RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX
BRANCH OF SERVICE: AIR FORCE

CASE: PD-2020-00179 SEPARATION DATE: 20040927

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (Cl) was an active duty E6, Milit ary Working Dog Handler, medically separated for "asthma," with a disability rating of 10%.

Cl CONTENTION: He should have received a 30% disability rating for his asthma (requested through legal counsel). 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 Eva luat ion Board (PEB) to be u nfi tt ing for continued military service, and when specifically requested by the Cl, those conditions identified by the Medical Eva luation Board (M EB), but determined by the PEB to be not unfi tti ng or non-compe nsable. Any conditions outside the panel' s defined scope of review, and any contention not requested in th is application, may remain eligible for fut ure 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, part icularly within 12 months of separation, but only to the extent that it reasonab ly reflects the severity of disability at the time of separation.

RATINGCOMPARISON:

SERVICE PEB	•	20040414	VARD • 20050802	
Condition	I	Code	I	RatinE	Condition	I	Code	I	RatinE	I	Exam	
Ast hma	I	660 2	I	10%	Bro nchial Ast hma	I	6602	I	30%	I 20050406	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Asthma. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the Cl' s first report ed "short ness of breath with cough and wheezing" while serving in Korea. The 22 March 2004 MEB NARSUM, 6 mont hsprior to separation, listed current asthma medications as Flovent MDI (inhalational steroid), albutero l (inha lationa l bronchodi lator) , and Singu lair (oral indirect-acting bronchodilator). The examiner also noted the Cl had been followed by a pulmonologist who concurred with the diagnosis of "mi ld persistent extrinsic/atopic asthma...currently well contro lled on inhaled steroid, antihistamines, Singulair and int ermitt ent usage of inhaled albut erol." At an allergy clinic evaluation on 31 March 2004, the provider documented that the Cl had been prescribed Singu lair as we ll as Combivent (inhalationa l bronchodi lator) as requ ired . Pulmon ary function tests (PFTs) were normal, showing FEV of 101.91%, and FEV-1/FVC of 103 % of predicte d value. During a primary care visit on 2 September 2004, 25 days before separation, the examiner stated the Cl was well controlled on Singu lair, Flovent and Combivent, and that he was " doing great" and had never had any " bad asthma attacks." There was no evidence in the STR that asthma exacerbations were frequent enough to requ ire monthly visits to a physician.

The 6 Apr il 2005 VA Compensat ion and Pension (C&P) examination, 6 months after separation, noted the Cl was taking Singulai r, Serevent (inha lational bronchodilator), and Combivent, but did not provide details of frequency or prescribed dosages. The examiner noted chronic, recurrent bronchial asthma "current ly contained on medication," with normal PFTs and no disability .

The panel directed attention to its rating recommendatoi n based on the above evidence. The PEB rated the asthma 10%,coded 6602 (asthma, bronchia l), citi ng genera l DoD and VASRD guid elines. The VA also rated the asthma 30%, coded 6602, based on the C&P examination , citing daily oral bronchodilator treatment .	The MEB NARSUM, primary care treatment entry, and C&P  examination documented current prescriptions and use of daily bronchodilators and inhaled anti­ inflammator y medications. Thus, the panel agreed that the VASRD §4.97 threshold for a 30% rating was reasonably satisfied in this case. 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 disabi lity rating of 30% for the asthma, coded 6602.

BOARD FINDINGS: In the matter of the asthma, the panel recommends a disab ility rating of 30%, coded 6602 IAW VASRD §4.71a. There are no other conditionswithin the panel' s scope of review for consideration .

The panel recommends the Cl's prior determination be modified as fo llows; and, that the discharge with severance pay be re-characterized to refl ect permanent disability retirement , effective the date of medical separation:

	CONDITION	VASRD CODE	PERMANENT RATING	
Asthma		6602	30%	

The fo llowi ng documentary evidence was considered:

DEPARTMENT OF THE AIR FORCE
WASHINGTON DC

Office of the Assistant Secretary

SAF/MRB
3351 Celmers Lane
IBA NAF Washington, MD 20762-6435
Dear XXXXXXXXXXXXXXX:
Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2020-00179.
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 Ratmg 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 con ected accordingly. The office responsible for making the con ection will infonn you when your records have been changed.
As a result of the aforementioned con ection, 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 SAF.HAF.CPSWorkflow@us.af.mil to make an angements to obtain an SBP briefmg 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 maITied , in suc h a case, failure to render an election will result in automatic enrollment by law