RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2003-01236
				INDEX CODE:  100.00
				COUNSEL:  None

				HEARING DESIRED:  No

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APPLICANT REQUESTS THAT:

Her diagnosis of Undifferentiated Somatoform Disorder at the time of her disability discharge be changed to herniated lumbar discs and cervical spine degenerative disease.

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APPLICANT CONTENDS THAT:

Her medical condition did not occur prior to entering military service.  She was diagnosed and discharged with Somatoform Disorder, when in fact she had two herniated discs.

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

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STATEMENT OF FACTS:

Applicant enlisted in the Regular Air Force on 4 October 2000 for a period of six years as an airman basic.

The applicant completed Basic Military Training (BMT), however, during her first week of technical training, the applicant reported the onset of pain.  During November-December 2000, the applicant developed right foot tingling and pain, and pain in both legs up to her knees.  In April-May 2001, the applicant was experiencing severe pain that prohibited her from performing her duties.  She reported pain of the low back in the lateral lumbar area, hips, anterior thighs, knees, calves, ankles, the right side of the neck - trapezius muscle, and left shoulder.  The applicant could not perform normal activities due to the pain she was experiencing.  In May 2001, the applicant was bedridden due to complaints of pain.  During an examination by a neurologist at Wilford Hall Medical Center (WHMC), the applicant, even with a light touch, experienced pain so severe she could not hold herself up and cried.  She also reported she suffered from headaches with blurred vision, blurred vision and pain in the right eye, intermittent tremor and shaking throughout her entire body, right face pain, sensation of swelling of the right side of the tongue and throat, intermittent difficulty with word formation, chest pain and palpitations, itching of her back, arms and neck, heavy and weak feeling of her arms, difficulty catching her breath, episodes of burning and redness of her hands, difficulty with urination control, swollen lymph nodes, red spots on her skin and muscle spasms.

The applicant underwent extensive medical evaluations at Sheppard AFB, Baylor University and WHMC.  The Baylor University evaluation concluded with a diagnosis of chronic pain syndrome, rule out organic versus Somatization syndrome.  The WHMC evaluation concluded with a diagnosis of undifferentiated somatoform disorder.  Two Air Force psychiatrists concluded her condition existed prior to service.  The applicant underwent a Medical Evaluation Board on 5 June 2001.  Her case was forwarded to the Informal Physical Evaluation Board (IPEB).  On 13 June 2001, the IPEB found the applicant was unfit for continued military service due to existing prior to service (EPTS) undifferentiated somatoform disorder (with social and industrial adaptability impairment with a disability rating of 30 percent/not applicable) and recommended the applicant be discharged under other than Chapter 61.  The applicant nonconcurred with the IPEB’s findings on 18 June 2001 and requested a Formal Physical Evaluation Board (FPEB).  On 12 July 2001, the FPEB concurred with the findings and recommendations of IPEB.  On 12 July 2001, the applicant disagreed with the findings and recommendations of the FPEB.  On 18 July 2001, the applicant declined to submit statements in her behalf.  The applicant’s case was forwarded to the Secretary of the Air Personnel Council (SAFPC) for final determination.  On 26 July 2001, the SAFPC determined the applicant was physically unfit for continued military service due to a physical disability which existed prior to service and directed she be separated without disability benefits.

On 7 September 2001, the applicant was honorably discharged under the provisions of AFI 36-3212, Disability, existed prior to service, PEB.  The applicant served 11 months and 4 days of active military service.

Upon application to the Department of Veterans Affairs (DVA), the applicant was awarded a 20 percent disability rating for service connected disability for lower back and neck disability.

