Connecting my asthma to my time in the service?

[AFRunner]

For starters, thanks for any and all help!

I went to USAFA and graduated in 2011 and then served about 3.5 years before voluntarily separating during the budget cuts. So my final day was the last day of September 2014. That following Spring (2015) I began to have issues breathing and by June it was unbearable. It took them a month or so to track it down but they diagnosed me with Asthma. I breathe at 60% and use the highest dosage steroid they're allowed to give me now 2x/day every day. Additionally they found a little bit of AV Block and some times at rest my heart beat stops for upwards of 4s. They put a loop recorder in my chest in July of 2015 to monitor my heart. 

My time in the service was divided between 4 years at USAFA (I also spent a semester on exchange at USNA), two 2 month TDYs to lackland, and then a little over 3 years at Wright Patterson AFB in Building 1 (a building from the 1930's). I worked in contracting and spent my final year and a half in construction contracting. So I was often on site for my contracts which included a lot of time on site for a big HVAC project at NASIC and I oversaw numerous demolitions around base (I even got to break into a building in Area B once because CE didn't have the key for it, fun times). 

So I don't know if I have any sort of connection to the service or not. It's been frustrating. I've been healthy my entire life and then just months after leaving the service I came down with Asthma. My new work place is amazing and definitely not the cause (everyone in my new job is just fine and our building is very new). 

So maybe i'm grasping at straws here, but I shelled out thousands of dollars this past year in appointments, medicine, and having a loop recorder installed. It would be fantastic to hear I have an opportunity to get help with this. If not though, so is life. 

In the meantime, I'm going to send the initial documents to my local VFW service officer and they will represent my claim. 

I'm all ears for any advice. 

Warm regards

[Vync]

Welcome to Hadit!

Service connection (SC) requires three things:

1. An event/diagnosis during service
2. Current diagnosis
3. A medical doctor connecting the two

Start by requesting any and all records from your service including medical records, personnel records, etc.. Look for anything during service and the 12 months following which might be connected or might cause it. It doesn't necessarily need to be a medical cause. The demolition is a good example where you might have been subject to inhaling fine particulate. I'm not an expert in demolition, but some very old buildings might have contained chemicals like asbestos, which are obviously bad.

You mentioned VFW. Did you serve in Iraq/Afghanistan?

[AFRunner]

Thanks for the responses thus far. Really appreciate. 

VYNC, I did not serve oversees. I reached out to the VFW because I was really confused on where to start with everything so I reached out to the local service officer. He's been very useful so far and has responded immediately to my emails. He has sent me the initial claim form to fill out thus far and i'm going to fill that out tomorrow and get it back to him. 

Dot09, thank you for that well worded response. So I guess after reading the 5 conditions, number 1 seems like my best bet. As I never had Asthma before hand, Asthma is not on the list of presumptive disabilities, I don't think the Asthma was caused by a secondary condition and lastly the VA has caused me no harm at this point. 

Thus it happened within 1 year so I have the opportunity to show there was a direct service connection, I just have to prove that something happened during my service that could have caused it? That's tough but there had to be something. I really can't imagine how all of a sudden a very healthy young man with a strong aerobic history just, gets asthma? But as I said, I could totally be grasping at straws because the entire situation has left me so frustrated. 

Thanks again for the help thus far, definitely starting to make quite a bit more sense even if I no claim. 

[AFRunner]

Well some good news. For the first time since I separated, I decided to pour over my SMRs. I thought I was pretty healthy but I look at 7.5 years of records and suddenly I feel like I was sick all the time. I had bronchitis 3x, upper respiratory infections twice, was prescribed SIX different inhalers in my 7.5 years. I even complained of shortness of breath 2x (one they attributed to stress, one to costochondritis). So perhaps it was there all along and just was never noticed and it got aggravated with my final job in the military or by something shortly after I separated? 

