RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201248 SEPARATION DATE: 20021118 

BOARD DATE: 20130315 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty PFC/E-3 (31U10/Signal Support Systems Specialist), 
medically separated for asthma. He began experiencing atypical chest pain in July 2000 and 
exercise-induced breathing difficulties in June 2001, with no prior history noted. Following a 
Methacholine Challenge Test (MCT) he was diagnosed with asthma and was placed on maximal 
asthma and allergy medications with initiation of allergy immunotherapy. Despite these efforts 
the CI did not improve adequately with treatment to meet the physical requirements of his 
Military Occupational Specialty (MOS) or satisfy physical fitness standards. He was issued a 
permanent P4 profile and referred for a Medical Evaluation Board (MEB). Allergic rhinitis, 
intermittent non-radiating lower back pain, essential hypertension, chronic gastritis and 
hypercholesterolemia conditions, identified in the rating chart below, were also identified and 
forwarded by the MEB. The Physical Evaluation Board (PEB) adjudicated the asthma condition 
as unfitting, rated 10% with application of the Veteran’s Affairs Schedule for Rating Disabilities 
(VASRD). The remaining conditions were determined to be not disqualifying. The CI made no 
appeals, and was medically separated with a 10% disability rating. 

 

 

CI CONTENTION: “even when the Army knew. I have more medical condition, They only 
evaluted one.” [sic] 

 

 

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. The MEB medical conditions alluded to on 
the application: allergic rhinitis, intermittent non-radiating lower back pain, essential 
hypertension, chronic gastritis and hypercholesterolemia meet the criteria prescribed in DoDI 
6040.44 for Board purview; and, are addressed below, in addition to a review of the rating for 
the unfitting condition. 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. 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20020725 

VA (2 Mos. Post-Separation) – All Effective Date 20021119 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Asthma 

6602 

10% 

Bronchial Asthma 

6602 

30% 

20030126 

Allergic Rhinitis 

Not Unfitting 

Allergic Rhinitis 

6522 

0% 

20030123 

Intermittent Low Back 
Pain 

Not Unfitting 

Low Back Pain 

5299-5292 

NSC 

20030127 

Essential Hypertension 

Not Unfitting 

Arterial Hypertension 

7101 

10% 

20030126 

Chronic Gastritis 

Not Unfitting 

Gastritis 

7307 

10% 

20030126 

Hypercholesterolemia 

Not Unfitting 

Hypercholesterolemia 

7199-7114 

NSC 

20030126 

.No Additional MEB/PEB Entries. 

0% X 3 / Not Service-Connected x 4 

20030126 

Combined: 10% 

Combined: 40% 




ANALYSIS SUMMARY: The Board acknowledges the CI’s contention that suggests ratings should 
have been conferred for other conditions documented at the time of separation. The Board 
wishes to clarify that it is subject to the same laws for Service disability entitlements as those 
under which the Disability Evaluation System (DES) operates. While the DES considers all of the 
member's medical conditions, compensation can only be offered for those medical conditions 
that cut short a member’s career, and then only to the degree of severity present at the time of 
final disposition. However the Department of Veterans Affairs (DVA), operating under a 
different set of laws (Title 38, United States Code), is empowered to compensate all service-
connected conditions and to periodically reevaluate said conditions for the purpose of adjusting 
the Veteran’s disability rating should the degree of impairment vary over time. 

 

Asthma Condition. The narrative summary (NARSUM) 5 months prior to separation notes a 
history atypical chest pain and shortness of breath beginning in January 2000. The symptoms 
improved with Albuterol. In June 2001, a cardiologic evaluation ruled out cardiogenic chest 
pain and shortness of breath (SOB). In September 2001, the CI underwent pulmonary function 
tests (PFTs) and a MCT which confirmed the diagnoses of asthma with exercise induced 
bronchospasms and allergic rhinitis. He was treated with Albuterol (inhaled bronchodilator), 
Singular (oral anti-inflammatory), and Advair (inhaled bronchodilator/anti-inflammatory 
combination) without improvement. At the time of the narrative summary (NARSUM), the CI 
reported asthmatic symptoms at rest at least 3 times per week. He was placed on a permanent 
P4 profile. The allergy/immunology consultation 6 months prior to separation, noted that the 
CI’s symptoms were severe and persistent despite compliance with all treatment 
recommendations. The NARSUM respiratory examination was unremarkable. 

