RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:				DOCKET NUMBER:  BC-2015-03881
 
							COUNSEL:  NONE

							HEARING DESIRED:  NO

APPLICANT REQUESTS THAT:

His records be corrected to reflect that he was on Medical Continuation (MEDCON) orders for the following periods:

a. 9 August 2014 – 2 December 2014.

b. 27 May 2015 – 1 September 2015.

APPLICANT CONTENDS THAT:

He was injured while he was on active duty; therefore he should have remained on active duty orders until his surgery and recovery were complete.

The applicant’s complete submission, with attachments, is at Exhibit A.

STATEMENT OF FACTS:

According to DD Form 4, Enlistment/Reenlistment Document – Armed Forces of the United States, the applicant enlisted in the South Carolina Air National Guard on 4 May 2013.

Order Number Z5V3WA dated 25 July 2014, was issued to the applicant to attend Formal Training School for the period 29 October 2013 to 8 August 2014.

According to the applicant’s DD Form 214, Certificate of Release or Discharge from Active Duty, he entered a period of active duty service from 4 November 2013 to 8 August 2014, and was credited with nine months and five days of active service.  His narrative reason for separation is “Completion of Initial Active Duty Training.”

According to AF IMT 348, Line of Duty Determination, dated 17 August 2014, the applicant received treatment on 25 March 2014, for an injury he received when he slipped on ice while in training and aggravated a pre-existing injury/condition (Anterior Cruciate Ligament [ACL] right knee).  This injury was found in the line of duty by the approval authority.  He was in active duty status from 29 October 2013 to 8 August 2014.

According to DA Form 3349, Physical Profile, dated 27 October 2014, the applicant received a three month temporary profile for his ACL right knee injury.  The form does not include the signature of an approving authority.

Order Number Z6F23A dated 21 April 2015, was issued to the applicant for the period 3 December 2014 to 26 May 2015, for the purpose of MEDCON.

The applicant is currently serving in the Air National Guard in the grade of senior airman (E-4).

AFI 36-2910, Line of Duty (LOD) Determination, Medical Continuation (MEDCON) and Incapacitation (INCAP) Pay, states, the purpose of MEDCON is to authorize medical and dental care for members who incur or aggravate an injury, illness or disease in the Line of Duty (ILOD) and to provide pay and allowances while they are being evaluated, treated for or recovering from a service-connected injury, illness or disease.  MEDCON orders shall begin when the condition renders the member unable to perform military duties (not necessarily when the injury or illness occurred, when the disease was diagnosed or when the member was released from active duty).  A member who can perform military duties but requires medical care for a minor or chronic medical condition may be provided medical treatment for such condition through the Department of Veterans Affairs or TRICARE benefits; the member does not have to be on MEDCON orders to receive medical care for an in the line of duty condition.

AIR FORCE EVALUATION:

AFPC/DPFA recommends denial of the applicant’s MEDCON request for the period 9 August 2014 – 2 December 2014.  According to AFI 36-2910, a service member 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 determination and a finding by a credentialed military health care provider that the airman has an unresolved health condition requiring treatment and renders the airman unable to meet retention or mobility standards in accordance with AFI 48-123, Medical Examinations and Standards, Chapters 5 and 13.  A thorough review of MEDCON related systems found no evidence the government committed an error with regard to the applicant’s MEDCON request package.  The applicant began a period of MEDCON [3 December 2014 to 26 May 2015] the day he was scheduled for surgery.  Up until that point, Air Reserve Command (ARC) Case Management Division (CMD) could not locate any evidence that would indicate the applicant had a treatment plan that qualified for MEDCON, specifically an active treatment plan for the period 9 August 2014 to 2 December 2014.  Notwithstanding the above, AFPC/DPFA recommends the Board approve MEDCON for the period 27 May 2015 – 1 September 2015, only if the applicant provides the required physical therapy documents for this period.  The applicant’s MEDCON application is still missing the required physical therapy documentation and technically does not qualify for MEDCON entitlements.  The ARC CMD case managers performed additional due diligence and researched the Armed Forces Health Longitudinal Technology Application (AHLTA) database discovering notes from the applicant’s provider saying he was “continuing to progress with physical therapy” that would cover the period from 27 May 2015 to 1 September 2015.  However, there was no documentation available in AHLTA to certify the frequency or inclusive dates of physical therapy appointments.  Had the applicant provided documentation to verify the physical therapy appointments to ARC CMD at the time, the MEDCON extension more than likely would have been approved.  The applicant is eligible to receive care for the injury incurred in the line of duty at any military treatment facility based on the reference “progress with physical therapy” found in AHLTA.

A complete copy of the AFPC/DPFA evaluation is at Exhibit C.

