RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW
BRANCH OF SERVICE: ARMY
DATE OF PLACEMENT ON TDRL: 20000826
DATE OF PERMANENT SEPARATION: 20020405
NAME: XXXXXXXXXXXXXXX
CASE NUMBER: PD1201076
BOARD DATE: 20121205
SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this
covered individual (CI) was an active duty Soldier, PVT/E‐2(88M/Motor Transport), medically
separated for asthma. The CI had a history of shortness of breath for approximately 9 months
with symptoms of wheezing, coughing and chest tightness. 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 P3 profile and referred for a
Medical Evaluation Board (MEB). The MEB forwarded asthma, severe persistent; and allergic
rhinitis as medically unacceptable IAW AR 40‐501. The MEB forwarded no other conditions for
Physical Evaluation Board (PEB) adjudication. The PEB adjudicated the asthma as unfitting,
rated 30%, with application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD),
and placed the CI on Temporary Disability Retired List (TDRL) as reflected in the chart below.
The PEB adjudicated the allergic rhinitis as not unfitting. A final PEB in March 2002 adjudicated
the asthma at 10%; the CI made no appeals; and was medically separated with a 10% disability
rating.
CI CONTENTION: The CI elaborated no specific contention in his application.
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 asthma condition as requested for
consideration meet the criteria prescribed in DoDI 6040.44 for Board purview; and, is addressed
below, in addition to a review of the ratings 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.
TDRL RATING COMPARISON:
Service PEB – Dated 20020305
VA* – All Effective Date 20000826
Condition
On TDRL –
20000826
Asthma
Allergic Rhinitis
Code
6602
Rating
TDRL
30%
Not Unfitting
Sep.
10%
Condition
Bronchial Asthma
No VA Entry
↓No Additional MEB/PEB Entries↓
Combined: 10%
0% x 0/Not Service Connected x 1
Combined: 30%
Code
6602
Rating
Exam
30%
STRs*
STRs*
* STRs from 1998 to 2000; CI failed to report for his VA exam on 10/27/00.
ANALYSIS SUMMARY:
Asthma Condition. There were three pulmonary function tests (PFT) in evidence, with
documentation of additional ratable criteria, which the Board weighed in arriving at its rating
recommendation; as summarized in the chart below.
Pulmonary Exam
FEV1 (% Predicted)
FEV1/FVC
Meds
MEB ~10 Mos. Pre‐TDRL*
Clinic ~9 Mos. Pre‐TDRL*
TDRL Exam ~3 Mos. Pre‐TDRL Exit
98%*
‐
59%*
‐
112%
89%
Pre‐Albuterol FEV1=57%; Flovent
and Salmeterol 2x daily;
Albuterol as needed; 1x course
of systemic steroids last month
Flovent and Salmeterol 2x
daily; Albuterol as needed
(at 2x/day)
Albuterol as needed; normal
spirometry; no change with
bronchodilator
30%
§4.97 Rating
30% (PEB & VA 30%)
10%
* PFT values by report; source spirometry not in record. Clinic 59% undocumented if pre‐ or post‐bronchodilator
At the pre TDRL MEB exam, the CI reported symptoms consistent with asthma, was diagnosed
with asthma and had inadequate relief with daily medications as summarized above. He had
been given a recent course of systemic steroids the prior month with an emergency room visit.
The CI had continued symptoms of exertional and nocturnal wheezing, and shortness of breath
with the above medications. The MEB physical exam noted clear lungs and the medications
and PFTs are summarized above.
The diagnosis was severe persistent asthma.
Allergy/Immunology clinic follow‐up the month after the MEB continued the diagnosis and is
summarized above. There was no VA Compensation and Pension (C&P) exam in evidence.
At the TDRL exam, the CI continued to have weekly flare ups of his asthma which were
controlled with Albuterol inhalers as needed. He stated he had not seen a physician for 2 years.
Medication was Albuterol inhaler as needed. Lungs were clear to auscultation bilaterally, and
PFTs are summarized above. The assessment was poorly controlled asthma “classified as at
least a moderate persistent asthma. He is currently without symptoms. The patient was
advised to locate and follow up with a PMD in his home town for follow up of asthma.”
The Board directs attention to its rating recommendation based on the above evidence. On
TDRL entry, the CI clearly met the 30% rating criteria IAW VASRD §4.97 as he required daily
bronchodilator and/or anti‐inflammatory therapy. He had only one course of systemic
corticosteroids in the last year. Revised Fast letter 97‐67 directs that post‐bronchodilator
results be used for rating, and the clinic report of “FEV1 59%” was not clearly indicated as post‐
bronchodilator use. However, even if this value is used, all PFTs were no greater than those
specified in the 30% criteria. The Board does not find adequate reasonable doubt favoring the
CI in support of a rating recommendation higher than 30% TDRL entry rating.
In its deliberations for rating at TDRL exit, the Board devoted ample attention to the issue of
whether the requirement for daily bronchodilator and/or anti‐inflammatory therapy was met in
this case, as that is the pivotal criteria between a 10% or 30% rating IAW VASRD §4.97. The
record was clear that at TDRL exit the CI was neither prescribed nor taking daily medications.
The Board noted that the CI’s asthma was not well controlled, he had not sought medical care
for his asthma for 2 years, and the CI was recommended to seek pulmonary physician
evaluation and care. The CI’s PFTs were normal and he was clearly on intermittent inhalational
bronchodilator therapy, meeting the criteria for the 10% rating IAW VASRD §4.97.
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 adjudications for the asthma condition for entry into TDRL or at exit from TDRL.
2 PD1201076
The Board concluded therefore that this condition could not be recommended for additional
disability 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. 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 and IAW VASRD §4.97, the Board
unanimously recommends no change in the PEB adjudication on TDRL entry or TDRL exit. 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
TDRL PERMANENT
30%
30%
10%
10%
6602
COMBINED
Asthma
The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20120606, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record
SFMR‐RB
XXXXXXXXXXXXX, DAF
President
Physical Disability Board of Review
MEMORANDUM FOR Commander, US Army Physical Disability Agency
(TAPD‐ZB / XXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA 22202‐3557
SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for
XXXXXXXXXXXXXXXXXXX, AR20120022721 (PD201201076)
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.
3 PD1201076
BY ORDER OF THE SECRETARY OF THE ARMY:
Encl
XXXXXXXXXXX
Deputy Assistant Secretary
(Army Review Boards)
CF:
( ) DoD PDBR
( ) DVA
4 PD1201076
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