RECORD OF PROCEEDINGS
                     PHYSICAL DISABILITY BOARD OF REVIEW

NAME:    XXXXXXX                                                BRANCH    OF
SERVICE: air force
CASE   NUMBER:    PD1100766                                       SEPARATION
DATE:  20050509
BOARD DATE:  20120308


SUMMARY OF CASE:  Data extracted  from  the  available  evidence  of  record
reflects that  this  covered  individual  (CI)  was  an  active  duty  Staff
Sergeant/E-5 (3M071 / Services Craftsman), medically separated  for  asthma.
The CI was diagnosed with bronchitis and reactive airway  disease  (RAD)  in
May, 2002, and was diagnosed with severe persistent  asthma  in  July  2004.
Her baseline pulmonary function  studies  (PFTs)  were  normalized  and  her
asthma  was  under  good  control  on  daily  low  dose  inhaled   steroids,
leukotriene receptor antagonists and rescue bronchodilators.  She  was  able
to tolerate exercise without symptoms; however, in     September  2004,  she
was issued a P4 profile which disqualified her  for  world  wide  deployment
and underwent a Medical Evaluation Board (MEB).   Asthma  was  forwarded  to
the Physical Evaluation Board (PEB) as medically unacceptable  IAW  AFI  48-
123.   No  other  conditions  appeared  on  the  MEB’s  submission.    Other
conditions included in the Disability Evaluation System  (DES)  packet  will
be discussed below.  The PEB adjudicated the asthma condition as  unfitting,
rated 10%, with application of DoDI  1332.39;  additionally,  a  history  of
tobacco abuse and being overweight were listed as  category  III  conditions
that are not separately unfitting  or  compensable.   The  CI  appealed  for
retention to the Formal PEB (FPEB), and to the Secretary of  the  Air  Force
Personnel Council (SAFPC) which upheld the unfit (at 10%) PEB  adjudication.
 The CI was then medically separated with a 10% combined disability rating.


CI CONTENTION:  “My rating  was  10%  at  the  time  of  discharge,  so  was
medically discharged, but later it was proven to be 30% based on my  service
records.  I  am  requesting  a  medical  retirement  instead  of  a  medical
discharge since my disability has been proven to be at 30% at  the  time  of
my discharge.”


RATING COMPARISON:

|SAFPC Decision – Dated 20050329|VA (3 Mo. After Separation) – All       |
|                               |Effective Date 20050510                 |
|Condition       |Code          |Rating                                  |
|Overweight      |Category III  |No Corresponding VA Entry               |
|↓No Additional MEB/PEB Entries↓|0% x 5 / Not Service Connected x|2005081|
|                               |10                              |1      |
|Combined:  10%                 |Combined:  30%                          |


ANALYSIS SUMMARY:   The  service  determination  of  unfit  for  the  asthma
condition was considered administratively final.

Asthma Condition.  There was no evidence for respiratory  failure,  frequent
exacerbations requiring physician  intervention,  daily  use  of  high  dose
corticosteroids  or  immune-suppressive  medications,  or  frequent  use  of
systemic corticosteroids.  Therefore the higher  60%  or  100%  ratings  IAW
6602 criteria are not  supported.   The  PFTs  were  near  normal  following
stabilization on medications and would rate no higher  than  10%  rating  on
PFT measurements alone.  The treatment criteria  underpinning  the  10%  and
30% ratings are the pivotal points for  decision  in  this  case.   The  10%
rating requires “intermittent inhalational or oral bronchodilator  therapy;”
the 30% rating requires “daily inhalational or oral bronchodilator  therapy;
or inhalational anti-inflammatory medication.”

