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AF | PDBR | CY2014 | PD-2014-02268
Original file (PD-2014-02268.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXX       CASE: PD-2014-02268
BRANCH OF SERVICE: AIR FORCE     BOARD DATE: 20141015
SEPARATION DATE: 20070406


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SRA/E-4 (3P051/Security Forces) medically separated for sleep apnea. The condition could not be adequately rehabilitated to meet the physical requirements of his Air Force Specialty or satisfy physical fitness standards. He was issued a permanent P4 profile and referred for a Medical Evaluation Board (MEB). Sleep apnea was forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123. No other conditions were submitted by the MEB. The Informal PEB adjudicated “obstructive sleep apnea (OSA) requiring use of continuous positive airway pressure (CPAP)” as unfitting, rated 0%, with application of the VA Schedule for Rating Disabilities (VASRD). The CI made no appeals and was medically separated.


CI CONTENTION: “Please consider all conditions. Sleep Apnea, PTSD, Lumbar Spine Strain with Intervertebral Disc- Syndrome, Radiculopathy of the Right Lower Extremity, and Radiculopathy of the Left Lower Extremity”.


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 those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI. The rating for the unfitting sleep apnea condition is addressed below; no additional conditions are within the DoDI 6040.44 defined purview of the Board. Any condition 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 Military Records.


 RATING COMPARISON :

Service IPEB – Dated 20070212
 VA* - (2 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Obstructive Sleep Apnea 6847 0% Obstructive Sleep Apnea 6847 50% 20070629
Other x 0 (Not in Scope)
 Other x 2 (Not in Scope) 20070629
Combined: 0%
 Combined: 50%
* Derived from VA Rating Decision (VA RD ) dated 200 40520 (most proximate to date of separation ( DOS ) )


ANALYSIS SUMMARY:

Obstructive Sleep Apnea Condition. The CI reported the onset of poor sleep beginning in September of 2005 which was associated with snoring per his spouse. He was referred for sleep studies which showed the presence of moderate OSA on 21 March 2006. A trial with CPAP on 24 April 2006 showed benefit and was prescribed. He had previously been evaluated by otolaryngology and thought to not be a surgical candidate. Due to the use of the CPAP, he was referred for an MEB to determine assignability. The condition was found to be medically unacceptable and he was referred to the PEB which determined the condition to be unfitting. The undated narrative summary noted the use of CPAP for OSA. No complications were noted and the examination showed no other respiratory issues. At the VA Compensation and Pension examination performed 2 months after separation, the CI reported improvement with the use of CPAP. The examination was otherwise unremarkable.

The Board directs attention to its rating recommendation based on the above evidence. The PEB and VA both coded the OSA condition as 6847, sleep apnea. The PEB rated the condition at 0% whereas the VA rated it at 50%. The use of CPAP supports the 50% rating assigned by the VA. Absent indications of respiratory failure, a higher rating is not supportable. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 50% for the OSA 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 OSA condition, the Board unanimously recommends a disability rating of 50%, coded 6847 IAW VASRD §4.100. 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
Obstructive Sleep Apnea requiring the use of CPAP 6847 50%
COMBINED 50%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20140520, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record








                 
XXXXXXXXXXXXXXXXXXXX
President
Physical Disability Board of Review


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

Dear XXXXXXXXXXXXXXXXXXXX :
         Reference your application submitted under the provisions of DoDI 6040.44 (Title 10 U.S.C. § 1554a), PDBR Case Number PD-2014-02268.
         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 not appropriate under the guidelines of the Veterans Affairs Schedule for Rating Disabilities. Accordingly, the Board recommended your separation be re-characterized to reflect disability retirement, rather than separation with severance pay.
         I have carefully reviewed the evidence of record and the recommendation of the Board. I concur with that finding, accept their recommendation and determined that your records should be corrected accordingly. The office responsible for making the correction will inform you when your records have been changed.
         As a result of the aforementioned correction, you are entitled by law to elect coverage under the Survivor Benefit Plan (SBP). Upon receipt of this letter, you must contact the Air Force Personnel Center at (210) 565-2273 to make arrangements to obtain an SBP briefing prior to rendering an election. If a valid election is not received within 30 days from the date of this letter, you will not be enrolled in the SBP program unless at the time of your separation, you were married or had an eligible dependent child, in such a case, failure to render an election will result in automatic enrollment.

                                                               Sincerely,






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

cc:
SAF/MRB

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