RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1101084 DATE OF PLACEMENT ON TDRL: 20010813 

BOARD DATE: 20130212 DATE OF PERMANENT SEPARATION: 20021105 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (75H20/Personnel Service Specialist), 
medically separated for asthma. He developed persistent shortness of breath and exercise 
intolerance shortly after entering service and was diagnosed with asthma. His treatment was 
initially successful and he was able to fully function in garrison. However, his symptoms 
worsened and he did not respond adequately to treatment to fully perform within his Military 
Occupational Specialty or to meet physical fitness standards. The CI was placed on a 
permanent P3 profile and underwent a Medical Evaluation Board (MEB). The moderate 
persistent asthma condition was forwarded to the Physical Evaluation Board (PEB) as medically 
unacceptable IAW AR 40-501. The MEB forwarded no other conditions for PEB adjudication. 
The PEB adjudicated the moderate persistent asthma condition as unfitting, rated 30% with 
application of Department of Defense Instruction (DoDI) and the Veterans Affairs Schedule for 
Rating Disabilities (VASRD), respectively. The CI was placed on Temporary Disability Retired List 
(TDRL) with ratings as reflected in the chart below. The CI was re-evaluated on 22 July 2002 
and was given a 0% disability rating by the PEB and was removed from the TDRL. The CI made 
no appeals, and was medically separated with a 0% disability rating. 

 

 

CI CONTENTION: “VA gave a rating of 30%.” 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44, Enclosure 3, paragraph 5.e. (2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.” The ratings 
for unfitting conditions will be reviewed in all cases. 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 Army Board for Correction of Military Records. 

 

 

TDRL Rating Chart 

 

Final Service IPEB – Dated 20021001 

VA – All Effective Date 20030911 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

On TDRL – 
20010813 

 

TDRL 

Sep. 

Asthma 

6602 

30% 

0% 

Asthma 

6602 

30%* 

20031023 

.No Additional MEB/PEB Entries. 

Not Service Connected x 3 

20031023 

Combined: 0% 

Combined: 30% 



*VA initially rated 0% when CI failed to show for initial C&P citing lack of post-service evidence of symptoms. 
However, after the first C&P examination was completed 20031223, a 30% rating was assigned. 

 

 

ANALYSIS SUMMARY: The Board’s authority as defined in DoDI 6040.44, resides in evaluating 
the fairness of Disability Evaluation System fitness determinations and rating decisions for 


disability at the time of separation. The Board utilizes VA evidence proximal to separation in 
arriving at its recommendations; and, DoDI 6040.44 defines a 12-month interval for special 
consideration to post-separation evidence. Post-separation evidence is probative only to the 
extent that it reasonably reflects the disability and fitness implications at the time of 
separation. 

 

Asthma Condition. The post-bronchodilator pulmonary function tests (PFTs) in evidence that 
the Board weighed in arriving at its rating recommendation, with documentation of additional 
ratable criteria, are summarized in the chart below. 

 

Pulmonary 
Exam 

Pulm ~17 Months 

Pre-TDRL Entry 

MEB ~3.5 Months 

Pre-TDRL Entry 

NARSUM 

~3.5 Months 

Pre-TDRL Exit 

VA C&P ~11 Months 

Post-Sep 

FEV1 (% 
Predicted) 

2.86 (82%) 

MEB NARSUM refers to PFTs 
completed by IM 13 April 
2001 but record unavailable 

2.6 (68.7%*) 

2.58 (67%) 

FEV1/FVC 

89% 

85% (2.6/3.13) 

80% 

Meds 

FEV1 Increased 17% 
post-bronchodilator; 
on Pulmicort 2p bid; 
renewed Singulair; “sx 
improving on anti-
inflammatory” 

FEV1 increased greater than 
15% post-bronchodilator; 
Allegra; Singulair; Flovent; 
Albuterol; “moderate 
persistent asthma” 

 “moderate 
persistent asthma”; 
Allegra, Singulair, 
AeroBid/Advair, 
Albuterol. 

FEV1 increased 12% post-
bronchodilator; Singulair 
1x/every evening, 
Albuterol and Advair 
Inhalers as needed; 
Allegra every day 

§4.97 Rating 

30% 

30% 

30% 

30% 



*68.7%, predicted calculated by CDC calculator. However, it is not clear if this is pre- or post-bronchodilator. 

 

The pre-TDRL entry pulmonary and MEB exams proximate to TDRL entry are summarized 
above. There was no VA Compensation and Pension (C&P) exam proximate to TDRL entry as 
the CI failed to show for his scheduled examination. 

 

Based on the above evidence, the Board directed its attention to its rating recommendation for 
the asthma condition at TDRL entry. The PEB rated the condition as 6602 asthma, bronchial 
and assigned a 30% disability stating the asthma condition was only moderately controlled on 
multiple medications, including daily inhaled anti-inflammatory aerosols. The PEB also stated 
that a permanent rating was not yet possible and the CI was placed on the TDRL. The VA 
determined asthma was service-connected. However, without any post-service medical 
evidence showing current findings for asthma, the VA assigned a 0% disability rating effective 
14 August 2001. After due deliberation, considering all of the evidence and mindful of VASRD 
§4.3 (Resolution of reasonable doubt), the Board concluded that there was insufficient cause to 
recommend a change in the PEB adjudication for the asthma condition at TDRL entry. 

