RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXX CASE: PD1200890 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130425 

SEPARATION DATE: 20030926 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty Private First Class /E-3 (93P10/Aviation Operations 
Specialist) medically separated for vocal cord dysfunction (VCD). The CI was referred to a 
Medical Evaluation Board (MEB) for asthma and seasonal allergic rhinitis (SAR) in August 2002. 
That PEB was terminated because the CI’s asthma did not warrant a P3 Profile. The CI 
continued to have problems, returned to the allergy clinic and was referred to the ear, nose, 
and throat (ENT) clinic when his pulmonary function tests (PFTs) were suggestive of VCD. The 
CI was then evaluated at Walter Reed Army Medical Center (WRAMC) where the diagnosis of 
VCD was made. The CI then began speech pathology treatment, but despite this the condition 
could not be adequately rehabilitated to meet the physical requirements of his Military 
Occupational Specialty (MOS) or satisfy physical fitness standards. He was issued a permanent 
P3 profile and referred for a new MEB. The VCD or paradoxical vocal cord motion (PVCM), and 
severe seasonal allergic rhinitis on allergy immunotherapy conditions were forwarded to the 
Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the 
MEB. The Informal PEB (IPEB) adjudicated VCD as unfitting, rated 0%. The remaining condition 
was determined to be not unfitting. The CI made no appeals, and was medically separated with 
a 0% disability rating. 

 

 

CI CONTENTION: “The Wounded Warrior Act – request review of DoD disability rating to 
ensure accuracy + fairness.” 

 

 

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 VCD condition is 
addressed below; 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 20030801 

VA - (14 Mos. Pre -Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Vocal Cord Dysfunction 

6599-6520 

0% 

Vocal Cord Dysfunction 

6699-6602 

30% 

20020723 

Seasonal Allergic Rhinitis 

Not Unfitting 

Perennial Allergic Rhinitis 

6522 

0% 

20020723 

No Additional MEB/PEB Entries 

Other x 1 

20020723 

Combined: 0% 

Combined: 50% 



Derived from VA Rating Decision (VARD) dated 20031105 (most proximate to date of separation [DOS]). 

 

 

 


ANALYSIS SUMMARY: 

 

Vocal Cord Dysfunction (VCD) Condition. The narrative summary (NARSUM), 4 months prior to 
separation, noted the history summarized above. The chief complaint was “difficulty breathing 
with exercise outdoors and difficulty maintaining gas mask on face.” Specialty evaluation for 
asthma and VCD demonstrated PFTs (flow loop flattening; negative Methacholine challenge; 
poor response to asthma medications) and direct cord visualization (laryngoscopy with 
paradoxical motion of the vocal cords) sufficient for diagnosis of VCD as the principle diagnosis. 
VCD therapy of speech pathology was not effective in decreasing the CI’s symptoms. 
Medications were listed as Zyrtec (cetirizine - is used to treat allergy symptoms) at night. The 
MEB physical exam noted lungs clear to auscultation and chest X-ray was normal. Diagnosis 
was “Vocal cord dysfunction or paradoxical vocal cord motion.” PFTs 2 months prior to 
separation were normal (July 2003; FEV1 83%, FEV1/FVC 95%). Speech therapy records 
indicated the CI “did not appear to be hoarse or have any significant vocal problems with 
quality or pitch.” The summary indicated “significant difficulty with relaxation and tightness in 
his chest, which is affecting his overall performance” and relaxation techniques were given. 
There was no evidence of nasal polyps documented in the record. 

 

At the VA Compensation and Pension (C&P) exam performed 14 months prior to separation, 
the CI reported he experienced wheezing with episodic shortness of breath, and used “Singulair 
and albuterol two or three times daily to help control these symptoms.” PFTs from February 
2002 (14 months prior to separation) were referenced with decreased FVC of 70-72% with no 
change with bronchodilators or Methacholine. Exam documented the chest was clear with 
diminished bases. Diagnosis was “Asthma, dependent on daily medication.” 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the CI’s VCD analogous to 6520 (larynx, stenosis of, including residuals of laryngeal 
trauma) at 0% while the VA rated the CI’s VCD analogous to 6602 (Asthma, bronchial) at 30%. 
There were no PFTs warranting any compensable rating IAW VASRD criteria for VCD or asthma 
proximate to separation. The VA’s analogous asthma rating of 30% was based on “daily use of 
Singulair and Albuterol” and a diagnosis of asthma a year prior to separation. The VA rating 
determination did reference the service treatment record including the laryngoscopy and the 
changed diagnosis from asthma to VCD. The NARSUM and treatment records indicated no 
chronic controller medication use proximate to separation, and normalization of PFTs. 
Analogous coding for the VCD as 6520 was considered predominate. After due deliberation, 
considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board 
concluded that there was insufficient cause to recommend a change in the PEB adjudication for 
the VCD 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. 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 VCD condition and IAW VASRD §4.97, the Board 
unanimously recommends no change in the PEB adjudication. There were no other conditions 
within the Board’s scope of review for consideration. 

 

 

 


RECOMMENDATION: The Board, therefore, recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Vocal Cord Dysfunction 

6599-6520 

0% 

COMBINED 

0% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120619, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxxxx, AR20130009571 (PD201200890) 

 

 

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD 
PDBR) recommendation and record of proceedings pertaining to the subject individual. Under 
the authority of Title 10, United States Code, section 1554a, I accept the Board’s 
recommendation and hereby deny the individual’s application. 

This decision is final. The individual concerned, counsel (if any), and any Members of Congress 
who have shown interest in this application have been notified of this decision by mail. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)