ADDEMDUM TO
RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF: 			DOCKET NUMBER: BC-2014-01886

						COUNSEL:  NONE

						HEARING DESIRED:  NO

APPLICANT REQUESTS THAT:

He be awarded the Purple Heart (PH) medal for injuries he sustained in combat.

RESUME OF CASE:  

The applicant’s initially requested award of the PH medal.  The applicant alleges he sustained a Traumatic Brain Injury (TBI) during his deployment in Apr 10.  On 28 Jan 15, the Board considered and denied his request due to his failure to exhaust his administrative remedies.  For an accounting of the facts surrounding his previous request and the rationale of the Board’s earlier decision, see the Record of Proceedings, with Exhibits A through E, at Exhibit F.  

On 1 Apr 15, the applicant submitted a DD Form 149, Application for Correction of Military Record, requesting reconsideration by the Board.  After reviewing the documentation provided in support of his request for reconsideration, the applicant was informed that it did not meet the criteria for reconsideration and that reconsideration is provided only where newly discovered relevant evidence is presented which was not available when the application was submitted.  Furthermore, the reiteration of facts that have been previously addressed, uncorroborated personal observations, or additional arguments on the evidence of record are not adequate grounds for reopening a case (Exhibit G).

On 28 Nov 15, by virtue, of a DD Form 149, the applicant seeks reconsideration for award of the PH medal for the TBI he sustained while deployed.  The applicant asserts he meets the criteria for the PH based on the injuries he sustained in combat.  He also states he has been suffering from residuals of TBI and has been undergoing medical at treatment at the Department of Veterans Affairs (DVA) for his TBI.  The applicant’s complete submission, with attachments, is at Exhibit H.

The remaining relevant facts pertaining to this application are contained in the memorandum prepared by the Air Force office of primary responsibility (OPR), which is attached at Exhibit I.  

AIR FORCE EVALUATION:

The Psychiatric Consultant recommends denial indicating there is no evidence of an error or an injustice.  

After reviewing the applicant’s documentation submitted, the case file, and the DVA records, the Psychiatric Consultant found limited evidence that reflects the applicant suffers from TBI.  In fact, she believes his presentation is more consistent with depression and Post Traumatic Stress Disorder (PTSD).  

While the applicant alleges his fall from the upper bunk resulted in the head trauma, concussion, and disabling residual TBI symptoms, he has not provided any factual evidence to support his assertion.  Three days after the incident, there was no mention of the head injury and the physician noted there were no neurological changes.  Also, during the visit the applicant did not report any complaints or symptoms consistent with the concussion such as headache, dizziness, tinnitus, nausea, vomiting, fatigue, sensitivity to light, irritability, insomnia or memory/concentration related issues.  The applicant denied history of the head injury on his PDA; however, he reported symptoms consistent with the mental health issues, such as anxiety and depression.  During the applicant’s DVA Compensation and Pension (C&P) examination, it was presumed the applicant possibly may have sustained TBI due to the post-traumatic amnesia; however, it was noted that the applicant has no residual symptoms of TBI.

Even if one is to accept the possibility of the head injury and concussion in Apr 10 during the fall, the level of injury the applicant could possibly sustained was a mild concussion.  Duration of loss of consciousness (LOC) and post traumatic amnesia (PTA) are used in determining the level of trauma.  Despite the inconsistency of the records on the details of the head trauma, it is clear that the applicant’s injury did not result in the LOC, or the LOC was very transient “knocked out momentarily”, which could imply possible mild TBI.  Diagnosis of mild TBI can be difficult because of the subjective nature of complaints and significant overlap with other conditions.  For most people, mild TBI is a self-limiting condition and is expected to resolve fully.  It is well recognized, there is a subcategory of patients, who continue to experience cognitive and psychological ailments.  The major issue, as stated above, is that post-concussion symptoms are very nonspecific and occur with high rates in healthy individuals as well as in persons with depression, PTSD and numerous other chronic illnesses, which can potentially present diagnostic and rating challenge.  For example, there are several symptoms which are found in both PTSD and mild TBI, such as deficits in attention and memory, irritability and sleep disturbance.  The Psychiatric Consultant opines, that given the trajectory of the applicant’s illness, progressing from minimal symptoms to significant disability, his presentation is most consistent with PTSD and depressions versus TBI.  Lastly, the applicant is not DVA service connected for TBI and there is no evidence of comprehensive TBI evaluation available in the record.

A complete copy of the Psychiatric Consultant’s evaluation is at Exhibit I.

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

A copy of the Air Force evaluation was forwarded to the applicant on 22 Jun 17, for review and comment within 30 days (Exhibit J).  As of this date, no response has been received by this office.

THE BOARD CONCLUDES THAT: 

We have thoroughly reviewed the evidence of record and considered the weight and relevance of the additional documentation provided by the applicant, and whether or not it was discoverable at the time of any previous application.  While we find the additional documentation rendered in support of the applicant’s request is new, we do not find it relevant.  Once a case has been considered and denied by the Board established by law for that purpose, reconsideration is authorized only where newly discovered relevant evidence is presented which was not available when the application was originally submitted.  Therefore, in view of the above and in the absence of new and relevant evidence, we find no basis to reconsider the applicant’s request.

THE BOARD DETERMINES THAT:

The applicant be notified the additional evidence presented did not meet the criteria for reconsideration by the Board; and 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-2014-01886 in Executive Session on 27 Jul 17, under the provisions of AFI 36-2603:

	, Panel Chair
	, Member
	, Member

The following documentary evidence pertaining to AFBCMR Docket Number BC-2014-01886 was considered:

	Exhibit F.  Record of Proceedings, dated 28 Jan 15, 
            w/Exhibits.
	Exhibit G.  Letter, AFBCMR, undated.
	Exhibit H.  DD Form 149, dated 28 Nov 15, w/atchs.
	Exhibit I.  Memorandum, AFBCMR Psychiatric Consultant, dated
			  12 Jun 17.
	Exhibit J.  Letter, AFBCMR, dated 22 Jun 17.

Pursuant to paragraph 1 of AFI 36-2603 (Title 32 Code of Federal Regulations, Part 865.1), it is certified that a quorum was present at the Board's review and deliberations, and that the foregoing is a true and complete record of the Board's proceedings in the above entitled matter.