RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2014-04673 COUNSEL: NONE HEARING DESIRED: NO APPLICANT REQUESTS THAT: His discharge be changed to a medical retirement. APPLICANT CONTENDS THAT: He was discharged for multiple Fitness Assessment (FA) failures. He suffered from back and feet pain and told his doctors and commanders about his pain. He did not pass the 1.5 mile run of the FA due to his pain. He was authorized to take the walk test and passed the FA without any issues. Since his discharge, he has learned that he has thoracolumbar spine degenerative disc disease and arthritis in his feet. The Department of Veterans Affairs (DVA) doctor stated he was discharged for failing a component of the FA that he was not healthy enough to attempt. The DVA doctors told him he should never run again as it puts too much strain on his back. He completed a number of combat deployments to Iraq and Afghanistan. It was during these deployments that he hurt his back which caused the arthritis in his feet. He was also fighting Post-Traumatic Stress Disorder (PTSD). He now receives care from the DVA and understands he did not ask questions in his own behalf because of his PTSD. He simply wanted to disappear because it was too much to handle. He understands he would not have been able to stay in the military on a permanent profile for his back condition. He served faithfully for over 13 years and experiences pain daily as a result of his service. He receives compensation from the DVA and believes his discharge should be changed to a medical retirement. In support of his request, the applicant provides copies of his DD Form 214, Certificate of Release or Discharge from Active Duty; DVA rating decision dated 7 February 2014 and various other documents associated with his request. The applicant’s complete submission, with attachments, is at Exhibit A. STATEMENT OF FACTS: On 1 July 1998, the applicant entered the Regular Air Force. In a memorandum dated 28 October 2011, the Global Support Squadron Commander (GSS/CC) notified the applicant that he was recommending he be discharged for failure in the fitness program under the provisions of AFI 36-3208, Administrative Separation of Airmen, paragraph 5.26.6. The specific reason for this action was the applicant received four fitness failures in a 24- month period. AFI 36-2905, Fitness Program, paragraph 9.1.5.2 requires a discharge or retention recommendation when a member receives four unsatisfactory fitness assessments in a 24- month period. On 7 June 2010, the applicant scored 70.40 (poor) and received a Letter of Counseling (LOC); on 16 August 2010, he scored 65.30 (unsatisfactory) and received a Letter of Reprimand (LOR); on 31 May 2011, he scored 52.70 (unsatisfactory) and received a LOR; on 29 Aug 2011, he scored 65.50 (unsatisfactory). The applicant was advised of his right to consult legal counsel, present his case to an administrative board, submit statements in his own behalf in addition to or in lieu of the board hearing or waive his rights. According to a memorandum from the Air Mobility Wing Judge Advocate (AMW/JA) dated 21 November 2011, the applicant waived his right to have his case brought to an administrative discharge board. The staff judge advocate recommended the applicant be separated with an honorable discharge without probation and rehabilitation. On 2 December 2011, the applicant was honorably discharged in the grade of Master Sergeant (MSgt, E-7) with a narrative reason for separation of “Physical Standards.” He was credited with 13 years, 5 months and 2 days of active duty service. According to a DVA rating decision dated 7 February 2014, the applicant was rated at a combined disability rating of 70 percent, 50 percent for PTSD and 20 percent for thoracolumbar spine degenerative disc disease and strain. AIR FORCE EVALUATION: The BCMR Medical Consultant recommends denial indicating the applicant has not met the burden of proof that warrants supplanting his administrative discharge with a medical retirement. While there were no recurring AF Form 422, Notification of Air Force Member’s Qualification Status, or AF Form 469, Notification of Air Force Member’s Qualification Status, to depict a given duty restriction of FA exemption, the evidence is generous depicting on-going struggles with weight management. Although there is evidence the applicant was restricted from performing running and sit-ups for 31 days following a 4 November 2010 medical appointment, there are no AF Forms 422 or AF Forms 469 depicting he had a medical condition that restricted duty and mobility to the extent and/or duration that warranted a referral for a Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) review). The Medical Consultant acknowledges the applicant has been granted service connection and compensation for PTSD. However, although soundly based on his deployment history and the symptoms he reported during a requested mental health screening just prior to discharge and at his