RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201453 DATE OF PLACEMENT ON TDRL: 20020129 

BOARD DATE: 20130307 DATE OF PERMANENT SEPARATION: 20040704 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (91B/Medic) medically separated for asthma. 
She was treated, but did not improve adequately to fully perform her military duties, or meet 
physical fitness standards. She was issued a permanent P3 profile and underwent a Medical 
Evaluation Board (MEB). The MEB found her asthma condition medically unacceptable IAW AR 
40-501, and referred her to a Physical Evaluation Board (PEB). Two orthopedic lower extremity 
conditions (fractured right 4th metatarsal, and bilateral retropatellar pain syndrome) were also 
listed on the DA Form 3947. The PEB found the asthma condition unfitting, but not sufficiently 
stable for final, permanent adjudication. The CI was placed on the Temporary Disability Retired 
List (TDRL) with 30% disability. The other two MEB conditions were both found “not unfitting, 
not rated.” In October 2003, a second Army PEB was convened. The CI was found unfit due to 
asthma, and separation was recommended at 10% based on intermittent inhalational 
bronchodilator therapy, IAW the Veterans’ Administration Schedule for Rating Disabilities 
(VASRD). The CI accepted the PEB findings and was medically separated with 10% disability. 

 

 

CI CONTENTION: “I feel I should have been rated higher than 10% because the side effects 
from the meds made me gain weight and contributed to other conditions. I was still able to do 
my job, but could not run anymore. My transition to civilian living was a hard process with 4 
children. I still suffer with asthma and taking meds every day.” 

 

 

SCOPE OF REVIEW: The Board’s scope of review as defined in DoDI 6040.44, 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 unfitting asthma condition and the two orthopedic lower extremity 
conditions (fractured right 4th metatarsal & bilateral retropatellar pain syndrome) meet the 
criteria prescribed in DoDI 6040.44, and are accordingly addressed below. No other conditions 
are within the Board’s purview. Any condition outside the Board’s defined scope of review may 
be eligible for future consideration by the Army Board for Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Final Army PEB – dated 20031014 

VA – All Effective 20020130 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

 

 

TDRL 

Sep. 

Asthma 

6602 

30% 

10% 

Asthma 

6602 

30% 

20020522 

Fracture, Right Foot 

Not Unfitting 

Fracture, Right Foot 

NSC 

 

20020522 

Bilateral Knee Pain 

Not Unfitting 

Arthritis, Bilateral Knees 

5010 

10%* 

20020522 

 

 

Major Depressive Disorder 

9434 

30%* 

20020528 

 

 

Gastroesophageal Reflux 

7399-7346 

10% 

20020522 

.No Additional MEB/PEB Entries. 

Other Not Service Connected (NSC) x 2 

20020522 

Combined: 10% 

Combined: 60%* 



* Some of the VA ratings (Arthritis, Depression) were later increased by subsequent VA Rating Decisions 

 


 

ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed by the CI regarding 
the impairment with which her conditions continue to burden her, and the significant impact 
they have had on her quality of life. It is noted for the record that the Board is subject to the 
same laws for disability entitlements as those under which the Disability Evaluation System 
(DES) operates. The DES has neither the role nor the authority to compensate the CI for future 
severity or potential complications of conditions. That role and authority is granted to the 
Department of Veterans Affairs (DVA). The Board evaluates DVA evidence in arriving at its 
recommendations, but its authority resides in evaluating the fairness of DES fitness and rating 
determinations at the time of separation. Compensation can only be granted for the degree of 
severity present at separation. The DVA, however, is empowered to re-evaluate a CI’s 
conditions for the purpose of adjusting the disability rating should the degree of impairment 
change over time. 

