RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2002-03318
		INDEX CODE:  107.00
		COUNSEL:  NONE

		HEARING DESIRED:  YES

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APPLICANT REQUESTS THAT:

His disability discharge with severance pay at 10 percent be changed to reflect that he was medically retired with a 30 percent disability rating.

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APPLICANT CONTENDS THAT:

He became ill while in Basic Military Training.  He was told that he had a virus and to let his body fight it off.  He was later diagnosed with eosiniphillic fasciitis, IGM nephropathy, and localized morphea.  He was told that the condition was the result of being sick while being under physical stress, combined with the immunization shots he received and an untreated strep infection.  His illness makes ordinary activities of daily living a challenge.  His illness prevented him from doing his job on the flight line.  

He faxed a rebuttal to the Formal Physical Evaluation Board (FPEB) findings to his lawyer, but his fax did not arrive and his case was closed.  He is asking for 30 percent disability so that he can go to school and be retrained for a different career.  His close proximity to an Air Force base would allow him use of base exchange facilities and access to the gym to further his physical therapy.  

In support of his request, applicant provided a personal statement; his AF Form 100, Request and Authorization for Separation; his DD Forms 214, Certificate of Release or Discharge from Active Duty; and a copy of a facsimile cover sheet.  His complete submission, with attachments, is at Exhibit A.

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STATEMENT OF FACTS:

Applicant enlisted in the Regular Air Force on 25 Sep 01.  He was progressively promoted to the grade of airman first class, having assumed that grade effective and with a date of rank of 9 Nov 01.  An MEB was convened on 9 Jul 02 and referred his case to an Informal Physical Evaluation Board (IPEB) with a diagnosis of Eosinophilic Fasciitis, Generalized Morphea, and IgM Nephropathy.  On 17 Jul 02,the IPEB found him unfit for further military service based on a diagnosis of Eosinophilic Fasciitis associated with Morphea and Schlerodermoid and Generalized Morphea - EPTS without service aggravation, and IgM Nephropathy.  The IPEB recommended that he be discharged from the Air Force with an EPTS condition.  The applicant disagreed with the findings and recommended disposition of the IPEB.  On 26 Aug 02, the FPEB reviewed the applicant's case and found him unfit for further military service with a diagnosis of Eosinophilic Fasciitis associated with Morphea and Schlerodermoid and Generalized Morphea - incurred in the line of duty while entitled to receive basic pay, and IgM Nephropathy.  The FPEB recommended that he be discharged with severance pay with a compensable percentage of 10 percent.  The applicant disagreed with the findings and recommended disposition of the FPEB and his case was forwarded to the Secretary of the Air Force Personnel Council for review.  Applicant's rebuttal to the FPEB findings was not received by the Secretary of the Air Force Personnel Council within the prescribed time limits and the Personnel Council reviewed his case and agreed with the findings and recommended disposition of the FPEB.  The applicant was discharged from the Air Force on 10 Oct 02, with a compensable disability rating of 10 percent.  He served 1 year and 16 days on active duty

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AIR FORCE EVALUATION:

The BCMR Medical Consultant recommends that the applicant be placed on the Temporary Disability Retired List (TDRL) with a 30 percent disability rating.  The Consultant states that eosinophilic fasciitis is a rare condition of unknown cause that is characterized by inflammation of skin resulting with fibrosis of the affected skin.  The applicant's condition involved his arms and legs and produced joint contractures of mild to moderate degree.  His renal disease was considered unrelated to his skin disease and was not unfitting for continued duty.  The physical limitations exhibited appeared to have been related to limited joint motion of the wrist and elbows, mildly decreased grip strength and decreased stamina.  The FPEB assigned the disability rating using the analogous VASRD code 6350/6399 under systemic lupus erythematosos/systemic autoimmune diseases.  However, the applicant has a disease characterized by fibrosis of the skin and classified closely with the disease called schleroderma.  The use of VASRD code 7821 "Cutaneous manifestations of collagen-vascular diseases not listed elsewhere appears" to be more appropriate.  This code assigns disability rating based on percent of body surface and use of medications.  The applicant would appear to have somewhat more than 20 percent of his body surface area involved and a requirement for corticosteroids on an intermittent basis.  This degree of involvement correlates with a 30 percent rating.  The FPEB, having the benefit of seeing the applicant in person assigned a 10 percent rating based on their global impression of his functional ability.  Since the course of this disease is not predictable and may either improve substantially or persist, the Medical Consultant believes that his condition is both not stable and of sufficient severity to warrant further observation prior to assigning a permanent rating.  The Medical Consultant evaluation is at Exhibit C.

