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AF | PDBR | CY2013 | PD-2013-02521
Original file (PD-2013-02521.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXX  CASE: PD-2013-02521
BRANCH OF SERVICE: AIR FORCE    BOARD DATE: 20150506
SEPARATION DATE: 20050729


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3 (Information Management Journeyman) medically separated for asthma. The condition could not be adequately rehabilitated to meet the physical requirements of her Air Force Specialty and she was referred for a Medical Evaluation Board (MEB). The “asthma” was forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123. No other condition was submitted by the MEB. The Informal PEB adjudicated asthma as unfitting rated 10%, c iting application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). The CI made no appeals and was medically separated.


CI CONTENTION: The CI elaborated no specific contention in her application, but simply wrote: “Medical discharge due to asthma.”


SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2). It is limited to those conditions determined by the PEB to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting. Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military/Naval Records. Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate. The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation. The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions. That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws. The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.


RATING COMPARISON :

IPEB – Dated 20050610
 VA* - (based on Service Treatment Records (STR)
Condition
 Code Rating Condition Code Rating Exam
Asthma 6602 10% Asthma 6602 0%** STR
Other x0
 Other x7
RATING: 10%
 RATING: 0%
* Derived from VA Rating Decision (VA RD ) dated 200 60630 (most proximate to date of separation ) . * * Increased to 10% effective 20070802

ANALYSIS SUMMARY:

Asthma. The data reflects that the CI had experienced exercised induced shortness of breath (SOB) when she significantly exerted herself. She also noted that her symptoms were worse when she exercised outdoors. Additionally, she had a history of allergic rhinitis which was treated with non-sedating antihistamines. The CI had initial pulmonary function tests (PFTs) performed in October 2004 that revealed subtle obstruction of small airways with a positive response to bronchodilators. The specific results were FEV1 92% (predicted) that increased to 117% (predicted) after bronchodilator administration and FEV1/FVC% of 72 that increased to 82 after Albuterol. The pulmonologist diagnosed exercise-induced asthma and recommended that the CI to continue the Albuterol on an as needed basis. The data supports that the CI responded to the Albuterol inhaler when used before exercise. She became reluctant to perform fitness testing due to fear of symptoms with severe exertion and was referred for an MEB. The narrative summary prepared 3 months prior to separation noted no change in her exercised-induced SOB but confirmed that Albuterol continued to control symptoms. The pulmonary exam was normal, specifically with no wheezing with equal excursion bilaterally.

The CI did not attend her initial VA Compensation and Pension (C&P) exam scheduled in May 2006. The first C&P exam contained in the evidence was performed 27 months after separation and contained the following sentence, “She does not require outpatient oxygen therapy, immunosuppressive medication and steroid therapy.”

The Board directed attention to its rating recommendation based on the above evidence. The PEB applied VASRD code 6602 (bronchial asthma) and rated it 10%. Over 31 months after separation, the VA also applied code 6602 and also rated the asthma condition at 10% effective 2 years after separation. The VASRD considers physician visits, asthma attacks, PFT results and/or medication use to assign a rating level. The data in this case supports that the CI only experienced asthma symptoms with intense exercise and that her symptoms were controlled with intermittent inhaled bronchodilator use. Her PFTs were in the non-compensable range after bronchodilator use (>80% is non-compensable per VASRD §4.97) and there was no evidence of inhalational anti-inflammatory medication use. All data supports that the CI only required intermittent inhalational medications as required for the 10% rating. Considering the totality of the evidence and mindful of VASRD §4.3 (reasonable doubt), members agreed that the disability rating of 10% for the asthma condition was appropriately recommended in this case.


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. There were no other conditions within the Board’s scope of review for consideration.


RECOMMENDATION: The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20131120, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record








XXXXXXXXXXXXXXXXX
President
Physical Disability Board of Review


 SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

 XXXXXXXXXXXXXXXXX

Dear XXXXXXX:

         Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2013-02521 .

         After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate. Accordingly, the Board recommended no re-characterization or modification of your separation.

         I have carefully reviewed the evidence of record and the recommendation of the Board. I concur with that finding and their conclusion that re-characterization of your separation is not warranted. Accordingly, I accept their recommendation that your application be denied.

 Sincerely,





XXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency
Attachment:
Record of Proceedings

cc:
SAF/MRBR

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