RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXXXXXXXXXXXXXXX                                                     BRANCH OF SERVICE:  MARINE CORPS 
CASE NUMBER:  PD1200681                                                                SEPARATION DATE:  20020131 
BOARD DATE:  20130103 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  LCPL/E-3  (3051/Warehouse  Clerk),  medically 
separated  for  reactive  airway  disease.    The  condition  first  presented  in  January  2001  and 
required  hospitalization.    The  CI  did  not  improve  adequately  with  treatment  to  meet  the 
physical  requirements  of  his  Military  Occupational  Specialty  or  satisfy  physical  fitness 
standards.  He was placed on limited duty [LIMDU] and referred for a Medical Evaluation Board 
(MEB).  The MEB forwarded reactive airway disease and vocal cord dysfunction to the Physical 
Evaluation  Board  (PEB)  as  medically  unacceptable  IAW  SECNAVINST  1850.4E.    No  other 
conditions appeared on the MEB’s submission.  The PEB adjudicated the reactive airway disease 
condition as unfitting, and assigned a rating of 10%.  The vocal cord dysfunction (VCD) condition 
was determined to be Category II: conditions that contribute to the unfitting condition.  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.    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 Naval Records. 
 
 
RATING COMPARISON:   
 

VA (1 Mo. Pre -Separation) – All Effective Date 20020201 

Service IPEB – Dated 20011210 
Condition 

Reactive Airway Disease 
Vocal Cord Dysfunction 
(Laryngeal Dyskinesia) 

Code 
6602 

Rating 
10% 

CAT II 

Condition 

Reactive Airway Disease 
Laryngeal Dyskinesia 
Left Subacromial Impingement 
and Strain 
Right Scaphoid Fracture 
Left Ankle Sprain 
Lumbar Strain 

Code 
6602 
6516 

Rating 
60% 
0% 

Exam 

20020111  
20020111 

5299-5201 
5299-5215 
5299-5271 

5295 

10% 
10% 
10% 
10% 

20020111 
20020111 
20020111 
20020111 
20020111 

0% X 2 / Not Service-Connected x 1 

Combined:  70% 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

 
 
 
 
 
 
 

ANALYSIS SUMMARY:   
 
Reactive  Airway  Disease  Condition.    Bronchospasm  first  presented  in  January  2001  while 
exercising and required hospitalization at that time.  Pulmonary function test (PFT) results on 
21 March 2001 showed an FEV1 of 95% of predicted normal and an FEV1 / FVC ratio of 79%.  In 
July 2001 the CI was briefly hospitalized for observation when diagnosed with VCD, a condition 
characterized  by  paradoxical  closure  of  the  vocal  cords  during  inspiration.    Follow-up  with  a 
speech therapist on 8 August 2001 indicated that no further episodes of VCD had occurred and 
that it was likely induced by his asthma.  No further mention of symptomatic VCD was made in 
the  outpatient  record.   A  review  of  all  clinical  entries  was  performed  to  assess  frequency  of 
visits to a physician for care of an asthma exacerbation.  There were two emergency room visits 
for asthma, one in January 2001 and one in April 2001; both visits required systemic steroids.  
Of the few primary care visits for asthma between January and April 2001, possibly one of them 
could  be  considered  as  necessary  for  an  exacerbation.    There  were  seven  visits  to  the 
pulmonologist  between  April  and  December  2001.    Only  one  of  those  could  be  considered 
related  to  an  acute  exacerbation,  which  was  the  event  leading  to  admission  for  VCD  in  July 
2001.    This  was  the  last  visit  to  a  physician  that  was  possibly  required  for  care  of  an 
exacerbation.  No further systemic steroids were given after the April 2001 emergency room 
visit.  The narrative summary (NARSUM) prepared 4 months prior to separation noted that the 
CI continued to experience daily episodes of respiratory distress, as well as bronchospasm with 
exercise.  Albuterol and Singulair were mentioned as currently used medications, but frequency 
was not specified.  However, an outpatient note written on the same day by the same examiner 
stated: “Continued respiratory distress every night with maximal medical therapy.”  The list of 
prescribed  medications  included  an  inhaled  steroid.    No  mention  of  further episodes  of  VCD 
was made.  At the VA Compensation and Pension (C&P) exam 3 weeks prior to separation the CI 
reported  that  weather  changes  or  any  activity  caused  a  flare  up  of  his  asthma.    He  used  an 
inhaled  bronchodilator  and  an  inhaled  steroid  daily,  and  was  reported  to  have  had  “six 
treatments at the hospital.”  Details of these episodes were not provided.  He also reported 
occurrences  of  VCD  two  or  three  times  per  month  that  caused  hoarseness  for  3-4  days.  
Physical examination revealed no wheezing, although expiration phase of the respiratory cycle 
was prolonged.  PFTs could not be performed due to severe bronchospasm. 
 
