RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2014-04714 COUNSEL: NONE HEARING DESIRED: NO APPLICANT REQUESTS THAT: 1.  Her DD Form 214, Certificate of Release or Discharge from Active Duty, be corrected to reflect she was medically discharged. 2.  She be placed on Medical Continuation Orders (MEDCON) for the duration of the Medical Evaluation Board (MEB) process. APPLICANT CONTENDS THAT: Her DD Form 214 does not reflect a medical discharge and she was only issued an AF Form 100, Request and Authorization for Separation, to document her medical discharge. The AF Form 100 is inadequate for Veteran Affairs (VA) benefits. She was removed from active duty orders when her MEB was initiated. She should have remained on MEDCON orders. Her break in service has severely affected her access to certain care and benefits. When she complained through the Inspector General (IG), false information was provided by medical officials, causing her issues to be thrown out and not addressed. Her service connected injuries entitles her to 100 percent Post 9/11 GI Bill educational benefits; however, she is only receiving 70 percent. The applicant’s complete submission, with attachments, is at Exhibit A. STATEMENT OF FACTS: The applicant’s military personnel records indicate she enlisted in the Air Force Reserve in the grade of airman first class on 2 November 2009. On 6 April 2010, the applicant entered initial active duty training (IADT). On 28 March 2011, according to the applicant’s podiatrist narrative summary (NARSUM), she underwent left ankle arthroscopic surgery. On 15 May 2011, an AFRC 348, Informal Line of Duty Determination, was initiated that indicated while the applicant was on active duty training she stepped off of a stair badly on 7 August 2010 and has had pain in the posterior portion of her left ankle. She received initial treatment on 9 August 2010. On 7 July 2011, the applicant’s injury was recommended to be in line of duty (ILOD). The staff judge advocate concurred and the appointing authority determined her injury was ILOD. On 1 August 2011, the applicant acknowledged receipt of ILOD action. On 20 January 2012, the applicant was relieved from active duty and honorably discharged with a narrative reason for separation of “Completion of Required Active Duty Training”. She was credited with 1 year, 9 months, and 15 days active service. On 3 March 2012, an AF Form 469, Duty Limiting Condition Report, was initiated that restricted the applicant’s duty and mobility through 3 March 2013. Specifically, she was required to undergo a MEB to determine her medical fitness for continued worldwide duty and retention. In addition, she was referred to the Department of Defense (DoD) and Department of Veterans Affairs (DVA) Disability Evaluation System (DES) Program. On 1 April 2012, according to AFRC/DPTAB, the applicant began receiving incapacitation (INCAP) pay. On 17 May 2012, a physical therapy discharge summary was initiated which indicated the applicant was in an improved condition, goals have been partially met, and she was due for scheduled surgery. On 30 May 2012, according to the podiatrist NARSUM, the applicant underwent left ankle subtalar fusion. On 1 October 2012, according to AFRC/DPTAB, the applicant’s INCAP was terminated. On 16 November 2012, the applicant’s commander initiated a notification to the MEB and DES that the applicant has been on no points/no pay since early 2012, awaiting a MEB. She recommended if the applicant is unable to pass a flying class III physical and become a qualified aircrew member then she should be reassigned to a ground medical unit. On 19 November 2012, a podiatrist MEB NARSUM indicated the applicant was not mobility qualified, only able to complete the abdominal circumference portion of the physical training (PT) test, and unable to stand or bear weight for prolonged periods of time. Also, her prognosis was unknown because she had a fusion which could limit and impact her ability to meet deployment requirements, as well as, the need for future surgeries and re-injuries were much greater. On 27 November 2012, the applicant was referred to a MEB for consideration of fitness for duty determination due to her left ankle impingement/joint synovitis. On 29 November 2012, the applicant acknowledged receipt of the Integrated Disability Evaluation System (IDES) process. On 4 January 2013, a compensation and pension (C&P) examination was completed due to the MEB referred condition of left ankle impingement/joint synovitis and the applicant’s claimed conditions of left knee pain and insomnia. The applicant was diagnosed with