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AIR STAFF EVALUATION:

The AFBCMR Medical Consultant states that within three months of entering active duty, the applicant developed a variety of symptoms that interfered with her duty performance.  After extensive medical evaluation at three different medical facilities, the applicant’s condition remained unexplained.  The applicant was diagnosed by two psychiatrists with undifferentiated somatoform disorder because of its onset so soon after entering active duty.  It was further determined that her condition existed prior to service based on established psychiatric medical principles.  According to DOD disability evaluation policy, signs or symptoms of chronic disease identified so soon after the day of entry on active military service (usually within 180 days) the disease could not have originated in that short a period would be accepted as proof the disease manifested prior to entering active military service.  Somatoform disorder is considered to have its basis in long standing difficulty with emotion expression where symptoms of pain and other physical symptoms become the equivalent of an emotion.  The stress of military service or other stressors can bring out previously mild or asymptomatic conditions.  Somatoform disorder symptoms usually resolve with the resolution of the particular stressor and military service is not expected to permanently aggravate the condition.  The DVA rating decision submitted by the applicant does not mention psychiatric illness or physical complaints other than neck and back suggesting the applicant’s symptoms improved after she separated.

The findings in the cervical, thoracic, and lumbar spine on the imaging studies showed mild degenerative disc disease, mild scoliosis, and bulging/small herniated L4-5 and L5-S1 discs do not explain the applicant’s symptoms and degree of disability while on active duty.  Scoliosis is a developmental condition that develops during adolescence and not on active duty.  The described degenerative changes in the spine, typically take longer than the period of time between entry onto active duty and the dates of the imaging studies.  The bulging disc could have occurred while on active duty, but were demonstrated to not be impinging on any neural structure by magnetic resonance imaging (MRI) and normal electromyogram/nerve condition velocity testing (EMG/NCV).  There is no medical relationship between her bulging lumbar discs and her myriad, widespread symptoms.  These findings are common in asymptomatic populations and do not cause disability.

The AFBCMR Medical Consultant, based on the evidence presented, recommends denying the applicant’s request.

A complete copy of the Air Force evaluation is attached at Exhibit C.

HQ AFPC/DPPD states the purpose of the military disability evaluation system (DES) is to maintain a fit and vital force by separating or retiring members who are unable to perform the duties of their office, grade, rank or rating.  The members who are separated or retired for reason of a physical disability may be eligible for certain disability compensation.  The Medical Evaluation Board (MEB) determines if the servicemember should be processed through the DES when a member is determined to be disqualified for continued military service.  The medical treatment facility that provides health care to the sevicemember makes the decision whether or not to conduct an MEB.

The disability processing records indicate the applicant was treated fairly throughout her DES process and was properly rated under disability laws and policy at the time of her medical discharge.  DPPD concurs with the Medical Consultant’s deposition of the applicant’s case and, based on the evidence submitted, they recommend denying the requested relief (Exhibit D).

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APPLICANT'S REVIEW OF AIR STAFF EVALUATION:

On 30 January 2004, copies of the Air Force evaluations were forwarded to the applicant for review and response within 30 days.  As of this date, no response has been received by this office.

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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.  Applicant’s contentions are duly noted; however, we agree with the opinions and recommendations of the Air Force and adopt their rationale as the basis for our conclusion that the applicant has not been the victim of an error or injustice.  Shortly after entering active duty, the applicant began experiencing mild to severe pain throughout her body.  She underwent several medical evaluations at military and civilian medical facilities and was diagnosed with undifferentiated somatoform disorder.  The applicant was also evaluated by two Air Force psychiatrists and they determined the applicant’s condition existed prior to service.  The applicant’s case was processed through the medical disability evaluation system and it was determined the applicant’s condition rendered her unfit for continued military service and the condition existed prior to her entering active duty.  The applicant has not established that she was not properly evaluated by the DES.  Therefore, in the absence of evidence to the contrary, we find no compelling basis to recommend granting 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 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 AFBCMR Docket Number BC-2003-01236 in Executive Session on 10 March 2004, under the provisions of AFI 36‑2603:

The following documentary evidence was considered:

	Exhibit A.	DD Form 149, dated 13 Feb 03, w/atchs.
	Exhibit B.	Applicant's Master Personnel Records.
	Exhibit C.	Letter, BCMR, Medical Consultant, dated
				22 Oct 03.
	Exhibit D.	Letter, HQ AFPC/DPPD, dated 20 Jan 04.
	Exhibit E.	Letter, SAF/MRBR, dated 30 Jan 04.