The  Board  directs  attention  to  its  rating  recommendation  based  on  the  above  evidence.    A 
compensable rating for asthma is predicated on the frequency of bronchodilator use, on the 
use of systemic or inhaled steroids, or on PFT results.  The PEB’s 10% rating and the VA’s 60% 
rating were both assigned under the VASRD code for asthma, 6602.  A 10% rating is justified by 
intermittent inhalational or oral bronchodilator therapy; or an FEV1 of 71-80% predicted, or an 
FEV1 / FVC ratio of 71-80%.  In this case, the FEV1 / FVC ratio of 79% meets the 10% criteria.  
However, in considering the criteria for a higher rating, the Board members agreed that the CI 
required  daily  bronchodilator  use  and  inhalational  anti-inflammatory  medication,  either  of 
which  alone  justifies  a  30%  rating.    The  criteria  for  the  next  higher  60%  rating  are  “at  least 
monthly visits to a physician for required care of exacerbations, or; intermittent (at least three 
per year) courses of systemic (oral or parenteral) corticosteroids.”  The VA assigned the 60% 
rating  on  the  basis  of  frequent  visits  to  a  physician.    Board  members  agreed  however  that 
evidence presented above does not meet the 60% criteria.  The last visit to a physician required 
for care of an exacerbation was in July 2001; the remaining visits were scheduled follow ups for 
maintenance management, not exacerbation management.  The Board also considered the VCD 
condition diagnosed in July 2001, considered a Category II condition by the PEB and rated 0% by 
the  VA.    After  follow  up  with  the  speech  therapist  in  August  2001,  there  were  no  further 
documented  complaints  related  to  VCD  symptoms  in  the  service  treatment  record  and  no 
further  visits  required  for  care  of  the  condition.    The  Board  concluded  therefore  that  this 
condition could not be recommended for additional disability rating.  After due deliberation, 
considering all of the evidence and mindful of VASRD §4.3 (Resolution of reasonable doubt), the 
Board recommends a disability rating of 30% for the reactive airway disease condition. 

   2                                                           PD1200681 
 

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.    In  the  matter  of  the 
reactive  airway  disease  condition,  the  Board  unanimously  recommends  a  disability  rating  of 
30%, coded 6602 IAW VASRD §4.97.  In the matter of the VCD condition 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 his prior medical separation:   
 

UNFITTING CONDITION 

VASRD CODE  RATING 

6602 

COMBINED 

30% 
30% 

Reactive Airway Disease 

 
 
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 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

   3                                                           PD1200681 
 

 COMMANDER, NAVY PERSONNEL COMMAND 

MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS 
 
 
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 
 
Ref:   (a) DoDI 6040.44 
          (b) PDBR ltr dtd 29 Jan 13 ICO XX 
          (c) PDBR ltr dtd 15 Jan 13 ICO XX 
          (d) PDBR ltr dtd 22 Jan 13 ICO XX 
                                         
1.  Pursuant to reference (a) I approve the recommendations of the Physical Disability Board of 
Review set forth in references (b) through (d). 
 
2.  The official records of the following individuals are to be corrected to reflect the stated 
disposition: 
 
     a.  XXXXXXX former USN:  Disability retirement with a final disability rating of 30 percent 
with retroactive placement on the Permanent Disability Retired List effective 23 October 2002. 
 
     b.  XXXXXXXXX former USMC:  Disability retirement with a final disability rating of 30 
percent with retroactive placement on the Permanent Disability Retired List effective 31 January 
2002. 
 
     c.  XXXXXXXXX former USMC:  Disability separation with a final disability rating of 20 
percent (increased from 10 percent) with entitlement to disability severance pay effective 30 
September 2002. 
 
3.  Please ensure all necessary actions are taken, included the recoupment of disability severance 
pay if warranted, to implement these decisions and that subject members are notified once those 
actions are completed. 
 
 
 
 
 
 
 
 
 
 
 

  XXXXXXXXXXX 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

 

 
 
 

 
 
 

 
 
 

 
 
 

 
 
 

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