RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2014-04672 COUNSEL: NONE HEARING DESIRED: YES APPLICANT REQUESTS THAT: He receive medical continuation (MEDCON) orders for convalescence and treatment immediately following his shoulder surgery on 29 May 13. APPLICANT CONTENDS THAT: Despite being told he would be placed on MEDCON orders commencing on the day of his line of duty (LOD) determination injury surgery, he was denied MEDCON orders. The applicant’s complete submission, with attachments, is at Exhibit A. STATEMENT OF FACTS: At the time of the matter in question, the applicant was serving in the Air National Guard (ANG) in the grade of staff sergeant (E-5). On 6 Jun 13, the appointing authority signed the AF IMT 348, Line Of Duty determination, for the applicant’s left shoulder rotator cuff tear, labral tear, and biceps tear injury that occurred on 5 Nov 11. The remaining relevant facts pertaining to this application are described in the memoranda prepared by the Air Force office of primary responsibility (OPR) and the AFBCMR Medical Consultant, which are included at Exhibits C and F. AIR FORCE EVALUATION: AFPC/DPFA recommends granting relief, indicating sufficient evidence has been presented to demonstrate the existence of error or injustice. Per Aug 12 SAF MEDCON Policy Guidelines, paragraph 3, MEDCON eligibility requires a LOD determination and a finding by a credentialed military health care provider highlighting that the service member (SM) has an unresolved health condition requiring treatment, and renders the SM unable to meet retention or mobility standards in accordance with AFI 48-123, Medical Examinations and Standards, Chapters 5 and 13. In this case the applicant’s LOD is valid, there is a duty limiting condition and medical treatment plan in accordance with applicable guidelines. If the applicant’s LOD had been processed according to guidelines he would have been eligible for MEDCON orders on 29 May 13 at the time of surgery until 14 Feb 14 when the applicant’s medical treatment for the subject injury was completed. AFPC/DPFA recommends approval for military pay & points covering the period 29 May 13 through 14 Feb 14. A complete copy of the AFPC/DPFA evaluation is at Exhibit C. APPLICANT'S REVIEW OF AIR FORCE EVALUATION: The applicant responded by identifying some administrative errors (name and address), some alleged discrepancies in the OPR evaluation regarding that they could not find evidence indicating the National Guard Bureau (NGB) denied issuing him MEDCON orders, and argues that the OPR’s recommendation for his medical treatment (shoulder) completion date to be Feb 14 is not appropriate if he still continues to have issues related to his fitness. He does state that his doctor’s care for his shoulder injury ended Nov 14, when he was determined to be at Maximum Medical Improvement (MMI). He states he still suffers from the impact of his injury and has been recommended by the National Guard Bureau (NGB) for a full Medical Evaluation Board (MEB). In support of his response, the applicant provides copies of all civilian medical reports, appropriate military medical records, a copy of the NGB recommendation for his Medical Evaluation Board (MEB), and his most recent AF Form 469, Duty Limit Condition Report. A complete copy of the applicant’s response to the Air Force Evaluation is at Exhibit E. ADDITIONAL AIR FORCE EVALUATION: AFBCMR Medical Consultant recommends granting the relief recommended by AFPC/DPFA, indicating sufficient evidence has been presented to demonstrate the existence of error or injustice. The applicant’s case file revealed that he injured his shoulder while on duty in Nov 11. Surgical repair of the injured shoulder occurred on 29 May 13. Reportedly, while in likely convalescence leave status in Jun 13, the applicant slipped on a wet floor sustaining a re-injury to his shoulder, and injuring his right knee. A repeat arthroscopic surgery on 16 Sep 13 repaired his shoulder. Follow-up medical appointments addressed both his shoulder and knee pain. Subsequent medical reports indicated continued improvement with his shoulder, but his knee still was hurting him, specifically when attempting to run. An MRI scan of the knee demonstrated “no evidence of any ligamentous or meniscal tear.” However, the medical provider noted that a ganglion cyst captured in the MRI, which may be contributing to the pain. In view of the identified pathology (a ganglion cyst) on MRI scan of the knee and the absence of bony or ligamentous injury, the Medical Consultant found the evidence insufficient to outright recommend additional relief (more treatment time) for the applicant’s reported knee injury, and there is no LOD determination related to his knee injury. Therefore, the medical consultant recommends the applicant pursue obtaining a LOD determination for his right knee if he chooses to further pursue MEDCON orders beyond that recommended by AFPC/DPFA. A complete copy of the AFBCMR Medical Consultant additional evaluation is at Exhibit F. APPLICANT'S REVIEW OF ADDITIONAL AIR FORCE EVALUATION The applicant refutes the AFBCMR Medical Consultant’s evaluation arguing that the Medical Consultant focused on his secondary injuries and did not consider his continuing issues with his pain and injury to his left shoulder. He contends that if he was appropriately placed on MEDCON orders on 29 May 13 as recommended, then any subsequent injuries occurring while on MEDCON orders would be service connected, and until he fully recovers or be determined unfit for military service, he should receive military pay and points. He contends he was just notified via email that the Integrated Disability Evaluation System (IDES) has determined him unfit for duty and is recommending separation from duty. To this date, neither of those has occurred. A complete copy of the applicant’s response to the additional evaluation is at Exhibit G. 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 an error or injustice. We took notice of the applicant's complete submission in judging the merits of the case to include his rebuttals, and agree with the opinions and recommendations of the Air Force office of primary responsibility (OPR) and the AFBCMR Medical Consultant and adopt their rationale as the basis for our conclusion the applicant has been the victim of an error or injustice. While we note his contention that if he was appropriately placed on medical continuation (MEDCON) orders on 29 May 13 as recommended, then any subsequent injuries occurring while on MEDCON orders would be service connected, and until he fully recovers or be determined unfit for military service, he should receive military pay and points; we agree with the AFBCMR Medical Consultant that the applicant should pursue and obtain a LOD determination for his right knee injury if he wants to further pursue MEDCON orders beyond that recommended by AFPC/DPFA. Therefore, we recommend the applicant's records be corrected as indicated below. 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 issues involved. Therefore, the request for a hearing is not favorably considered. THE BOARD RECOMMENDS THAT: The pertinent military records of the Department of the Air Force relating to the APPLICANT be corrected to show that he was placed on medical continuation (MEDCON) orders effective 29 May 2013, and approved for military pay and points covering the period 29 May 2013 through 14 February 2014. The following members of the Board considered AFBCMR Docket Number BC-2014-04672 in Executive Session on 7 Oct 15, under the provisions of AFI 36-2603: All members voted to correct the records as recommended. The following documentary evidence pertaining to AFBCMR Docket Number BC-2014-04672 was considered: Exhibit A.  DD Form 149, dated 11 Nov 14, w/atchs. Exhibit B.  Applicant's Master Personnel Records. Exhibit C.  Memorandum, AFPC/DPFA dated 5 Mar 15. Exhibit D.  Letter, SAF/MRBR, dated 1 Apr 15. Exhibit E.  Letter, Applicant, dated 13 Apr 15, w/atchs. Exhibit F.  Memorandum, AFBCMR Medical Consultant, dated   25 Aug 15. Exhibit G.  Letter, SAF/MRBR, dated 31 Aug 15. Exhibit H.  Letter, Applicant, dated 10 Sep 15.