Here's the ultimate nugget though, from my graduation physical back in October of 2010, "In comparison with the two prior studies (the doctor is referring to two previous studies of my chest in August of 2007 and January of 2010), there is again mild peribronchial thickening and interstitial prominence of the mid to upper thoraces bilaterally."

Per wikipedia, peribronchial thickening (referred to as peribronchial cuffing)...

Peribronchial cuffing is seen in a number of conditions including:

• acute bronchitis
• asthma following exercise or during an acute episode

...it goes on to list numerous other diseases of the pulmonary/cardio systems. But the very first two are one I now have and bronchitis which per my records I had 3x not including upper respiratory infections. 

At one point one doctor even noted, "Appears to have stranding in RML infiltration", which upon further research means, thickening of the bronchial wall which is related to chronic bronchitis and asthma which is what was mentioned above. So this was clearly a thing I had going on the entire time it seems. 

Additionally, during the military I had tons of leg issues. I never realized how many times i went to the doctor for them though (let the record show, I never missed a physical fitness test and my best 1.5 mile was 7:22, so no I didn't try to get out of testing!). I have like 3-4 doctors visits for leg injuries and some ungodly amount of physical therapy sessions (something like 3 dozen with many lasting 30 minutes to an hour). Those physical therapy sessions spanned from 2007 to the final one in 2013. So maybe I will get some respite on those issues. 

So for those who have dealt with this entire process, does this seem like any decent standing? 

Additionally, here's the schedule of ratings for asthma, 

 

6602    Asthma, bronchial:

 

                  FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than

                        40 percent, or; more than one attack per week with episodes of

                        respiratory failure, or; requires daily use of systemic (oral or

                        parenteral) high dose corticosteroids or immuno-suppressive

                        medications....................................................................................................... 100 

                  FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55

                        percent, or; 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...................................... 60 

                  FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70

                        percent, or; daily inhalational or oral bronchodilator therapy,

                        or; inhalational anti-inflammatory medication.................................................... 30 

                  FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80

                        percent, or; intermittent inhalational or oral bronchodilator therapy.................. 10

 

My FEV is roughly 60% which is equivalent to 30% disability. However, I take an oral/inhaled corticosteroid (beclomemethasone diproportionate) at the highest dose possible 2x a day every day and have been since I was diagnosed. They originally had me on a middle dose but it only showed marginal improvements in my condition. So the switch to the highest dose has gotten me to 90% ish although I still frequently have to take very deep breaths to relax/breath and I use albuterol still before I run. 

Thoughts on that?

Edited March 31, 2016 by AFRunner

[broncovet]

Yea.  My thoughts are you did your homework are are likely to get a good result.  You looked at your SMR's

(good, most vets dont bother) and you looked up the criteria (good, and most vets dont bother).  The 5 P's should work well for you:  Proper Preperation Prevents Poor Performance.  

I also liked that you thank the volunteers who gave their time (dot and vync) to help you.  

Edited March 31, 2016 by broncovet

[broncovet]

Also, Vync and Dot gave you great advice, that is spot on.  

[Vync]

Thanks Broncovet!

AFRunner,
When you go in for the asthma C&P exam, they will likely refer you to pulmonary for testing. They will take tests both before and after using a bronchodilator inhaler (like albuterol) and your FEV1 would be taken from the higher of the two.

But like you read in the asthma ratings, there are other criteria for ratings which do not rely on FEV1. For example, if you are on a daily inhaled corticosteroid because that would put you minimum at the 30%. If you happened to have been prescribed swallowed (like prednisone) or injected/IV steroids (like bethamethasone or solumedrol) three or more times within 12 months, then that could bump you up to a 60% rating, as would visiting a physician monthly for treatment of exacerbations.

Keep in mind that if you get a 60% rating due to the steroid pills/injections/IV, then the VA will likely tell you the condition is expected to improve. They will schedule a new C&P 6 to 12 months out for another C&P exam.