RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBERS:  BC-2003-00299
		INDEX CODE 108.01 108.10
	 	COUNSEL:  None

	 	HEARING DESIRED:  Yes

_________________________________________________________________

APPLICANT REQUESTS THAT:

His 1968 honorable discharge for a disability that existed prior to service (EPTS) be changed to a medical discharge for a service-aggravated condition, and all statements alleging he denied a history of knee injury during his induction physical and all references to a preexisting knee condition be stricken from the record.

_________________________________________________________________

APPLICANT CONTENDS THAT:

He had surgery to his left knee in 1967. When he had his entrance physical in 1968, the doctor examined both knees and noticed the scar on his right knee; his left knee was fine from surgery and he told the doctor this. During his training, he re-injured his left knee. 

The applicant’s complete submission, with attachments, is at Exhibit A. 

_________________________________________________________________

STATEMENT OF FACTS:

The applicant first enlisted in the Air Force on 4 Jun 64 for a period of four years. However, he was granted a hardship discharge to help his widowed mother and, after 4 months and 26 days of active service, was discharged on 29 Oct 64 and transferred to the Air Force Reserves.

The applicant again enlisted in the Regular Air Force on 9 Jul 68. The Report of Medical Exam by a captain at the examining facility at Baltimore, MD, indicates only a tattoo on the applicant’s arm by the “Identifying body marks, scars, tattoos” item. No other abnormalities were listed.

An 18 Jul 68 Report of Medical Exam by Wilford Hall Medical Center (WHMC) at Lackland AFB identified a five-inch surgical scar on the applicant’s left knee and a four-inch laceration scar on his right leg.

Medical entries dated 22 Jul 68 indicate the applicant was experiencing range of motion (ROM) pain and mild edema from a very unstable left knee. The applicant apparently had a meniscectomy on 31 Jul 67 and a second operation in Aug 67 (for a staphylococcal infection). Apparently during basic training, the knee gave way and he fell. The orthopedist’s impression and diagnosis was residual instability of the left knee following injury and meniscectomy, EPTS.

The narrative summary of the 24 Jul 68 Medical Evaluation Board (MEB) claims the applicant “denied this whole history of the knee injury on the induction history because he wanted to enlist in the Air Force.” The summary indicates the induction physical does not mention any findings in regard to the left knee including the scars in that area. The medial collateral ligament of the left knee was extremely lax. The diagnosis was residual instability of the left knee following injury and meniscectomy. The condition was determined to have EPTS and not aggravated by the service beyond the normal progression of the disease. Discharge for an unfitting EPTS condition was recommended.

On 25 Jul 68, the applicant acknowledged by signature that he had been informed of the findings and recommendations of the MEB. On 2 Aug 68, he was discharged after 24 days of active service without entitlement to disability severance pay. 

Available Department of Veterans Affairs (DVA) medical records reflect that the applicant had disc surgery in Nov 71 and continued to experienced recurrent low back pain with radiation into the left leg. A rating claim of 26 Nov 76 denied service connection for the left knee condition and tuberculosis. The report indicated the records contained no evidence showing treatment for or diagnosis of pulmonary tuberculosis, and the left knee condition was shown to have EPTS with no service aggravation. The back pain was not incurred or aggravated during military service. A 16 Feb 1977 DVA rating decision indicates the applicant had been unemployed since Dec 75, claiming total disability due to a back condition. The narrative also indicated that the applicant’s disabilities did not prevent him from engaging in substantially gainful employment. He was given a combined rating of 20% for left knee post-operative meniscectomy, EPTS, and low back pain. A 6 Oct 78 hospital summary notes multiple back surgeries for disc problems as well as narcotic/alcohol abuse. A 30 Jan 95 DVA rating decision did not reopen the applicant’s claim for service connection for left knee disability.
_________________________________________________________________

AIR FORCE EVALUATION:

The AFBCMR Medical Consultant asserts the applicant was discharged because of a disqualifying EPTS medical condition. There is no evidence in the service medical records that the applicant’s left knee condition was permanently aggravated by service. Denial is recommended.

A complete copy of the evaluation is at Exhibit C.