left subtalar joint fusion with chronic left ankle sprain and persistently elevated blood pressure readings without a current diagnosis of hypertension. However, there was no pathological diagnosis in regards to her left knee pain, right ankle or right knee. It was determined she met the criteria for primary insomnia. However, her symptoms were not severe enough either to interfere with occupational and social functioning or to require continuous medication. On 12 February 2013, a MEB convened to consider the applicant for retention on active duty due to her diagnoses of left ankle impingement/joint synovitis (left ankle sprain status-post (s/p) subtalar joint fusion). The MEB recommended referral to an Informal Physical Evaluation Board (IPEB). On 21 February 2013, a referral completion report was accomplished pursuant to the applicant’s allegation that she was removed from active duty in violation of Air Force Reserve Command Instruction (AFRCI) 36-3004, paragraph 4.1, which states “Members on active duty under Reserve Personnel Appropriation (RPA) or Military Personnel Appropriation (MPA) orders for a specified period of 31 days or more are not involuntarily released from their orders if they incur a line of duty medical condition.” The inquiry officer found that the applicant was on a progressive tour in March 2012 and was advised that if she elected to go visit her friend in Korea, her progressive tour orders would have to end. Additionally, she was advised that she was medically disqualified and her case would be sent to a MEB. She was counseled to apply for incapacitation pay which she did (See Exhibit I). On 29 March 2013, an IPEB was convened and recommended the applicant be found unfit. However, since this was an IDES case, finalization would not be made until receipt of ratings from the DVA. On 19 April 2013, the USAF Physical Disability Division advised the DES rating activity that the PEB found the applicant physically unfit to continue military service due to her left ankle sprain s/p subtalar joint fusion and requested to be provided a disability rating percentage with a rationale for all referred and claimed conditions. On 1 May 2013, the DVA initiated a disability determination under the DES Program and proposed a service connected combined evaluation for DES purposes, at a disability rating of 20 percent. On 31 May 2013, an IPEB was convened and determined the applicant was unfit for her duties due to a left ankle sprain s/p subtalar joint fusion and recommended for discharge with severance pay (DWSP) with a disability compensable rating of 20 percent. The applicant was currently on no points/no pay status since awaiting a MEB. On 8 July 2013, the applicant concurred with the findings and recommendation of the IPEB. However, she requested a one-time reconsideration by the DES Decision Review Officer of the IDES disability rating decision. On 1 September 2013, it was determined no change was warranted in the IDES prior decision of evaluation for the applicant’s physical disability rating of 20 percent. On 12 November 2013, officials within the Office of the Secretary of the Air Force (SAF) determined the applicant was physically unfit for continued military service and directed she be honorably discharged with severance pay under the provisions of Title 10 USC 1203, effective 28 December 2013. On 11 December 2013, an AF Form 100, Request and Authorization For Separation, was initiated that indicated the applicant was to be honorably discharged under the authority and direction of the President. She was entitled to disability severance pay in the grade of senior airman computed IAW Title 10 USC 1212, with an SPD code of “JEB” (Disability, Severance Pay, Non-Combat Enhanced). The remaining relevant facts pertaining to this application are contained in the memorandum prepared by the Air Force offices of primary responsibility (OPR) and BCMR Medical Consultant, which are attached at Exhibits C, D, F and G. AIR FORCE EVALUATION: AFPC/DPFD recommends denial. The preponderance of evidence reflects that no error or injustice occurred during the applicant’s disability process. A complete copy of the AFPC/DPFD evaluation is at Exhibit C. ARPC/DPTS recommends denial. In accordance with Air Force Instruction (AFI) 36-3202, Separation Documents, the DD Form 214 provides separating members with brief, clear records of their active military service at the time they are transferred, released, discharged, or retired. The end date of the applicant’s DD Form 214 in question is 20 January 2012, which reflects the date she was released from active duty