RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2003-00597
		
		COUNSEL:  NONE

		HEARING DESIRED:  NO

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APPLICANT REQUESTS THAT:

Her narrative reason for separation be changed from “Hardship” to a medical disability discharge.

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APPLICANT CONTENDS THAT:

In March 2002, she was separated on a hardship discharge due to her mother being terminally ill with cancer.  In May 2002, she attempted to enlist in the Air Force Guard or Reserves.  She was disqualified to enlist because she was on Albutrol and Seizure medication prior to her hardship separation.  She was also told that she should have been put before a medical board once she was placed on these medications fulltime.  At this time, she still takes both of these medications, as well as another steroid that was given to her by the military facility here at Maxwell AFB.  She currently receives treatment through the VA.

For these reasons, she is asking that her military record be corrected to reflect a medical discharge for the disqualifying medical conditions that she had while still on active duty.

In support of her request, she submits a copy of DD Form 214, Certificate of Release or Discharge from Active Duty, copies of medical records, and DD Form 293, Application for the Review of Discharge or Dismissal From the Armed Forces of the United States.

Applicant's complete submission, with attachments, is at Exhibit A.

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STATEMENT OF FACTS:

The applicant enlisted in the Regular Air Force on 16 October 1996 and was progressively promoted to the grade of staff sergeant. She was discharged under the provisions of AFI 36-3208, Administrative Separation of Airmen (Hardship) from the Air Force on 31 March 2002 with an honorable discharge.  She served 5 years, 5 months and 15 days of total active duty service.

A review of the service medical record finds a history of headaches, which existed prior to service.  The applicant’s enlistment medical examination (30 July 1996) documents that the applicant was taking Advil for headaches. While in basic military training, the applicant was treated for headaches and was diagnosed as migraine headaches receiving prescriptions for anti-migraine medications in February 2001 and June 2001.  On 18 February 2002, she experienced a severe headache associated with loss of consciousness/altered consciousness lasting 30 minutes. She had apparently sought care at two different civilian emergency rooms but left before being seen because of long waits.  She presented to the base clinic for evaluation on February 19, and 22, 2002.  Those medical record entries document that she reported four similar episodes over several years.  The applicant reported a family history of seizures in her paternal uncle and aunt.  The neurological examination was unremarkable and a computed axial scan of her brain was normal.  Her physician was concerned about the atypical nature of her symptoms and was concerned about the possibility of seizure and referred the applicant for an electroencephalogram (EEG) and a neurology evaluation.  The EEG, performed 1 March 2002, was normal; however, the neurologist pointed out “the absence of eleptiform discharges during the EEG recording does not rule out the diagnosis of a seizure disorder.  Sleep was not observed during the recording”.  The neurology evaluation report is not present in the record.  There are no further recurrences of severe headaches with altered consciousness documented in the service medical record after 18 February 2002.  On her separation medical examination the applicant reported recurrent headaches “over the past year and a half, periods lasting 3 days in which severe headache encompasses the entire head with neck stiffness and followed blackout lasting 35 minutes to 3 hours.  Not currently diagnosed - o/r epilepsy by EEG.”  Her medications at the time of discharge included her migraine medication but did not include any anti-seizure medication.

On 4 February 2002, the applicant, a cigarette smoker with a history of smoking ½ to 2 packs of cigarettes a day for 24 years, presented complaining of a history of intermittent episodes of coughing and wheezing, with decreased air intake for the previous 6 months along with a family history of asthma (not reported in previous medical records).  On physical examination her lungs were clear to auscultation (no audible wheezing wit the stethoscope), however her symptoms and peak flows (rate of air exhalation measured by a simple peak flow device) improved with inhaled bronchodilator medication.  She was diagnosed with reactive airway disease and treated with a short course of prednisone and also prescribed an inhaler (bronchodilator medication).  There are no further medical record entries after an 8 February 2002 follow up documenting further problems.  There were no prior clinic visits for cough, shortness of breath or wheezing in the service medical record.  The applicant had previously been counseled regarding smoking and had made attempts to quit (was prescribed nicotine patches etc).  

In her letter accompanying her application for correction, she reports that following the death of her mother she attempted to enlist in the Air Force Guard/Reserves in May 2002 (two months after discharge) but was denied because of her medical conditions and associated medications.  She provides a medication list dated 26 April 2002 from the VA clinic that includes Dilantin, an anti-seizure medication, inhalers, and her migraine medication.  
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AIR FORCE EVALUATION:

The BCMR Medical Consultant indicates the mere presence of a physical defect or condition does not qualify a member for disability retirement or discharge.  The physical defect or conditions must render a member unfit for duty, and their military career must have been cut short due to the service connected disability.  Active duty members who develop medical problems during the final 12 months of their active duty period (i.e. have a scheduled retirement or separation as in this case) are presumed fit for continued active duty unless there is clear and convincing evidence to the contrary.  For members who are in the process of retirement or separation, medical hold (retaining on active duty for disability evaluation of medical conditions) is not approved for the purpose of evaluating or treating chronic conditions, performing diagnostic studies, elective surgery or it's convalescence, other elective treatment of remedial defects, or for conditions that do not otherwise warrant termination of active duty through the Disability Evaluation System.  Furthermore, when there has been no serious deterioration within the presumptive period, the ability to perform duty in the future shall not be a consideration.  The applicant's condition regardless of whether it was due to complicated migraine headache or seizure disorder, was a chronic condition spanning "several years" that had not worsened, had not interfered with her performance of duty, was not the cause for her separation and would not have warranted placement on medical hold.  Therefore the BCMR Medical consultant is of the opinion that no change in the records is warranted.  Action and disposition in this case are proper and equitable reflecting compliance with Air Force directive that implement the law.

BCMR Medical Consultant's complete evaluation is at Exhibit C.

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Applicant reviewed the Air Force evaluation and stated the episodes of non-consciousness had not continued, however, she attribute that to the continuation of medication.  However, as she stated, even though she have stopped smoking for a year now, the episodes of breathing difficulty have continued, as well as the treatment of both conditions.  

At the time, she was active duty, she was informed that she could not sue the Air Force for the mismarked medical record by flight medicine, and she and her commander were also informed that that was something that could be corrected through this Board.

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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.  Insufficient relevant evidence has been presented to demonstrate the existence of error or injustice.  We took notice of the applicant's complete submission in judging the merits of the case and do not find that it supports a determination that the applicant should have been medically discharged.  The Board notes that for an individual to be considered unfit for military service, there must be a medical condition so severe that it prevents performance of any work commensurate with rank and experience.  In this case, her condition did not render her unfit for continued service prior to her applying for a hardship discharge. Therefore, we agree with the opinion and recommendation of the Air Force office of primary responsibility and adopt their rationale as the basis for our conclusion that the applicant has not been the victim of an error or injustice.  In the absence of evidence to the contrary, we find no basis to recommend the relief sought in this application.

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THE BOARD DETERMINES THAT:

The applicant be notified that the evidence presented did not demonstrate the existence of a 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.

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The following members of the Board considered Docket Number BC-2003-00597 in Executive Session on 17 February 2004, under the provisions of AFI 36-2603:

			Vice Chair
			Member
			Member

The following documentary evidence was considered:

    Exhibit A.  DD Form 149, dated 14 Mar 03, w/atchs.
    Exhibit B.  Applicant's Master Personnel Records.
    Exhibit C.  Letter, BCMR Medical Consultant, dated 10 Nov 03.
    Exhibit D.  Letter, SAF/MRBR, dated 23 Jan 04.

								
								Vice Chair