condition	I	Code	I  Rating  I	Exam	
Asthma		I	6602	I	1 0%	N o VA Examination  Proximate to Separation  in Evidence	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUM M ARY:

Asthma. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the Cl' s asthma condition manifest ed as chest tightness and coughing while deployed in 2001. Pulmonary function testing (PFT) on 30 July 2001 were normal (FEV-1 at 79% predicted and FEV-1/ FVCat 76.6), and methacholine challenge was positive for asthma. The 17 April 2002 MEB NARSUM examination , 21 months prior to separation , noted complaints of chest t ight ness, coughing and wheezing. Methacholine challenge on 30 July 2001 was positive. Physical examination showed the lungs were clear without wheezes, rales, or retractions. Current asthma medications included Advair (inhalational anti-inflammatory / bronchodilator combination) and albuterol (inhalational bronchodilator). There was no MEB NARSUM addendum more proximate to separation in evidence. PFTs on 28 April 2003, 9 months before separation, showed FEV-1 at 97.9% predicted and FEVl / FVC at 82 .8%. The STR showed the Cl' s use of Advair and albuterol for asthma treatment in multiple notes and as late as 17 December 2003 during a family practice visit, one month before separation. There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the asthma condition 10%, 6602 (asthma), noting the Cl " still uses his rescue inhaler (albuterol) despite adequate treatment..." 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 ." A 30% rating is supported due to the Cl' s prescribed use of inhalational anti-inflammatory medication (Advair ), as during documented in the MEB NARSUM and subsequent STRs. A higher 60% rating was not justified in the absence of monthly visits to a physician for required care of exacerbations, or intermittent (at least three per year) courses of systemic corticosteroids. There was no PFT evidence to support a higher rating. 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 Cl'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%

2	PD-2020-00074

Office of the Assistant Secretary

DEPARTMENT OF THE AIR FORCE
WASHINGTON DC

Dear XXXXXXXX:
Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2020-00074.

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 co1Tec ted 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 a r e 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  an  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 s u c h a case , failure t o r e n der an election will result in automatic enrollment by law.