orders. She was not medically discharged until 28 December 2013. Specifically, the DD Form 214 certifies a military member’s release of discharge from active duty and captures item by item, by authority, the military member’s pertinent data and military service data. Since participation records show the member was not on active duty orders at the time of her medical discharge, a new DD Form 214 or correction to the current DD Form 214 cannot be issued. A complete copy of the ARPC/DPTS evaluation is at Exhibit D. APPLICANT'S REVIEW OF AIR FORCE EVALUATIONS: Copies of the Air Force evaluations were forwarded to the applicant on 17 February 2015 for review and comment within 30 days (Exhibits E). As of this date, no response has been received by this office. ADDITIONAL AIR FORCE EVALUATIONS: AFPC/DPFA recommends denial. The applicant is ineligible for MEDCON because she failed to submit an application to request MEDCON. In accordance with (IAW) SAF MEDCON policy guidelines, MEDCON is a voluntary program. An airman may be eligible for MEDCON orders when an injury, illness, or disease is incurred or aggravated while serving on orders and that condition renders the airman unable to perform military duties. MEDCON eligibility requires a Line of Duty (LOD) determination, a finding by a credentialed military health care provider that the airman has an unresolved health condition requiring treatment (with an active treatment plan), and the airman is rendered unable to meet retention or mobility standards IAW Air Force Instruction 48-123, Medical Examinations and Standards. A service member not on MEDCON orders at the time of entry into the Integrated Disability Evaluation System (IDES), may apply for MEDCON while processing through IDES; however, the service member must apply. The service member must also provide an AF Form 469, which reflects a duty limiting condition. IAW MEDCON policy, service members are required to submit MEDCON requests/application within 60 days of injury. The applicant did not provide documentation highlighting an error by the government, nor any administrative delays due to this issue. Nevertheless, based on the disability retirement order, the applicant may be eligible for care through the Veterans Administration. A complete copy of the AFPC/DPFA evaluation is at Exhibit F. BCMR Medical Consultant recommends denial. While, in agreement with the opinion of ARPC/DPTS that the existing DD Form 214 for the designated period of [active] service should not be changed to a medical discharge and that AFPC/DPFD has no authority to change or create a new DD 214, it would seem unjust to deny the applicant a new DD Form 214 to accurately reflect the date and reason for her ultimate release from the Air Force Reserve due to a disability, with entitlement to severance pay, as stated on her AF Form 100, unless strictly prohibited by established Department policy or law. It is the Medical Consultant opinion that the applicant should be issued a DD Form 214 indicating she was released from the United States Air Force Reserve (USAFR), under authority of AFI 36-3212, Physical Evaluation for Retention, Retirement, and Separation, by reason of “Disability – Entitled to Severance Pay”, with an effective date commensurate with her established date of release from the USAFR. The applicant’s medical documentation from her active duty training, nor following her release from those orders, to include an AF Form 618, Medical Board Report, or MEB narrative summary was supplied for review. Despite the absence of this specific documentation, the supplied AF Form 356, Findings and Recommended Disposition of USAF Physical Evaluation Board, completed by the IPEB and the remarks made on the applicant’s AF Form 100 leads to the conclusion that an MEB did in fact take place for an In Line of Duty medical condition, finding the applicant unfit for continued service, and the issuance of a 20 percent disability rating with entitlement to severance pay. Additionally, it is questionable as to why the applicant was not retained on active duty orders from January 2012 UNTIL she was either returned to unrestricted duty or processed out via the Disability Evaluation System (DES). While one can argue the applicant should have been retained on active duty orders for training beyond their expiration, the lack of supplied medical documentation, as also noted by AFPC/DPFA, such as, service treatment records, civilian treatment records, AF Form 422, Notification of Air Force Member’s Qualification Status, or AF Forms 469, Duty Limiting Condition Reports, determining any potential effective