HQ AFPC/DPPD notes the MEB determined the applicant’s physical defect was EPTS and not service aggravated. The case was never forwarded to the PEB for adjudication. When the applicant applied for a disability discharge on 24 Jul 68, he acknowledged he understood he would be discharged without disability retirement or severance pay. They agree with the AFBCMR Medical Consultant and also recommend denial. 

A complete copy of the evaluation is at Exhibit D.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

He contends successful knee surgery was performed more than one year before his enlistment which stabilized the left knee and reestablished full ROM, reflex and function. He was in no way disabled when he entered the Air Force.  The physical military training and exercise during his 24 days of service aggravated the knee, causing a disability where none had existed prior to active duty. The statement of the attending physician that he “had not reported (t)his history of knee surgery at the time of the entrance medical examination on April 15, 1968” was presumptuous and entirely in error. A number of the medical comments are inaccurate and untrue and precipitated the MEB decision to disqualify him for continued military service and disallow his request for a service-connected disability. He does not know why the examining physician failed to note, describe or mention findings regarding the left knee, but he and the doctor did discuss the obvious, one-year-old, five-inch scar while he sat in a chair across from the doctor in nothing but boxer shorts. Following a regimen of knee exercises, the examining physician pronounced him physically fit for military service. It is inconceivable that he would have denied the knee injury so he could enlist, as alleged, when there was no way he could have convinced a trained medical professional that the clearly visible scar really wasn’t there. His rights were deprived in the discharge process and there were no hard facts to support the diagnosis that his condition was pre-existing. 

The applicant provides photos to show the scar area is still highly visible 35 years later, as well as medical evaluations done in 1997, 1998 and 2002. He indicates he is trying to obtain more medical records from various VA medical centers. His complete responses, with attachments, are at Exhibit F.

_________________________________________________________________

THE BOARD CONCLUDES THAT:

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

2.	The application was not timely filed; however, it is in the interest of justice to excuse the failure to timely file.

3.	Insufficient relevant evidence has been presented to demonstrate the existence of error or injustice. After a thorough review of the evidence of record and the applicant’s submission, we are not persuaded he should be granted a medical discharge for a service-aggravated condition. We do not dispute the scar on his left knee from his prior-service surgery would probably have been visible during his entry physical.  However, this does not negate the fact that the applicant’s knee condition existed prior to service. The meniscectomy and subsequent surgery on his left knee for infection occurred in Jul and Aug 67. Within days after the applicant’s enlistment in Jul 68, his left knee was found to be very unstable with the medial collateral ligament extremely lax. The applicant has not shown to our satisfaction that the residual instability of his left knee following injury and surgery in 1967 did not exist prior to service or was aggravated by the service beyond the normal progression of the malady. The applicant acknowledged the MEB’s findings and recommendations that he be discharged for an EPTS condition that was not aggravated by military service.  We therefore adopt the rationale by the Medical Consultant and the Air Force as the basis for our decision that the applicant has failed to sustain his burden of having suffered either an error or an injustice. In view of the above and absent persuasive evidence to the contrary, we conclude this appeal should be denied.  

4.	The applicant’s case is adequately documented and it has not been shown that a personal appearance with or without counsel will materially add to our understanding of the issue(s) involved. Therefore, the request for a hearing is not favorably considered.
_________________________________________________________________

THE BOARD DETERMINES THAT:

The applicant be notified that the evidence presented did not demonstrate the existence of material error or injustice; that the application was denied without a personal appearance; and that the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application.

_________________________________________________________________

The following members of the Board considered this application in Executive Session on 8 July 2003 under the provisions of AFI 36-2603:

			Chair
			Member
			Member

The following documentary evidence relating to AFBCMR Docket Number BC-2003-00299 was considered:

   Exhibit A.  DD Form 149, dated 30 Dec 02, w/atchs.
   Exhibit B.  Applicant's Master Personnel Records.
   Exhibit C.  Letter, AFBCMR Medical Consultant, dated 8 Apr 03.
   Exhibit D.  Letter, HQ AFPC/DPPD, dated 6 May 03.
   Exhibit E.  Letter, SAF/MRBR, dated 13 May 03.
   Exhibit F.  Letter, Applicant, dated 4 Jun 03

                                   
                                   Chair