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

He has provided medical documents which will hopefully indicate he was not gainfully employed with his unit for the first three or more months [9 August 2014 – 2 December 2014].  In further support of his appeal, the applicant provides medical documents for the period 18 December 2014 through 12 May 2015.

The applicant’s complete response, with attachments, is at Exhibit E.

ADDITIONAL AIR FORCE EVALUATION: 

The BCMR Medical Consultant recommends granting the applicant MEDCON for the period 9 August 2014 through 2 December 2014.  The applicant is correct in his assertion that individuals who sustain an injury or illness while on active duty orders, will remain on active orders until either returned to duty without restrictions or processed through Disability Evaluation System.  It is noted that the applicant reportedly sustained an injury in March 2014, but sought treatment in June 2014.  The evaluating provider issued the applicant a temporary 30-day profile, but advised him to address any further care at his home unit.  It is very unclear and unstated exactly what limitations were initially imposed at the time and how the medical condition affected the applicant’s ability to perform his military duties.  Nonetheless, the provider did find it appropriate to issue a 30 day profile to protect the applicant from further injury or suffering until evaluated at his home station. Based upon the series of interactions between the applicant and the health care system, which included initial assessment, the referral request, the approval of referral, the orthopedics evaluations, scheduling and completing surgery, [all during June 2014, July 2014, August 2014, October 2014, November 2014, and December 2014], the Medical Consultant finds it reasonable to have extended the applicant on active duty orders for the period 9 August 2014 through 2 December 2014; as there is a provision for MEDCON orders even in preparation for elective surgery; if the medical condition precludes/prevents/interferes with the individual’s ability to perform his or her military duties.

With respect to the final requested MEDCON period [27 May 2015 through 1 September 2015], the Medical Consultant recommends denial, unless additional evidence is presented, e.g., an AF Form 469, Duty Limiting Condition Report, to indicate the applicant was not returned to unrestricted duty during the contested period following end date of his orders on or about 26 May 2015.  Should the Board also choose to deny the initial requested period [9 August 2014 through 2 December 2014], since no timely AF Form 469 has been presented by the Air Force, the BCMR Medical Consultant opines this was likely because of shared culpability between the applicant and his Air Force healthcare providers; the former who had the responsibility to timely present his civilian medical records and progress to his military provider and the latter whose responsibility would have been to carryout necessary administrative activities for proper disposition.  Being evaluated at multiple institutions also contributed to the delays.  Again, based upon the continuum of evaluations and referrals from the time the applicant presented for care at his TDY training location, through the referral process upon his return to home station, and ultimately receiving surgery in early December 2015, suggest that MEDCON orders were likely appropriate from 9 August through 2 December 2014.

A complete copy of the BCMR Medical Consultant’s evaluation is at Exhibit F.

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

On 26 October 2016, a copy of the BCMR Medical Consultant’s evaluation was forwarded to the applicant for review and comment within 30 days (Exhibit G).  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 to warrant correcting the applicant’s records to indicate he was on MEDCON orders for the period 27 May 2015 – 1 September 2015.  As noted by the Air Force OPR, had the applicant provided documentation to ARC CMD to certify the frequency or inclusive dates of physical therapy appointments, the MEDCON extension more than likely would have been approved. While the applicant provides medical documentation in support of his requests; none of the documentation he provides supports his request for MEDCON for the contested period.  Should the applicant provide additional evidence to verify his physical therapy appointments during the period in question, we may be willing to reconsider his request.  In view of the above and in the absence of evidence to the contrary, we find no basis to favorably consider this portion of the applicant’s request.

4.  Notwithstanding the above, sufficient relevant evidence has been presented to demonstrate the existence of error or injustice to warrant placing the applicant on MEDCON orders for the period 9 August 2014 – 2 December 2014.  Having carefully reviewed this application, we agree with the recommendation of the BCMR Medical Consultant and adopt the rationale expressed as the basis for our decision that the applicant has been the victim of either an error or an injustice.  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 he was not released from active duty on 8 August 2014, but on that date he continued on active duty for the purpose of medical evaluation through 26 May 2015, at which time he was released from active duty.

The following members of the Board considered AFBCMR Docket Number BC-2015-03881 in Executive Session on 13 September 2016 and 12 December 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-2015-03881 was considered:

Exhibit A.  DD Form 149, dated 1 September 2015, w/atchs.
Exhibit B.  Applicant's Master Personnel Records.
Exhibit C.  Memorandum, AFPC/DPFA, dated 18 April 2016.
Exhibit D.  Letter, AFBCMR, dated 24 June 2016.
Exhibit E.  Letter, Applicant, undated, w/atchs
Exhibit F.  Memorandum, BCMR Medical Consultant, dated 
  26 October 2016.
Exhibit G.  Letter, AFBCMR, dated 26 October 2016.

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.