 

Pulmonary Exam 

MEB ~5 Mo. Pre-Sep 

VA ~2 Mo. Post-Sep 

FEV1 (% Predicted) 

86.5% 

“Normal” 

FEV1/FVC 

85% 

“Normal” 

Meds 

Albuterol 2 puffs QID, 
Advair, Singulair 10MG QD 

Proventil & AeroBid puffs 

§4.97 Rating 

30%* 

30%* 



 *Based on medications, not PFT results 

 

At the VA Compensation and Pension (C&P) exam 2 months after separation, the CI reported 
asthma symptoms consisting of a choking sensation, chest tightness, wheezing, and productive 
cough twice a week. There was no history of incapacitating episodes. The CI reported use of 
Proventil (inhaled bronchodilator) and AeroBid (inhaled anti-inflammatory). The physical 
examination and PFTs were normal. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the asthma condition at 10%, coded 6602, for intermittent inhalational or oral 
bronchodilator therapy. The VA assigned a 30% rating under the same code for daily 
inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication. The 
CI’s service treatment record (STR) documented compliance with the prescribed medications to 
include daily anti-inflammatories and as needed inhaled bronchodilator. The VA examiner 
documented medical compliance with daily inhaled bronchodilator and daily inhaled anti-
inflammatory. Board members agreed that the requirement and use of daily bronchodilator 
and anti-inflammatory medication in this case clearly met the VASRD §4.97 threshold for a 30% 
rating. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 
(reasonable doubt), the Board recommends a disability rating of 30% for the asthma condition. 

 

Contended PEB Conditions. The contended conditions adjudicated as not unfitting by the PEB 
were allergic rhinitis, intermittent non-radiating lower back pain, essential hypertension, 
chronic gastritis and hypercholesterolemia. The Board’s first charge with respect to these 


conditions is an assessment of the appropriateness of the PEB’s fitness adjudications. The 
Board’s threshold for countering fitness determinations is higher than the VASRD §4.3 
(reasonable doubt) standard used for its rating recommendations, but remains adherent to the 
DoDI 6040.44 “fair and equitable” standard. 

 

Allergic Rhinitis Condition. The NARSUM notes the diagnosis of perennial allergic rhinitis as part 
of a non-cardiac chest pain evaluation in 2001. The CI skin tested positive for multiple 
allergens. The allergy consultant documented the condition as mild and stable on daily 
medication. Although the allergic rhinitis condition was listed as part of the permanent profile 
and was mentioned in the commander’s statement, it was not judged to fail retention 
standards. Furthermore, at the VA C&P examination 2 months after separation, the CI reported 
no nasal or sinus symptoms and was not on any medications for allergic rhinitis. The Board 
concluded that the allergic rhinitis condition, independent of his asthma, would not impair his 
ability to perform the duties of his MOS. 

 

Low Back Condition. The NARSUM notes the CI first presented with lower back pain in April 
1999. There was no history of trauma. Although mentioned in the commander’s statement as 
one of many reasons that the CI should not continue his service, the STR documents one 
episode per year for mid or lower back pain which resolved with activity modification and pain 
medication. Radiographs of the thoracic and lumbar spine were normal. There was one 
temporary profile issued in 2001 for back pain. 

 

Essential Hypertension Condition. The CI was diagnosed with essential hypertension (HTN) in 
2000 and was treated with diet modification and oral anti-hypertensive medication with 
moderate control of the HTN. The HTN condition was included with the P4 profile during the 
MEB process, but there were no prior profiles for this condition. The HTN was not implicated in 
the commander’s statement. At the C&P exam 2 months after separation, the CI reported no 
hypertensive complaints. 

 

Chronic Gastritis and Hypercholesterolemia Conditions. These conditions were not 
permanently profiled; were not implicated in the commander’s statement; and, were not 
judged to fail retention standards. 

 

All the above conditions were reviewed by the action officer and considered by the Board. 
There was no performance based evidence from the record that any of these conditions 
significantly interfered with satisfactory duty performance. After due deliberation in 
consideration of the preponderance of the evidence, the Board concluded that there was 
insufficient cause to recommend a change in the PEB fitness determination for the any of the 
contended conditions and so no additional disability ratings are recommended. 

 

 

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 
disability rating of 30%, coded 6602 IAW VASRD §4.97. In the matter of the contended allergic 
rhinitis, intermittent non-radiating lower back pain, essential hypertension, chronic gastritis and 
hypercholesterolemia conditions, the Board unanimously recommends no change from the PEB 
determinations as not unfitting. 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 

Asthma 

6602 

30% 

COMBINED 

30% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120702, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 

 XXXXXXXXXXXXXXXXXXXX, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


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, AR20130006138 (PD201201248) 

 

 

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 the individual’s original medical separation for disability 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 the 
original medical separation for disability with severance pay. 

 

 b. Providing orders showing that the individual was retired with permanent disability 
effective the date of the original medical separation for disability 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 original medical separation for disability 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 xxxxxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)