RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXXXXXXXXXXXX                                                                BRANCH OF SERVICE:  ARMY 
DATE OF PLACEMENT ON TDRL:  20021011 
CASE NUMBER:  PD1200469 
BOARD DATE:  20121114                                DATE OF PERMANENT SEPARATION DATE:  20031112 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty Major/O4, (67C/Senior Preventive Medicine Officer) 
medically separated for asthma.  The CI had a history of symptoms consistent with asthma for 
over  ten  years.    Prior  to  November  2001,  his  asthma  was  easily  controlled  with  daily 
medications and he experienced no respiratory problems when donning protective equipment.  
In  October  2001,  he  failed  a  physical  fitness  test  due  “asthma  attack”  and  was  then  having 
nocturnal symptoms and inability to don protective equipment due to respiratory symptoms.  
He  was  issued  a  P2  profile  in  November  2001  for  alternative  physical  fitness  testing.    His 
symptoms  persisted,  he  continued  to  require  daily  controlled  medications  and  the  asthma 
condition did not improve adequately with treatment to meet the physical requirements of his 
Military  Occupational  Specialty  or  satisfy  physical  fitness  standards.    In  June  2002,  he  was 
issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB).  The MEB 
identified  and  forwarded  moderate  persistent  asthma  as  the  only  condition  for  Physical 
Evaluation Board (PEB) adjudication.  The PEB adjudicated the asthma condition as unfitting, 
rated  30%,  with  application  of  the  Veteran’s  Affairs  Schedule  for  Rating  Disabilities  (VASRD).  
The CI was placed on the temporary disability retired list (TDRL) because his condition was not 
sufficiently stable for final adjudication.  The CI was re-evaluated almost 14 months later and 
the PEB recommended removal of the CI from the TDRL with a permanent disability rating of 
10%.  The CI made no appeals and was medically separated with a 10% disability rating. 
 
 
CI  CONTENTION:    “I  was  originally  diagnosed  with  asthma  after  returning  from  Desert 
Shield/Storm  in  1991.    I  was  able  to  control  the  asthma  through  medication  and  it  did  not 
impact  my  ability  to  deploy.    However,  in  2001,  I  began  experiencing  adverse  health  effects 
while wearing the protective mask and during physical fitness tests due to asthma.  I was placed 
on a permanent profile and began the medical evaluation board.  I was discharged from the 
Army  Oct,  2002  after  17  years  of  service  and  placed  on  the  temporary  retired  list  with  a 
disability rating of 30%.  The VA had also completed its assessment and assigned a disability 
rating of 30% as well in November, 2002.  The following year, the Army reduced my disability to 
10%  and  removed  me  from  the  retired  list  and  changed  my  status.    However,  the  VA 
reassessment in 2005 still resulted in a 30% disability rating.  I ask that the DOD reconsider the 
10% rating and align to the VA rating.” 
 
 
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.    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 the Correction of Military Records. 
 
 
 
 

PFTs 

FEV1 (% Predicted) 

FEV1/FVC 

Meds 

§4.97 Rating 

117% 
112% 

Daily inhaled steroids 

Daily inhaled beta agonists 
30%(daily inhaled steroids) 

93% 
82% 

Daily inhaled steroids 

Inhaled beta agonists as needed 

30%(daily inhaled steroids) 

TDRL RATING COMPARISON: 
 

Service PEB – Dated 20031022 

VA – All Effective Date 20021011 

Condition on TDRL entry – 20021011 
Asthma 

Code 
6602 

Rating 

TDRL 
30% 

Sep. 
10% 

Condition 
Asthma 

Code 
6602 

Rating 
30%* 

Exam 

20020925 

↓No Additional MEB/PEB Entries↓ 

0% x 4/Not Service Connected x 4 

Combined:  10% 

Combined:  30% 

*30% rating continued after scheduled VA C&P review examination in February 2005. 
 
 
ANALYSIS  SUMMARY:    The  Board  notes  the  current  Department  of  Veterans’  Affairs  (DVA) 
ratings  listed  by  the  CI  for  his  service-connected  condition  but  must  emphasize  that  its 
recommendations are premised on severity at the time of separation.  The DVA ratings which it 
considers in that regard are those rendered most proximate to separation.  The DES has neither 
the role nor the authority to compensate service members for anticipated future severity or 
potential complications of conditions resulting in medical separation.  That role and authority is 
granted by Congress to the DVA. 
 
Asthma Condition.  There were two pulmonary function tests (PFTs) evaluations in evidence, 
with  documentation  of additional  ratable  criteria,  which  the  Board  weighed  in  arriving  at  its 
rating recommendation; as summarized in the chart below. 
 

PFTs performed ~4 Mo. Pre-TDRL entry 

PFTs performed ~2 Mo. Pre-TDRL exit 

Used in NARSUM & VA C&P 

Used by PEB at TDRL exit 

 
At the MEB exam performed almost 4 months prior to TDRL entry, the CI reported diagnosed 
with  asthma  symptoms  and  an  asthma  attack  in  1991.    He  was  taking  Serevent,  Flovent, 
Albuterol and Zyrtec.  The MEB physical exam noted normal lung examination. 
 
