RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2004-02004
		INDEX CODE:  108.02

		COUNSEL:  

		HEARING DESIRED:  YES

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APPLICANT REQUESTS:

Service connection for her medical condition and either permanent disability retirement at 30 percent or placement on the Temporary Retired Disability List (TDRL) at 30 percent.

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APPLICANT CONTENDS THAT:

She did not have supraventricular tachycardia (heart condition) before entering the service.

She developed a severe heart condition, aggravated by surgical intervention.  The Air Force disability system determined she was not entitled to compensation for her condition.  The Air Force medical community determined she was not physically qualified to continue on active duty and her request for continuation on active duty was denied.  The final action on her case by the Secretary of the Air Force Personnel Council (SAF/PC) was to return her to active duty to await her August 2004 separation for expiration of initial active duty service commitment.

In support of her request, the applicant submits a statement from counsel, a personal statement and additional documents associated with the issues cited in her contentions.  The applicant’s complete submission, with attachments, is at Exhibit A.

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STATEMENT OF FACTS:

On 4 May 1999, the applicant was appointed a second lieutenant, Medical Corps (MC), Reserve of the Air Force.  After completing medical school on the Health Professions Scholarship Program (graduated May 1999), she was voluntarily ordered to active duty in the grade of captain, Reserve of the Air Force, for a period of four years on 23 August 2000.

On 22 May 2002, the applicant initially underwent a Medical Evaluation Board (MEB) evaluation at Randolph AFB, TX, for supraventricular tachycardina, migraines and latex allergy.  An MEB was convened on 11 June 2002, with the recommendation for referral to the Informal Physical Evaluation Board (IPEB).  On 31 July 2002, an IPEB convened and established a diagnosis of supraventricular tachycardia, existed prior to service without service aggravation; migraine headaches, existed prior to service without service aggravation; and, latex allergy, existed prior to service without service aggravation.  The IPEB found the applicant fit and recommended she be returned to duty for further care and observation.

In September 2002, the applicant was reassigned to Little Rock AFB, AR.  Due to the significant medical changes that occurred since the applicant’s last MEB, she underwent an MEB evaluation in June 2003.  An MEB convened on 15 July 2003 and their diagnosis and findings were: supraventricular tachycardia, status post ablation with worsening symptoms; latex allergy; and migraines.  The MEB recommended referral to the Informal Physical Evaluation Board (IPEB).  The IPEB convened on 6 August 2003 and found her medical condition existed prior to service (EPTS), was not permanently aggravated through military service, found unfit because of physical disability and recommended discharge under the provisions other than Chapter 61 (administrative discharge).  She apparently appealed to the Formal Physical Evaluation Board (FPEB).  An FPEB was convened on 20 November 2003 and their findings and recommended disposition reveals their concurrence with the IPEB.  The FPEB found the applicant unfit and recommended discharge.  The applicant, through counsel, submitted a rebuttal to the FPEB findings.  Counsel requested the IPEB’s findings and recommendations be modified to find the applicant with a service-connected disability of 30 percent or an EPTS condition permanently aggravated by service; regardless, she should be placed on the Temporary Disability Retired List (TDRL).

The applicant appealed to the Secretary of the Air Force Personnel Council (SAF/PC).  On 1 March 2004, SAF/PC upheld the findings and conclusions of the Physical Evaluation Boards (PEBs).  The Secretary of the Air Force directed the applicant be returned to duty.

On 17 May 2004, the applicant tendered her active duty resignation, effective 22 August 2004.  The applicant was released from active duty in the grade of captain under the provisions of AFI 36-3208 (completion of required active service) and transferred to the Air Force Reserve on 22 August 2004.  She had completed a total of four years of active service.  Effective 23 August 2004, the applicant was assigned to the Obligated Reserve Section (ORS) of the Ready Reserve.

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AIR FORCE EVALUATION:

The BCMR Medical Consultant summarized the information contained in the applicant’s personnel and medical records and is of the opinion that no change in the applicant’s record is warranted.  Details of his evaluation are at Exhibit C.

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Counsel and applicant reviewed the advisory opinion and provided statements.  Counsel states the quandary in this case is that the applicant developed a serious heart condition while on active duty the evidence shows did not exist prior to entering the Air Force.  She received surgery and either the condition itself or the surgery has caused permanent injury that requires further evaluation and treatment.  The Personnel Council was unable to determine the seriousness of her current condition, yet she was forced to separate with all these questions remaining unanswered.  The records in this case support a finding that her condition was as a minimum, aggravated during her service and she should be retired.  However, even were the records not supportive of retirement at this time, the applicant could have been placed on the Temporary Disability Retired List (TDRL) for continued care and observation.  Alternatively, the Air Force could have allowed her to extend her service for the continued care and observation that was felt necessary.  For the Personnel Council to have just said they can’t make a decision and let her separate without making a final resolution of the issues in this case simply is untenable.  Refer to Exhibit E for applicant’s response.