 

At the TDRL narrative summary (NARSUM) completed approximately 3 months prior to TDRL 
exit, the CI reported that he did very little physical training but felt that if he were to do it again, 
he would still have consistent wheezing with exercise. He stated that his medications were 
Allegra, Singulair, AeroBid, and Albuterol. However, his medication profile shows that he had 
been prescribed Advair in July 2002 in place of the Aerobid. Advair consists of an inhaled beta 
agonist combined with an inhaled anti-inflammatory medication. The pulmonary exam was 
normal. The NARSUM does not specifically state whether the FVC and FEV1 reported in the 
chart above were measured pre- or post-bronchodilator but the examiner did opine the values 
were consistent with moderate asthma. A C&P examination was completed approximately 11 
months after TDRL exit and the post-bronchodilator PFT results are recorded in the chart 
above. The CI reported he had asthma attacks about two times per week and during an attack, 


he was able only to walk about an eighth of a mile or three flights of stairs. He reported he was 
taking Singulair and Allegra daily and using his albuterol and Advair inhalers as needed. 

 

The Board directs attention to its rating recommendation for the asthma condition at TDRL exit 
based on the above evidence. The TDRL exit PEB rated 6602 asthma at 0% stating that, based 
on the pharmacy record, the CI was intermittently using medication and that while he remained 
unfit for the rigors of Army life, he appeared to be unaffected by his asthma in civilian life. The 
VA assigned a 30% rating for asthma based on the PFT result of FEV-1 at 2.58 liters or 67% of 
predicted. The TDRL NARSUM reported an FEV-1 of 2.60 or 68.7% of predicted. These results 
are essentially equivalent and both support a 30% disability rating. While the TDRL NARSUM 
did not specifically state whether the values reported were obtained from testing pre- or post-
bronchodilator administration, the values were consistent with other post-bronchodilator 
measurements. Additionally post-bronchodilator results are required for rating and applying 
resolution of reasonable doubt, the Board determined that, more likely than not, these results 
were obtained after administration of a bronchodilator. The TDRL NARSUM reported the use of 
inhaled beta agonist medication as well as both inhaled and oral anti-inflammatory medication; 
however did not specify the doses or frequency of these medications. The PEB stated the 
medication profile documented intermittent use of medication and assigned the 0% rating. 
However, intermittent use of medication meets the criteria for a 10% rating and it not clear 
why the PEB did not assign this rating. Additionally, a complete review of both service 
(Composite Health Care System) and VA medication profiles indicated consistent use of oral, 
inhaled anti-inflammatory, and inhaled beta agonist medication at the time of separation. 
Aerobid inhaled anti-inflammatory medication was issued by the VA on 6 March 2002 and 
21 March 2002. A 3 month supply of Advair, a combination of inhaled anti-inflammatory, and 
inhaled beta agonist medications was issued by the military treatment facility (MTF) on 11 July 
2002 (4 months prior to TDRL exit) with three refills remaining. The 3 month supply of Singulair 
(an oral anti-inflammatory medication), was dispensed by the VA on both 29 November 2001 
and 21 March 2002. An additional 3 month supply was dispensed by the MTF on 11 July 2002. 
The MTF medication profile does not have a date and therefore contains no information 
regarding prescriptions dispensed after 11 July 2002. The VA medication profile includes a 
through date of 9 September 2002. However, with the medications dispensed on 11 July 2002, 
the CI would not require any refills until October 2002. Albuterol was neither prescribed nor 
issued in sufficient quantities to support daily use, and it appears to have been used as a rescue 
medication. Normal usage of chronic medication includes occasional missed doses, especially 
for conditions with only intermittent symptoms such as asthma and this may account for some 
of the gaps in dispensing dates. There is adequate evidence to show the CI was taking both 
daily inhaled (Advair) and oral anti-inflammatory (Singulair) medications, as well as daily 
inhaled bronchodilator medication (Advair), at the time of separation and this independently 
supports a 30% disability rating. After due deliberation, considering all of the evidence and 
mindful of VASRD §4.3 (Resolution of reasonable doubt), the Board recommends a disability 
rating of 30% for the asthma condition at TDRL exit. 

 

 

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. The Board did not 
surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD 
were exercised. In the matter of the asthma condition, the Board unanimously recommends a 
30% permanent rating at TDRL exit, coded 6602 and 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 

PERMANENT 

Asthma 

6602 

30% 

COMBINED 

30% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20111121, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 XXXXXXXXXXXXXXXXXXXXXX, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


Grant 

SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / XXXXXXXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for XXXXXXXXXXXXXXXXXX, AR20130004001 (PD201101084) 

 

 

1. Under the authority of Title 10, United States Code, section 1554(a), I approve the enclosed 
recommendation of the Department of Defense Physical Disability Board of Review (DoD PDBR) 
pertaining to the individual named in the subject line above to recharacterize the individual’s 
separation as a permanent disability retirement with the combined disability rating of 30% 
effective the date of removal from the Temporary Disability Retired List (TDRL) with severance 
pay. 

 

2. I direct that all the Department of the Army records of the individual concerned be corrected 
accordingly no later than 120 days from the date of this memorandum: 

 

 a. Providing a correction to the individual’s separation document showing that the 
individual was separated by reason of permanent disability retirement effective the date of his 
removal from the TDRL with severance pay. 

 

 b. Providing orders showing that the individual was retired with permanent disability 
effective the date of the removal from the TDRL with severance pay. 

 

 c. Adjusting pay and allowances accordingly. Pay and allowance adjustment will 
account for recoupment of severance pay, and payment of permanent retired pay at 30% 
effective the date of the removal from the TRDL with severance pay. 

 

 d. Affording the individual the opportunity to elect Survivor Benefit Plan (SBP) and 
medical TRICARE retiree options. 

 

 

 

 

 

 

 

3. I request that a copy of the corrections and any related correspondence be provided to the 
individual concerned, counsel (if any), any Members of Congress who have shown interest, and 
to the Army Review Boards Agency with a copy of this memorandum without enclosures. 

 

BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl 


XXXXXXXXXXXXXX 

 Deputy Assistant Secretary 

 (Army Review Boards)