RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2011-02690 COUNSEL: NONE HEARING DESIRED: YES _________________________________________________________________ APPLICANT REQUESTS THAT: Her honorable discharge be changed to a medical discharge. _________________________________________________________________ APPLICANT CONTENDS THAT: 1. Due to her medical history, the discharge should have been classified as a medical discharge. She experienced several medical problems that were not taken into consideration during the discharge process. She has Poly Cystic Ovarian Syndrome (PCOS) with insulin resistance; however, this diagnosis was wrongfully taken away by a doctor who misinterpretated her symptoms and who was not qualified to do so. Her current doctor supports the PCOS diagnosis. She has undergone some treatment to elevate her PCOS symptoms. However, the insulin she takes makes it hard to lose weight and also can lead to Type 1 Diabetes; she was borderline diabetic and was diagnosed with Pituitary Adenoma while on active duty. It cannot be proved nor disproved that Pituitary Adenoma it causes weight gain. Further, it cannot be proved nor disproved that this is the reason she failed to lose weight which led to her not meeting physical training standards for the Air Force. She continues to undergo treatment and is being observed to see if her symptoms change. 2. She had Laparoscopic Roux-en-Y Gastric Bypass on 2 Dec 09 which was successful and she now meets military weight standards. In support of her request, the applicant provides a copy of a letter from her current OB/GYN Surgeon and excerpts of her medical records. Her complete submission, with attachments, is at Exhibit A. _________________________________________________________________ STATEMENT OF FACTS: The applicant enlisted into the Regular Air Force on 28 Jun 05. The applicant was notified by her commander that he was recommending her for discharge from the Air Force under the provisions of AFI 36-3208, paragraph 5.65, for failing in the fitness program. The applicant received a Letter of Counseling and two Letters of Reprimand (LOR). She received an honorable discharge on 17 Apr 08 after serving 2 years, 9 months and 21 days on active duty. The Department of Veterans Affairs (DVA) awarded the applicant a 20 percent disability rating for Diabetes mellitus, 10 percent rating for PCOS, 10 percent rating for Lumbar Spine Degenerative Disease with Strain, 10 percent for an upper back and neck rash (acanthosis nigricans), and 0 percent ratings each for Bilateral Plantar Fasciitis and for the Benign Pituitary Adenoma. The remaining relevant facts pertaining to this application are contained in the letter prepared by the appropriate office of the Air Force, which is at Exhibit C. _________________________________________________________________ AIR FORCE EVALUATION: The BCMR Medical Consultant recommends denial. The evidence of record shows that the applicant’s health care provider conducted several diagnostic evaluations, to include an ultrasound of the ovaries, a brain MRI scan, and thyroid function studies, in search of possible organic cause of her weight problems. The MRI scan of the brain demonstrated a 2mm hypodence area which was believed to be compatible with a micro adenoma of the pituitary gland. The findings on the pelvic ultrasound were reported as “normal pelvic ultrasound without evidence of polycystic ovary syndrome.” Her weight fluctuated from 150 pounds to 115 pounds during Basic Military Training and then to 130-135 pounds during technical school. She reportedly got married at the end of technical school and two months later, in Apr 05, her weight “ballooned to 200 pounds.” She was prescribed Metformin 1000 milligrams twice per day for the suspected diagnosis of PCOS; a diagnosis which was empirically based upon the changes in the applicant’s menstrual cycles. She was referred to an endocrinologist and a subsequent medical entry in her records reflects, “Patient with normal thyroid function on many checks, no evidence of diabetes mellitus (DM) on several checks, non-Cushingoid (normal blood pressure, no striate, weight is distrusted over body and not all truncal and normal UFC) and no PCOS by definition.” The provider discussed a plan of action with regard to monitoring her pituitary micro adenoma and encouraged her to continue to exercise and suggested dietary modifications. Further, the applicant “raised significant medical issues” to her commander for his consideration in response to the LOR, which the commander took time to speak with her medical providers and the medical operations squadron commander to obtain an opinion before deciding to leave the LOR as is and to continue the Unfavorable Information File (UIF) action. The Medical Consultant notes that the specific paragraph, Failure in the Fitness Program, in AFI 3608 states, “Airmen who do not meet fitness standards in AFI 10-248, Fitness Program, (formerly AFIs 40-501- and 40-502) may be discharged when the failure in the fitness program resulted from a cause which was within their control. Follow the procedures for failure in the fitness program according to AFI 10-248 before starting action to discharge. Make sure the case file shows the record of those actions.” An additional set of guidelines reads: “Evaluation by a military health care provider has ruled out medical conditions precluding the member from achieving a passing score.” The applicant’s commander indicated that the professional medical opinions were taken into consideration and the applicant was held responsible for her fitness failures. It is noted that obesity due to any cause is not considered a compensable physical disability. Although she has been issued disability compensation for specific medical conditions, the evidence does not reflect that either of the conditions interfered with her ability to perform her military duties or posed a decided health or mission risk to the extent that warranted referral to a Medical Evaluation Board (MEB) and a Physical Evaluation Board (PEB) for possible medical discharge. Neither of her physicians determined that with proper diet control and exercise the applicant could not achieve fitness standards. Notwithstanding the post-service medical opinion provided, which implies the applicant’s weight and subsequent failures may not have been totally within her span of control, the Medical Consultant opines the applicant’s commander followed established Air Force policies when administering the administrative discharge. The complete BCMR Medical Consultant’s evaluation is at Exhibit B. _________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: A copy of the Air Force evaluation was forwarded to the applicant on 17 Jan 12 for review and comment within 30 days. As of this date, this office has received no response. _________________________________________________________________ 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. We took notice of the applicant's complete submission in judging the merits of the case; however, we agree with the opinion and recommendation of the BCMR Medical Consultant and adopt his rationale as the basis for our conclusion that the applicant has not been the victim of an error or injustice. Therefore, in the absence of evidence to the contrary, we find no basis to recommend granting the relief sought in this application. 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 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 AFBCMR Docket Number BC-2011-02690 in Executive Session on 5 Apr 12, under the provisions of AFI 36-2603: , Chair , Member , Member The following documentary evidence for Docket Number BC-2011- 02690 was considered: Exhibit A. DD Form 149, dated 13 Jul 12, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, BCMR Medical Consultant, dated 12 Jan 12. Exhibit D. Letter, SAF/MRBR, dated 17 Jan 12. Chair