DVA Compensation and Pension examination, there is absolutely no service evidence to demonstrate that PTSD was or should have been a reason for cutting short his career; nor that it interfered with his ability to perform his military duties. Acknowledging that it is the healthcare provider’s responsibility to initiate the aforementioned procedures where there has been a long-standing exemption or duty restriction, the lack of sufficient evidence precludes making an unfit decision based upon conjecture or opinion. Even rendering the benefit of doubt for the applicant, considering the disability ratings assigned by the DVA, the Medical Consultant opines his lumbar spine condition, if found unfitting, would rate no greater than 20 percent and would result in Discharge With Severance Pay (DWSP) at best; funds which would have been off- set/recouped by the DVA before DVA payments would begin. The applicant has supplied evidence of disability ratings from the DVA. These include a 50 percent rating for PTSD effective 3 December 2011 and an increased rating from 10 to 20 percent for thoracolumbar spine degenerative disc disease and strain. When combined, the applicant’s previous evaluation of 60 percent effective 3 December 2011 became 70 percent effective 24 October 2013. Addressing the applicant’s desire for a medical retirement, the military Disability Evaluation System (DES) established to maintain a fit and vital fighting force, can by law, under 10 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. DOD 1332.32, Physical Disability Evaluation, Enclosure 3, Part 3, Standards for determining Unfitness Due to Physical Disability Or Medical Disqualification, in effect at the time of the applicant’s service reads, “A service member shall be considered unfit when the evidence establishes that the member, due to a physical disability, is unable to reasonably perform the duties of his or her office, grade, rank or rating (hereafter called duties) to include duties during a remaining period of Reserve obligation.” In the case under review, the applicant was periodically placed on Duties Not Including Flying (DNIF) status for episodic acute minor illnesses and injuries while serving as a loadmaster. He also attended episodes of physical therapy for low back pain, and an episode of care for knee and ankle pain. Based on the supplied evidence, neither of the aforementioned medical conditions is shown to have interfered with his ability to perform his military duties. Finally, the applicant is advised that operating under a different set of laws, 38 U.S.C., with a different purpose, the DVA is authorized to offer compensation for any medical condition determined service incurred, without regard to, and independent of, its demonstrated or proven impact upon a service member’s retainability, fitness to serve, or narrative reason for separation. This is why a member may be discharged for one reason; yet sometime thereafter receive compensation ratings by the DVA. Moreover, the DVA is also empowered to conduct periodic re-evaluations for the purpose of adjusting the disability rating awards (increase or decrease) as the level of impairment from a given service connected medical condition may vary (improve or worsen) over the lifetime of the veteran. A complete copy of the Medical Consultant’s evaluation is at Exhibit C. APPLICANT'S REVIEW OF AIR FORCE EVALUATION: The Medical Consultant presents a very one sided case. He continuously refers to the fact that he was prescribed weight management classes which is certainly true. However, his weight was not the deciding factor for his discharge. During the two years prior to his discharge, he only exceeded the waist circumference once on 31 May 2011. He was within the limits for the abdominal circumference during all other FAs during this period. The Medical Consultant fails to mention that during his final FA which led to his discharge he was within the requirements for all components with the exception of the 1.5 mile run which is the largest contributor of overall points. He took part in physical conditioning without fail and took walks in the evening. He did not fail his FA for a lack of effort or from poor diet. His failure was because he could not make the required time for the 1.5 mile run. In his application he stated that he told his commanders and doctors he had problems with the run because of his back and that they would not listen. The Medical Consultant’s opinion echoes what he was constantly told. When he would explain he was having back and respiratory issues it was immediately assumed he should lose weight. The Air Force never explored his back or respiratory issues. The Medical Treatment Facility (MTF) never took the time to perform a single x-ray on his back. The DVA took one x-ray and said he should not run anymore. He was ultimately diagnosed with degenerative disc disease and dyspnea (a respiratory issue) which prevented him from successfully completing the 1.5 mile run. He