In support of applicant’s request, counsel and applicant submit personal statements, a statement from applicant’s commander and additional documents associated with the issues cited in the contentions.  The counsel’s complete submission, with attachments, is at Exhibit E.

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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.  While we are reluctant to substitute our judgment for that of medical personnel who are qualified to review and make recommendations concerning medical issues, after thoroughly reviewing applicant’s submission and the evidence of record, we believe there is sufficient doubt as to whether or not the applicant should have been placed on the Temporary Disability Retired List (TDRL).  We noted that, due to the applicant’s episodes of supraventricular tachycardia (SVT), extensive heart procedures were performed and she was evaluated under the Air Force Disability Evaluation System.  In reviewing the disability processing of the applicant’s case, we noted the inconsistencies in the medical opinions.  In August 2003, the Informal Physical Evaluation Board (IPEB) indicated the applicant’s medical condition existed prior to service (EPTS); she was found unfit and the IPEB recommended discharge action.  In November 2003, the Formal Physical Evaluation Board (FPEB) stated it was beyond their scope to determine if the applicant’s condition was permanently aggravated by a medical mishap.  Although her condition is EPTS, the FPEB opined the applicant’s “PSVT meets the criteria for a 30% rating.”  However, they found the applicant unfit and recommended discharge.  On 1 March 2004, the Secretary of the Air Force Personnel Council (SAF/PC) upheld the findings and conclusions of the Physical Evaluation Boards.  However, they concluded returning the applicant to duty for continued care and observation was the most appropriate course of action.  SAF/PC also indicated that, should the applicant again experience a recurrence of duty-limiting symptoms that cannot be promptly brought under control, she was subject to a repeat medical assessment upon which her fitness for continued military service would again be based.  Furthermore, as evidenced by the 26 July 2004 statement from her commander, the applicant approached him months earlier concerning the possibility of extending her service commitment another year to allow her to seek additional medical treatment.  Even though the applicant did not receive the MAJCOM support necessary for approval of her extension request, which resulted in her ultimate separation, her commander strongly recommended the applicant be provided the necessary medical benefits needed.  In view of the above, it appears the applicant’s medical condition may have been far more severe at the time of final determination.  In addition, the available evidence has created some doubt as to propriety of the finding of EPTS without service aggravation in this case.  The comments of the Air Force evaluator are noted.  However, based on the totality of the evidence before this Board and in an effort to remove any possibility of an injustice, we recommend that she be found unfit and placed on the TDRL, with a disability rating of 30 percent.  Placing the applicant on the TDRL allows for a reevaluation and, at the appropriate time, a final disposition will be made.  Accordingly, we recommend that the records be corrected as indicated below.

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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 a Physical Evaluation Board recommended and the Air Force Personnel Board agreed that she should be found unfit to perform the duties of her office, rank, grade or rating by reason of physical disability incurred while entitled to basic pay; that the diagnosis in her case was supraventricular tachycardia status post ablation, Veterans Administration Schedule of Rating Disabilities (VASRD) code 7010, rated at 30%; and that her case be forwarded to the Assistant Secretary of Defense (Health Affairs) for approval in accordance with Title 10, United States Code, Section 1216(d), and DOD Directive 1332.18.

Upon approval by the Assistant Secretary of Defense (Health Affairs), her records be further corrected to show that she did not tender her resignation and was not separated upon completion of her active service commitment on 22 August 2004, but, on that date, her name was placed on the Temporary Disability Retired List (TDRL).
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The following members of the Board considered this application in Executive Session on 2 December 2004, under the provisions of AFI 36-2603:

All members voted to correct the records, as recommended.  The following documentary evidence was considered in connection with AFBCMR Docket Number BC-2004-02004.

   Exhibit A.  DD Form 149, dated 16 Jun 04, w/atchs.
   Exhibit B.  Applicant's Master Personnel Records.
   Exhibit C.  Letter, BCMR Medical Consultant, dated 14 Jul 04.
   Exhibit D.  Letter, SAF/MRBR, dated 23 Jul 04.
   Exhibit E.  Letter from Counsel, dated 26 Jul 04, w/atchs.

AFBCMR BC-2004-02004

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 a Physical Evaluation Board recommended and the Air Force Personnel Board agreed that she should be found unfit to perform the duties of her office, rank, grade or rating by reason of physical disability incurred while entitled to basic pay; that the diagnosis in her case was supraventricular tachycardia status post ablation, VASRD code 7010, rated at 30%; and that her case be forwarded to the Assistant Secretary of Defense (Health Affairs) for approval in accordance with Title 10, United States Code, Section 1216(d), and DOD Directive 1332.18.

	Upon approval by the Assistant Secretary of Defense (Health Affairs), her records be further corrected to show that she did not tender her resignation and was not separated upon completion of her active duty service commitment on 22 August 2004, but, on that date, her name was placed on the Temporary Disability Retired List (TDRL).