The narrative summary (NARSUM) indicated “she is currently being managed  on
triple therapy with Singulair,  Pulmicort,  and  albuterol.   She  is  doing
better with this regimen and is using less albuterol now,” and  “her  asthma
is controlled with inhaled steroids, leukotriene  receptor  antagonists  and
bronchodilators.   Her  current  asthma  can  be  classified   as   moderate
persistent.”  The FPEB remarks indicated “has had no  difficulties  although
she is currently taking two medications  (Singulair  &  Pulmicort)  for  her
condition.”  The Department of  Veterans’  Affairs  (DVA)  Compensation  and
Pension (C&P)  exam,  three  months   after  separation  stated,  “she  uses
Albuterol rescue inhaler two puffs  once  a  week.   Pulmicort  inhaler  two
puffs twice daily and Singulair 10 mg at bedtime.”

The service’s 10% rating was IAW DoDI 1332.39, para. E2.A1.2.12,  which  did
not mirror VASRD criteria for rating asthma and is not  applicable  to  PDBR
adjudication.  All evidence  proximate  to  separation  clearly  established
that the CI was prescribed and was using daily inhalational therapy  meeting
the VASRD 30% criteria.  After due  deliberation,  considering  all  of  the
evidence and mindful of VASRD §4.3 (reasonable doubt), the Board  recommends
a separation rating of 30% for the asthma condition.

Other PEB Conditions.   Tobacco  abuse  and  overweight  were  category  III
conditions which are not physical disability conditions and not  compensable
IAW DoDI 1332.38.

Remaining Conditions.  Other conditions identified  in  the  DES  file  were
genital herpes, hemorrhoids, hyperplastic colon  polyps,  nausea,  vasovagal
syncope/anxiety  and   asymptomatic   mitral   valve   proplapse.    Several
additional non-acute conditions or medical complaints were also  documented.
 None of  these  conditions  were  significantly  clinical  during  the  MEB
period, none carried attached profiles, and  none  were  implicated  in  the
commander’s  statement.   These  conditions  were  reviewed  by  the  action
officer and considered by the Board.  It was determined that none  could  be
argued as unfitting and subject to separation rating.  No  other  conditions
were service-connected with a compensable rating by the VA within 12  months
of  separation  or  contended  by  the  CI.   The  Board  therefore  has  no
reasonable basis for recommending any additional  unfitting  conditions  for
separation rating.


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.  As discussed  above,  PEB  reliance  on  DoDI
1332.39 for rating asthma was operant in this case  and  the  condition  was
adjudicated independently of that instruction by the Board.  In  the  matter
of the asthma  condition,  the  Board  unanimously  recommends  a  permanent
service disability rating of 30%, coded 6602 IAW  VASRD  §4.97.   The  Board
unanimously agrees that there were no other conditions  eligible  for  Board
consideration which could  be  recommended  as  additionally  unfitting  for
rating at separation.


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 her prior medical separation:

|UNFITTING CONDITION                             |VASRD CODE  |RATING  |
|Asthma                                          |6602        |30%     |
|COMBINED    |30%     |


The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20110905, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record




                 XXXXXX
                 President
                 Physical Disability Board of Review


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

Dear XXX

      Reference your application submitted under the provisions of DoDI
6040.44 (Title 10 U.S.C. § 1554a), PDBR Case Number PD-2011-00766.

      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
Administration 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,




                                       XXXX
                                       Director
                                       Air Force Review Boards
                                       Agency

Attachment:
Record of Proceedings

cc:
SAF/MRBR
DFAS-IN


PDBR PD-2011-00766




MEMORANDUM FOR THE CHIEF OF STAFF

      Having received and considered the recommendation of the Physical
Disability Board of Review and under the authority of Title 10, United
States Code, Section 1554a (122 Stat. 466) and Title 10, United States
Code, Section 1552 (70A Stat. 116) it is directed that:

      The pertinent military records of the Department of the Air Force
relating to XXXXXXXX, is corrected to show that:

            a.  The diagnosis in her finding of unfitness for Asthma,
VASRD code 6602,  was rated at 30% rather than 10%.

            b.  On 8 May 2005 she elected not to participate in the
Survivor Benefit Plan.

            c.  She was not discharged on 9 May 2005; rather, on that
date she was released from active duty and on 10 May 2005 her name was
placed on the Permanent Disability Retired List.








  XXXXX

  Director

  Air Force Review Boards Agency