asks that his case be reviewed and the cause of his FA failure be considered. It was not the abdominal circumference; it was the 1.5 mile run. The Medical Consultant also states that his health condition was “very good.” Every time he brought up his back pain, he was told to “lose weight and take Motrin.” He lost faith with his providers and simply stated what would get him out of their office. He was having mental health issues at the time and no one even cared to notice. If the Board agrees that the cause of his FA failure was the 1.5 mile run then the just thing to do would be to change the characterization of his discharge. It is not just to administratively discharge a career airman with a bad back and respiratory issues for failure to run fast enough when a medical issue is preventing it. The Medical Consultant argues that a medical retirement may not be warranted because of the disability percentage and states that he may have only had a 20 percent disability and thus would have had a medical discharge. He was never placed in an MEB process and thus was never given the opportunity to put forth all of the medical conditions present. The arbitrary 20 percent should be discarded because the Air Force never even gave him that chance. A MEB is a lengthy process that ascertains the extent of the medical conditions present and includes an appeal process; he was never afforded this opportunity. He was simply discharged without a second thought. Even if the Board ultimately medically discharges him with or without severance pay that would be recouped from the DVA at least he would have been treated fairly and the characterization of his discharge would accurately reflect what should have occurred. The Medical Consultant states that his mental health struggles did not affect his duty performance. He simply states that at the time of his discharge he was unqualified as an aircraft loadmaster. He suffers from frequent panic attacks which started well before his discharge. He completed 658 combat sorties which totaled 1,173.2 combat hours. Because of his experiences, he lives a reclusive life suffering from PTSD symptoms frequently. He may have an honorable discharge; however, he was wronged and is ashamed that his DD Form 214 reflects he failed to maintain physical standards. At the very least, the Air Force should acknowledge that this was not a failure to maintain standards but was the result of a continuously overlooked medical condition that prevented him from being able to complete his job. His commanders and doctors had a preconceived notion and failed to perform even a minimal amount of research to ensure that proper actions were taken. The applicant’s complete submission, with attachments, is at Exhibit E. THE BOARD CONCLUDES THAT: 1. The applicant has exhausted all remedies provided by existing law or regulations. 2. The application was timely filed. 3. Insufficient relevant evidence has been presented to demonstrate the existence of an error or an injustice. We took notice of the applicant's complete submission in judging the merits of the case and do not find that it supports a determination that the applicant was improperly separated from active duty in 2011. While the applicant contends he was separated from active duty without an MEB, he has not provided substantial evidence showing that he had an unfitting medical condition that would have required his processing through the Military Disability Evaluation System – a prerequisite to a medical discharge. Based on the preponderance of the evidence, it appears the applicant’s discharge was properly adjudicated and we found no evidence which would lead us to believe that his separation was in error or contrary to the governing Air Force instructions. The applicant’s case has undergone an exhaustive review by the BCMR Medical Consultant and we did not find the evidence provided, sufficient to overcome his assessment of the case. Therefore, we agree with the opinion and recommendation of the BCMR Medical Consultant and adopt the rationale expressed as the basis for our decision that the applicant has failed to sustain his burden of proof that he has suffered from an error or injustice. In the absence of evidence to the contrary, we find no basis to recommend granting the relief sought in this application. THE BOARD DETERMINES THAT: The applicant be notified the evidence presented did not demonstrate the existence of material error or injustice; the application was denied without a personal appearance; 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-2014-04673 in Executive Session on 1 October 2015 under the provisions of AFI 36-2603: , Chair , Member , Member The following documentary evidence was considered: Exhibit A. DD Form 149, dated 12 November 2014, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Memorandum, BCMR Medical Consultant, dated 4 August 2015. Exhibit D. Letter, SAF/MRBR, dated 20 August 2015. Exhibit E. Letter, Applicant, undated, w/atchs.