date of orders without objective evidence would be based on conjecture; particularly in the context of the applicant’s stated objective to complete her training and her apparent request to be released from orders, despite her medical condition. Any further recommendation related to MEDCON orders would require submission of actual objective medical evidence from all sources, both military provider and civilian. Such an analysis would also take into account of whether the applicant was alternatively eligible for incapacitation pay, if civilian employment was adversely affected by her medical condition; noting she was capable of performing military administrative duties; and if the requested extension and alleged denial of Progressive Tour, 21 January 2012, was related to a medical issue. A complete copy of the BCMR Medical Consultant evaluation is at Exhibit G. APPLICANT'S REVIEW OF ADDITIONAL AIR FORCE EVALUATIONS: A copy of the Air Force evaluation and the BCMR Medical Consultant’s evaluation were forwarded to the applicant on 28 October 2015 for review and comment within 30 days (Exhibits H). As of this date, no response has been received by this office. 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 injustice with respect to the applicant’s request to be placed on MEDCON orders for the duration of the MEB process. We note the applicant contends she should have remained on MEDCON orders and her break in service has severely affected her access to certain care and benefits. However, we also note that AFPC/DPFA and the BCMR Medical Consultant find that not only did the applicant not apply for MEDCON, there is a lack of supplied medical documentation to make an assessment particularly in light of her apparent request to be released from orders, despite her medical condition. Any further recommendation related to MEDCON orders would require submission of actual objective medical evidence from all sources, both military provider and civilian. Therefore, we are in agreement with their assessment and agree that the applicant has not been the victim of an error or injustice. 4.  Notwithstanding the above, sufficient relevant evidence has been presented to demonstrate the existence of an injustice with respect to the applicant’s records reflecting she was medically discharged. While we note the comments of ARPC/DPTS, indicating the applicant was not on active duty orders at the time of her medical discharge and therefore should not be provided a new DD Form 214 or correction to the current DD Form 214, we believe corrective action to reflect the applicant’s medical discharge, effective 28 December 2013 is warranted. In this respect, we note that the applicant is requesting a DD Form 214 be issued to officially document her medical discharge in order to obtain VA benefits. While governing directives preclude the issuance of a DD Form 214 for Reserve members that do not have qualifying active duty time to generate a DD Form 214, an alternative remedy in the form of a separation order stating her discharge is proper and avails the applicant with the relief she seeks. While we note the relief is not in the form of a DD Form 214, we believe this correction is proper and fitting. Accordingly, we recommend the applicant’s records be corrected to the extent indicated below. THE BOARD RECOMMENDS THAT: The pertinent military records of the Department of the Air Force relating to the APPLICANT be corrected to show that she was honorably discharged under the provisions of Title 10 United States Code, Section 1203, with a narrative reason for separation of “Disability, Severance Pay, Non-Combat (Enhanced), and SPD code of “JEB”, and RE code of “2Q”, effective 28 December 2013. The following members of the Board considered AFBCMR Docket Number BC-2014-04714 in Executive Session on 13 January 2016 under the provisions of AFI 36-2603: Panel Chair Member Member All members voted to correct the records as recommended. The following documentary evidence pertaining to AFBCMR Docket Number BC-2014-04714 was considered: Exhibit A.  DD Form 149, dated 2 November 2014, w/atchs. Exhibit B.  Applicant's Master Personnel Records. Exhibit C.  Memorandum, AFPC/DPFD, dated 2 December 2014. Exhibit D.  Memorandum, ARPC/DPTS, dated 20 January 2015, w/atch. Exhibit E.  Letter, SAF/MRBR, dated 17 February 2015, w/atchs. Exhibit F.  Memorandum, AFPC/DPFA, dated 5 October 2015. Exhibit G.  Memorandum, BCMR Medical Consultant, dated 19 October 2015. Exhibit H.  Letter, SAF/MRBR, dated 28 October 2015, w/atchs. Exhibit I.  Report, SAF/IG Investigation, dated 21 February 2013 – WITHDRAWN. 1 2