RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2013-02123
BRANCH OF SERVICE:  AIR FORCE	BOARD DATE:  20140618
SEPARATION DATE:  20051223

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SSgt/E-5 (3S071/Personnel Craftsman) medically separated for obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP).  The sleep apnea condition could not be adequately rehabilitated to meet the physical requirements of his Air Force Specialty or satisfy physical fitness standards.  He was issued a permanent 4P profile and referred for a Medical Evaluation Board (MEB).  Sleep apnea was forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123.  No other conditions were submitted by the MEB.  The Informal PEB adjudicated “Obstructive Sleep Apnea with CPAP, mild impairment” as unfitting, rated 0%.  Although not submitted by the MEB, the PEB adjudicated asthma as a Category II condition.  The CI made no appeals and was medically separated.

CI CONTENTION:  “Please see attachments.”  The CI attached six pages to his application which were reviewed by the Board and considered in its recommendations.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI.  The rating for the unfitting sleep apnea condition is addressed below; and, no additional conditions are within the DoDI 6040.44 defined purview of the Board.  Any conditions or contention not requested in this application, or otherwise outside the Board’s defined scope of review, remain eligible for future consideration by the Board for Correction of Military Records.

RATING COMPARISON:

Service IPEB – Dated 20051107	VA - (10 Mos. Post-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Obstructive Sleep Apnea w/ CPAP	6847	0%	Obstructive Sleep Apnea and Asthma w/CPAP	6847	50%	20061030 MISSING	
Asthma	CAT II					
Other x 0 (Not in Scope)	Other x 9		
Rating:  0%	Combined:  80%	
Derived from VA Rating Decision (VARD) dated 20061229 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:

Obstructive Sleep Apnea with CPAP.  The narrative summary notes the CI was diagnosed with severe OSA confirmed by a sleep test (polysomnography) on 12 June 2005 and was not a surgical candidate, therefore he was prescribed a CPAP machine for treatment.  At the MEB examination on 18 October 2005, 2 months prior to separation, the CI reported being lethargic at work and making errors due to fatigue.  He reported that he was having difficulty using his mask for the entire night and was having it refitted.  A trial of a stimulant medication did not improve his functioning at work.  The MEB physical exam noted the applicant was overweight and had mildly elevated blood pressure, but was otherwise unremarkable with normal cardiovascular and respiratory examinations.  The VARD on 29 December 2006 based upon this C&P examination noted the CI was diagnosed with OSA and required use of a C-PAP machine to facilitate normal breathing during sleep.

The Board directs attention to its rating recommendation based on the above evidence.  The PEB adjudicated the OSA with CPAP condition as unfitting and rated at 0%, coded 6847 (sleep apnea syndromes).  The VA rated OSA with CPAP at 50%, coded as 6847.  The Board deliberated the rating of the OSA condition.  The applicant was diagnosed with severe OSA, he was not a surgical candidate and required continued use of CPAP to manage his symptoms.  Therefore, IAW VA Schedule for Rating Disabilities (VASRD) §4.97 (schedule of ratings, respiratory system) and 6847 rating criteria, the disability due to the OSA condition meets the 50% rating specified as “requires use of breathing assistance device such as continuous positive airway pressure (CPAP) machine, but does not meet the next higher evaluation of 100% which requires evidence of respiratory failure, cardiac effects, or tracheostomy.”  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 50% for the OSA condition.

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  In the matter of the OSA condition, the Board unanimously recommends a disability rating of 50%, coded 6847 IAW VASRD §4.97.  There were no other conditions within the Board’s scope of review for consideration.

RECOMMENDATION:  The Board recommends that the CI’s prior determination be modified as follows; and, that the discharge with severance pay be recharacterized to reflect permanent disability retirement, effective as of the date of his prior medical separation:

UNFITTING CONDITION	VASRD CODE	RATING	
Obstructive Sleep Apnea 	6847	50%	
RATING	50%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20131030, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

		
XXXXXXXXXXXXXXXXXXXX
President
Physical Disability Board of Review

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

Dear XXXXXXXXXXXXXXXXXXXX:

	Reference your application submitted under the provisions of DoDI 6040.44 (Title 10 U.S.C. § 1554a), PDBR Case Number PD-2013-02123.

	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 appropriate under 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 their 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 30 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 or had an eligible dependent child, in such a case, failure to render an election will result in automatic enrollment.  

							Sincerely,

XXXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings

cc:
SAF/MRBR
DFAS-IN