The initial narrative summary (NARSUM) prepared approximately 3 months prior to TDRL entry 
noted the CI’s initial presentation to the pulmonary clinic in November 2001 after experiencing 
symptoms consistent with persistent asthma for the previous 10 years.  It was noted that his 
last visit to the emergency department was approximately ten years prior and that he had a 
positive  Methacholine  challenge  test  (MCT)  in  September  1991  (the  MCT  result  primary 
document is not available for review).  He failed an Army physical fitness test (APFT)  due to 
exertional symptoms and had no previous difficulty donning respiratory protective equipment.  
At the time of presentation to the pulmonary clinic, the CI was using inhaled bronchodilators 
and corticosteroid medications on a daily basis.  In November 2001, he was issued a P2 profile 
for alternate APFT and his asthma condition was monitored.  On follow-up in June 2002, the CI 
was  still  requiring  daily controller  medications,  continued  to  be  symptomatic  with  exertional 
activities, experienced an asthma exacerbation during a local field training exercise, admitted to 
nocturnal symptoms two to three times a week and was unable to don respiratory protective 
equipment presumable due to respiratory symptoms.  Physical exam revealed clear lungs.  PFT 
results, performed 4 months prior to TDRL entry, and medication use are documented in the 
chart above. 
 

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At  the  VA  Compensation  and  Pension  (C&P)  exam  performed  almost  a  month  prior  to  TDRL 
entry  prior  to  separation,  documented  a  history  similar  to  that  outlined  above  with  the 
following  additional  information:  never  required  hospitalization  for  asthma,  no  need for  oral 
steroids and treatment with both beta 2 agonists, long and short acting, and inhaled steroids.  
Physical  examination  revealed  clear  lungs to  auscultation.   This  C&P  examination referred  to 
PFT results obtained on 25 June 2002, the same PFT results referred to in the initial NARSUM. 
 
The TDRL evaluation summary prepared almost 2 months prior to separation documents the 
following interval history concerning the 11 month interval spent on TDRL.  The CI continued on 
the daily medications of Advair (twice daily), Flonase, Zyrtec and Albuterol as needed.  The CI 
reported symptoms approximately once a month with no nocturnal symptoms and no need for 
daily  Albuterol  use.    He  had  two  asthma  exacerbations  in  April  2003  that  required  only  fast 
acting Albuterol inhalers with no mention of oral steroid use.  Physical exam revealed lungs to 
be clear to auscultation bilaterally.  PFT data is summarized in the chart above. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  initially  utilized  VASRD  code  6602,  asthma,  and  rated  it  30%  based  on  daily  inhaled 
medications with normal PFTs and placed the CI on TDRL.  Three months after TDRL entry, the 
VA coded the asthma using 6602 and rated it 30%; citing the same PTF results used by the PEB 
at TDRL entry and treatment with beta 2 agonist and short acting inhaled steroids.  Fourteen 
months after TDRL entry, the PEB reevaluated the CI, making its final adjudication of asthma, 
coded 6602, and rated at 10% citing “pharmacy record noting intermittent use of medications 
since being placed on TDRL.”  The rating criteria for VASRD code 6602 rely on evaluation of the 
PFTs,  the  frequency  of  medication  use,  physician  visits  and  asthma  exacerbations.    The  10% 
rating requires an FEV-1 of 71- to 80% predicted or; FEV-1/FVC of 71 to 80% or; intermittent 
inhalational  or  oral  bronchodilator  therapy  and  is  the  rating  given  by  the  PEB’s  final 
adjudication.  This PEB rating was specifically based on the lack of documentation concerning 
the  CI’s  daily  use  of  inhaled  medications.    Both  the  NARSUM  and  the  TDRL  re-evaluation 
summary document PFT results that were above compensable levels and therefore the rating 
recommendation in this case is to be based entirely on medication use.  The records present for 
review document that daily inhaled steroids were consistently recommended by the medical 
providers  and  the  CI  consistently  reported  using  them  as  recommended.    The  medication 
profile is the key information required to justify a 30% rating in this case, as the intermittent 
inhalational bronchodilator medication use required for a 10% rating is easily met.  The criteria 
for the next higher rating, 30%, include “daily inhalational or oral bronchodilator therapy, or; 
inhalational  anti-inflammatory  medication.”    Any  frequency  of  use  of  inhalational  anti-
inflammatory medication satisfies the rating criteria and the pharmacy records are compatible 
with either a once daily dosing regimen or an intermittent twice-daily dosing regimen.  After 
due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), 
the Board recommends a permanent disability rating of 30% for the asthma 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 asthma condition, the Board unanimously recommends a 
30%  permanent  disability  rating,  coded  6602  IAW  VASRD  §4.97.    There  were  no  other 
conditions within the Board’s scope of review for consideration. 
 
 
 
 

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RECOMMENDATION:  The Board recommends that the CI’s prior determination be modified as 
to  reflect  a  permanent  combined  30%  disability  retirement  upon  removal  from  the  TDRL  as 
below: 
 

UNFITTING CONDITION 

VASRD CODE 

RATING 

PERMANENT 

6602 

COMBINED 

30% 
30% 

Asthma 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120604, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

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a.  Providing a correction to the individual’s separation document showing that the 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB /  ), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for XXXXXXXXXXXXXXXXXXXXX, AR20120021426 (PD201200469) 
 
 
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: 
 
 
individual was separated by reason of permanent disability retirement effective the date of the 
original medical separation for disability with severance pay. 
 
 
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. 
 
 
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 
 
 
 
CF:  
(  ) DoD PDBR 
(  ) DVA 

b.  Providing orders showing that the individual was retired with permanent disability 

d.  Affording the individual the opportunity to elect Survivor Benefit Plan (SBP) and 

 
 
 

     XXXXXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards) 

 
 
 

 
 
 

 
 
 

 
 
 

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