AFPC/DPPD recommends denial of the applicant's request.  DPPD states that having reviewed the recommendation of the BCMR Medical Consultant, they forwarded the case file to the PEB for another assessment.  The PEB determined that the applicant's medical condition, which is triggered by a Group A Beta Hemolytic Strep Throat, is best described as an autoimmune response.  Most undifferentiated autoimmune diseases have in the past been analogized to Lupus Erythematosis by consensus of the DoD medical personnel comprising of three services.  The Associate Professor in the Department of Rheumatology and the University of Oklahoma states in her consultation letter to the FPEB that she did not feel his condition represented a form of Scleroderma, but if it were Scleroderma then the condition would likely be considered as Existing Prior to Service (EPTS).  If the VASRD code is substituted, as the Medical Consultant is suggesting, then the IPEB's original decision should be reinstated and his disability severance pay be recouped since it was paid for an EPTS condition.  

DPPD states that the applicant was treated fairly through the disability evaluation process and he was properly rated under Federal disability guidelines.  The DPPD evaluation is at Exhibit D.
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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Copies of the Air Force evaluations were forwarded to the applicant on 7 Mar 03 for review and comment within 30 days.  As of this date, this office has received no response.

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THE BOARD CONCLUDES THAT:

1.  The applicant has exhausted all remedies provided by existing law or regulations.

2.  The application was timely filed.

3.  Sufficient relevant evidence has been presented to demonstrate the existence of error or injustice that would warrant corrective action.  The applicant was considered by the disability evaluation system and was diagnosed with eosinophilic fasciitis and subsequently discharged with severance pay.  The BCMR Medical Consultant has opined that the applicant's condition is more closely classified with fibrosis of the skin and that VASRD code of 7821, rather than VASRD code 6350/6389, appears to be more appropriate in this case.  After a thorough review of the evidence of record, we are inclined to agree with the Medical Consultant's opinion, since the course of the applicant's condition appears to be unstable and unpredicatable.  It is our opinion that placing the applicant on the TDRL at the recommended disability rating of 30 percent with further evaluation is the most reasonable resolution in this case.  Accordingly, we recommend his records be corrected to the extent indicated below.  We note that the Physical Evaluation Board indicates that substitution of the VASRD code would require recoupment of the applicant's severance pay; however, payments received while on the TDRL would be offset by monies he has already received and therefore, recoupment will not be necessary.

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THE BOARD RECOMMENDS THAT:

The pertinent military records of the Department of the Air Force relating to APPLICANT be corrected to show that he was not discharged from active duty with entitlement to severance pay on 10 October 2002, but on 11 October 2002 his name was placed on the Temporary Disability Retired List with a diagnosis of cutaneous manifestations of collagen-vascular diseases not listed elsewhere, with a VASRD code of 7821, and a compensable rating of 30 percent.

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The following members of the Board considered Docket Number BC-2002-03318 in Executive Session on 6 May 03, under the provisions of AFI 36‑2603:

All members voted to correct the records, as recommended.  The following documentary evidence was considered:

    Exhibit A.  DD Form 149, dated 4 Oct 02, w/atchs.
    Exhibit B.  Applicant's Master Personnel Records.
    Exhibit C.  Letter, BCMR Medical Consultant, dated 30 Dec 02.
    Exhibit D.  Letter, AFPC/DPPD, dated 27 Feb 03.
    Exhibit E.  Letter, SAF/MRBR, dated 7 Mar 03.

								
AFBCMR BC-2002-03318

MEMORANDUM FOR THE CHIEF OF STAFF

	Having received and considered the recommendation of the Air Force Board for Correction of Military Records and under the authority of Section 1552, Title 10, United States Code (70A Stat 116), it is directed that:

	The pertinent military records of the Department of the Air Force relating to APPLICANT, be corrected to show that he was not discharged from active duty with entitlement to severance pay on 10 October 2002, but on 11 October 2002 his name was placed on the Temporary Disability Retired List with a diagnosis of cutaneous manifestations of collagen-vascular diseases not listed elsewhere, with a VASRD code of 7821, and a compensable rating of 30 percent.