RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2012-03712 COUNSEL: NONE HEARING DESIRED: NO ________________________________________________________________ APPLICANT REQUESTS THAT: His medical conditions of Dysthymic Disorder, Superimposed Adjustment Disorder, Mild Cognitive Impairment (MCI), and Asperger’s Syndrome, be considered by a Medical Evaluation Board (MEB) and he be either reinstated in the Air Force or medically retired. ________________________________________________________________ APPLICANT CONTENDS THAT: He was separated without proper medical assessment. He has been diagnosed as having Dysthymic Disorder, Superimposed Adjustment Disorder, Mild Cognitive Impairment, and Asperger’s Syndrome. These diagnoses were attributed to his military service. Had he been diagnosed prior to his separation, he would have undergone an MEB review. The applicant’s complete submission, with attachments, is at Exhibit A. ________________________________________________________________ STATEMENT OF FACTS: According to copies of documents extracted from the Automated Records Management System (ARMS), the applicant is a former member of the Regular Air Force who enlisted on 24 April 1996, and was released from active duty on 22 February 2012, with an honorable characterization of service, a separation code of “JBK” and a narrative reason for separation of “Completion of Required Active Service.” He was credited with 15 years, 9 months and 29 days of active duty service. The remaining relevant facts pertaining to this application, extracted from the applicant’s military personnel records are contained in the letter prepared by the appropriate office of the Air Force at Exhibit C. ________________________________________________________________ AIR FORCE EVALUATION: 1. The AFBCMR Medical Consultant recommends denial. The Medical Consultant states that on 21 December 2011, the applicant underwent a Bronstrom Repair of his left ankle ligaments at the time of his discharge and was undergoing physical therapy. He was to complete physical therapy under the Transitional Assistance Management Program (TAMP). The applicant was seen on 18 January 2012 for his Separation Physical. The Separation Physical noted that he was recovering from left ankle surgery and had some localized bilateral knee pain. The applicant had a history of Obstructive Sleep Apnea (OSA) which was well controlled with CPAP, and was evaluated by a Medical Evaluation Board (MEB) on 4 October 2004. That MEB found the applicant fit and returned him to duty. On his separation physical the applicant specifically denied depression, as well as suicidal and homicidal thoughts. His PHQ-2 Depression Screen was also negative. The Psychiatric Exam found his mood to be euthymic (a medical term used to describe a psychological state that is statistically or otherwise normal, neither elated nor depressed), and his affect normal. No mention was made of a memory loss. 2. On 5 June 2012, over three months post-discharge, the applicant was seen for a chief complaint of memory issues. Both the applicant and his wife (who is a nurse at the clinic where he was seen) state that they have noticed his short term memory more so than long term memory worsening over the past 4-5 years. The applicant gave examples of forgetting to turn off the stove. Laboratory findings indicated a Vitamin D deficiency and the applicant was placed on replacement therapy. No laboratory findings of an infectious process were found, the applicant had a negative CT scan of the brain and was referred for a neuropsychological evaluation. 3. On 2 July 2012, the applicant was seen at a local neuropsychological office. The diagnostic impressions are as follows: Dysthymic Disorder, Superimposed adjustment disorder with mixed features of anxiety and depression (related to his leaving the military, having job difficulties, etc.), Mild Cognitive Impairment (MCI) exacerbated by depression, rule out Pervasive Developmental Disorder (Asperger's type). 4. The Medical Consultant states he reviewed the applicant’s medical documentation to include, a Separation Physical, Annual Physical Health Assessments (PHA), Dental History and Physicals, Optometry History and Physicals, Pre and Post-Deployment exams, which were established over a 15-year service history. He was unable to find any mention of depression or forgetfulness in the applicant’s service treatment record; to the contrary, the applicant time after time denied such symptoms. There were also no AF Forms 422, Physical Profile Serial Report, or AF Forms 469’s, Duty Limiting Conditions Report, rendering the applicant non-worldwide qualified due to a mood or cognitive disorder. The applicant states that he was "separated without proper medical assessment," and his "desire is to be considered for an MEB and either be reinstated or medically retired." The Medical Consultant notes again that the applicant had a full detailed medical assessment on his separation physical. 5. The military Disability Evaluation System (DES), established to maintain a fit and vital fighting force, can by law, under Title 10, United States Code (U.S.C.), only offer compensation for those service incurred diseases or injuries which specifically rendered a member unfit for continued active service and were the cause for career termination; and then only for the degree of impairment present at the time of separation and not based on future occurrences. In this case, it could not be established that the applicant was unable to reasonably perform his military duties due either to a Dysthymic Disorder, Cognitive Impairment, or Asperger’s Syndrome during his military service. Although the applicant was evaluated and treated for a number of other episodic complaints during his military service, e.g., recurrent left ankle pain, mid-foot pain, and sinusitis, the Medical Consultant found no medical condition that established, [or should have], a cause and effect relationship with the termination his of service. 6. The BCMR Medical Consultant concludes, based on the review of medical documentation provided that the applicant has not met the burden of proof of error or injustice that warrants the desired change of the record. The complete AFBCMR Medical Consultant evaluation is at Exhibit C. ________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: A copy of the Air Force evaluation was forwarded to the applicant on 19 February 2013 for review and comment within 30 days (Exhibit D). To date, this office has not received a response. ________________________________________________________________ THE BOARD CONCLUDES THAT: 1. The applicant has exhausted all remedies provided by existing law or regulations. 2. The application was timely. 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 find no evidence of error in the discharge process and after thoroughly reviewing the documentation that has been submitted in support of applicant's appeal, we do not believe he has suffered from an injustice. We note the applicant’s contention that his Dysthymic Disorder, Superimposed Adjustment Disorder, Mild Cognitive Impairment, and Asperger’s Syndrome, diagnoses were attributed to his military service. However, we also note that the BCMR Medical Consultant states that it could not be established that the applicant was unable to reasonably perform his military duties due to either of these conditions during his military service. Additionally, the applicant has not provided evidence to establish these conditions were present and deemed unfitting at the time of his separation and had a cause and effect relationship with the conclusion of his military service. Based on the above comments, we agree with the BCMR Medical Consultant’s assessment that the applicant has not been the victim of an error or injustice. Accordingly, the applicant’s request 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 May 2013, under the provisions of AFI 36-2603: , Vice Chair , Member , Member The following documentary evidence was considered in AFBCMR Docket Number BC-2012-03712: Exhibit A. DD Form 149, dated 31 July 2012, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, AFBCMR Medical Consultant, dated 18 February 2013. Exhibit D. Letter, SAF/MRBC, dated 19 February 2013.