RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  MARINE CORPS 

 
NAME:  XX                                                     
CASE NUMBER:  PD1200908                                                 SEPARATION DATE:  20020430 
BOARD DATE:  20130124 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  Cpl/E-4  (1171/Hygiene  Equipment  Operator), 
medically  separated  for  persistent  asthma.    Asthma  condition  could  not  be  adequately 
rehabilitated.    The  CI  did  not  improve  adequately  with  treatment  to  meet  the  physical 
requirements of her Military Occupational Specialty or satisfy physical fitness standards.  She 
was  placed  on  limited  duty  and  placed  on  light  duty  and  referred  for  a  Medical  Evaluation 
Board  (MEB).    The  MEB  forwarded  no  other  conditions  for  PEB  adjudication.    The  PEB 
adjudicated  the  mild  to  moderate  persistent  asthma  condition  as  unfitting,  rated  0%  with 
application of DoD instruction 1332.39.  The CI made no appeals, and was medically separated 
with a 0% disability rating.   
 
 
CI CONTENTION:  “My asthma was severe and they changed it when I went for another exam, 
but gave me the lowest rating possible when I was discharged.”   
 
 
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 (BCNR).   
 
 
RATING COMPARISON:   
 

Code 
6602 

Rating 
10% 

Rating 
0% 

to 

Moderate 

Exam 
20030719 
 

VA (14 Mos. Post-Separation) – All Effective Date 20020501 
Condition 
Asthma 
  Not Service-Connected x 8 
Combined:  10% 

Service IPEB – Dated 20020211 
Code 
Condition 
Mild 
6602 
Persistent Asthma 
↓No Additional MEB/PEB Entries↓ 
Combined:  0% 
*Per last VARD on record combined rating changed to 90% effective 20050502 
 
ANALYSIS SUMMARY:   
 
Mild to Moderate Persistent Asthma Condition.  The CI was diagnosed with asthma in 2000 and 
was  treated  with  inhaled  bronchodilators.    Spirometry  8  March  2001  was  normal  with  FEV1 
98%  predicted  and  an  FEV1/FVC  ratio  of  79%  (91%  predicted).    However  an  exercise 
bronchoprovocation test March 2001 was positive confirming the diagnosis and daily inhaled 
steroid medication was added to her treatment.  At the time of follow up in 11 July 2001, the CI 
was not using the inhaled steroid medication and she was advised to use the medication daily.  
The  MEB  narrative  summary  (NARSUM),  dictated  1  August  2001, 
inhaled 
bronchodilator  medication  used  as  needed,  but  later  indicates  prescription  for  daily  inhaled 
steroid.    The  MEB  history  and  physical  examination  dated  14  January  2002  lists  inhaled 
bronchodilator  and  inhaled  steroids  in  the  medication  list  indicating  “regular  use”  without 

lists  only 

further detail.  Service treatment records (STRs) leading up to the date of separation continue 
to list inhaled steroid and bronchodilator.  There was no VA Compensation and Pension (C&P) 
examination proximate to separation.  The first C&P examination was 19 July 2003, 15 months 
after  separation.    At  that  time,  inhaled  bronchodilator  and  inhaled  steroid  medication  was 
listed.  The CI declined spirometry testing.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
ratable pulmonary function parameters (FEV-1 and FEV-1/FVC) in the STRs were normal but the 
March 2001 results minimally supported a 10% rating.  The treatment regimens documented in 
the NARSUM examination reported that the CI was prescribed daily inhaled steroid medication 
along  with  a  rescue  inhaler  supporting  the  30%  rating  while  the  C&P  examination  noted 
intermittent  bronchodilator  supporting the  10%  rating.    The  Board  noted  STRs  leading up  to 
separation listed inhaled steroid medication in the active medication list.  There is no evidence 
in  this  case  that  the  CI  did  not  require  daily  maintenance  with  either  Flovent  or  Azmacort 
(which  was  listed  as  her  daily  medication  on  multiple  examinations  around  the  time  of 
separation)  in  order  to  maintain  good  control  of  her  asthma.    The  majority  of  the  Board 
considered  the  minority  voter’s  analysis  but  did  not  conclude  the  evidence  was  sufficiently 
convincing to conclude that the treatment agents were not being utilized on a daily basis.  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% using code 6602 for the 
mild to moderate persistent 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.  In the matter of the mild 
to moderate persistent asthma condition, the Board by a vote of 2:1 recommends a disability 
rating of 30%, coded 6602 IAW VASRD §4.97.  The single voter for dissent (who recommended 
10%)  submitted the  appended  minority  opinion.    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:   
 

VASRD CODE  RATING 
6602 
COMBINED 

30% 
30% 

UNFITTING CONDITION 
Mild to Moderate Persistent Asthma  

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120608, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

           XX 
           Director 
           Physical Disability Board of Review 

   2                                                           PD1200908 
 

 
Minority Opinion.  The minority voter concluded the preponderance of evidence of the service 
medical  record  indicated  the  CI  was  not  using  the  asthma  medications  as  prescribed  and 
therefore did not meet the threshold for the 30% rating based on medication use.  Prior to the 
NARSUM, a pattern of non-use of medication was documented in the STRs.  Following the time 
of the NARSUM, 1 August 2001, there are no clinical encounters for care of asthma or for refill 
of asthma medications.  The asthma medications are intermittently listed in STRs following the 
NARSUM and are inconsistently recorded.  No STR entry is in evidence that documents actual 
refill  of  these  medications  between  1  August  2001  and  separation,  9  months  later.    The 
presence  of  multiple  clinic  encounters  in  the  evidence  of  record  suggests  that  if  such 
documentation existed it would have been present in the evidence available for review.  The 
minority voter concludes the asthma condition more nearly approximates the 10% rating.  
 

 

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MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS 
 
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATION           
 
Ref:   (a) DoDI 6040.44 
          (b) PDBR ltr dtd 11 Feb 13 
           
1.  Pursuant to reference (a) I have reviewed the recommendation of the Physical Disability 
Board of Review set forth in reference (b).  For the reasons provided therein, I concur with the 
opinion of the minority voting member. 
 
2.  The official record of the following individual is to be corrected to reflect the stated 
disposition: 
 
      a. xx former USMC:  Separation from the naval service due to physical disability rated at 
10% (increased from 0%) effective 2 May 2002. 
 
3.  Please ensure all necessary actions are taken to implement this decision and that subject 
member is notified once those actions are completed. 
 
 
 
 
 
 
 
 

xx 
  Principal Deputy 
  Assistant Secretary of the Navy 
     (Manpower & Reserve Affairs) 

 
 
 
 

 
 
 
 

 
 
 
 

 
 
 
 

 
 
 
 

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