 

Asthma. The CI developed shortness of breath (SOB), and inability to run or perform physical 
training. She was seen by pulmonary medicine and was diagnosed with mild persistent reactive 
airway disease (RAD). She was treated with medications, and had some improvement in her 
asthma. However, in spite of treatment, she was unable to fully perform her military 
requirements and an MEB was initiated. The MEB clinical evaluation was in September 2001. 
At that time, she was on four chronic daily medications (Flovent, Seroquel, Albuterol, and 
Singulair). On exam, her lungs were clear to auscultation. As noted above, the CI was found 
unfit for military service and was placed on the TDRL with a disability rating of 30%. The Board 
considered all the evidence, and determined that a 30% rating at that time was appropriate 
since she was being treated with inhalational anti-inflammatory medication and daily 
inhalational bronchodilator therapy. The VASRD §4.97 criteria for a higher rating of 60% were 
not met. Based on the evidence in the treatment record, the Board has no basis to recommend 
a rating higher than 30%, at the time of initial placement on TDRL. 

 

In August 2003, the CI had a clinical re-evaluation. She was going to college and majoring in 
social work. She was physically active, playing softball 3 days a week and walking 2-3 miles per 
day. She was on daily doses of Advair (twice a day) and Singulair (nightly), and using Albuterol 
on an “as needed” basis. There had been no hospitalizations or emergency room visits for 
asthma. Her lungs were clear to auscultation with no wheezes, rales, or rhonchi. There was 
good air exchange to the bases of lungs. 

 

The Board carefully reviewed all evidentiary information available and directs attention to its 
rating recommendation based on the above evidence. The October 2003 Army PEB rated the 
CI’s asthma at 10% for requiring “intermittent inhalational bronchodilator therapy.” The PEB 
concluded that the medication profile did not reflect daily controller therapy. For the reader’s 
convenience, the VASRD §4.97 language for the 10% and 30% ratings (diagnostic code 6602) is 
excerpted below: 

 

FEV-1 of 56 to 70-percent predicted, or; FEV-1/FVC of 56 to 70 

percent, or; daily inhalational or oral bronchodilator therapy, 

or; inhalational anti-inflammatory medication .....................................................30 

 

FEV-1 of 71 to 80-percent predicted, or; FEV-1/FVC of 71 to 80 

percent, or; intermittent inhalational or oral bronchodilator therapy .................10 

 

Using data from the treatment record, the Board determined that at the time of final 
separation from military service, the CI was being treated with daily inhalational Advair. This 
would justify a 30% rating. Advair is a dual agent consisting of Fluticasone (a corticosteroid 
anti-inflammatory), and Salmeterol (a long-acting beta adrenergic bronchodilator). 

 


There was no evidence for respiratory failure, frequent exacerbations requiring physician 
intervention, or use of systemic corticosteroids. Therefore, a higher rating of 60% was not 
justified. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 
(reasonable doubt), the Board recommends by majority decision (2:1 vote) a permanent 
disability rating of 30% for the asthma condition. 

 

Other PEB Conditions. Two lower extremity orthopedic conditions (fractured right 4th 
metatarsal, and bilateral retropatellar pain syndrome) were adjudicated by the PEB as “not 
unfitting.” The Board’s first charge with respect to these conditions is an assessment of the 
appropriateness of the PEB’s fitness adjudication. 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. 
Both of these conditions were reviewed by the action officer and considered by the Board. 
There was no indication from the record that either 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 these two conditions, and therefore, 
no additional disability ratings can be 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 recommends by majority 
decision (2:1 vote) a permanent disability rating of 30%, coded 6602 IAW VASRD §4.97. The 
single voter for dissent (who recommended a 10% permanent rating) did not elect to write a 
minority opinion. In the matter of the fractured 4th metatarsal and the bilateral retropatellar 
pain syndrome, the Board unanimously recommends no change from the PEB determination 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 her 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 20120805, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 XXXXXXXXXXXXXXXXXXXXXX, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for XXXXXXXXXXXXXXXXXX, AR20130005348 (PD201201453) 

 

 

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 XXXXXXXXXXXXXXXXX 

 Deputy Assistant Secretary 

 (Army Review Boards)