RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF: 			DOCKET NUMBER:  BC-2016-02604

XXXXXXXXXXXXX				COUNSEL:  NONE

						HEARING DESIRED:  YES 

APPLICANT REQUESTS THAT:

The Assignment Limitation Code C3 (ALC C3) be removed from her Electronic Health Record (EHR).

APPLICANT CONTENDS THAT:

She previously applied to the Air Force Board for Correction of Military Records (AFCMR) to remove the diagnosis of Bipolar Disorder, which drove the ALC C3, from her records.  The diagnosis of Bipolar Disorder was found questionable by both military and civilian specialists.  The request was denied, but included in the denial was a recommendation that her EHR be updated to reflect “Worldwide Qualified and Deployable.”

The ALC C3 code is extremely detrimental to her career, requiring a waiver for technical school, and she is barred from deployments, temporary duty assignments (TDY), formal schools, mandays, and any duty away from home station.  She currently faces being placed in the Inactive Ready Reserve or removal from her critically-manned career field.

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

STATEMENT OF FACTS:

On 20 Mar 02, the applicant initially entered the Regular Air Force.

On 19 Mar 06, the applicant was furnished an Honorable discharge, and credited with 4 years, 0 months, and 0 days, active service.

On 20 Mar 06, the applicant enlisted in the Air Force Reserve.

On 23 Oct 13, the applicant was medically disqualified by AFRC/SGO for a diagnosis of Bipolar Disorder.

On 31 Jan 14, the applicant was found fit for duty by a Formal Physical Evaluation Board.

The applicant is currently serving in the Air Force Reserve.

The remaining relevant facts pertaining to this application are contained in the memoranda prepared by the Air Force offices of primary responsibility (OPR), which are attached at Exhibits C, F, and G.

AIR FORCE EVALUATION:

AFRC/SGO recommends denial, indicating there is no evidence of error or injustice.

In 2013, the applicant underwent a non-duty related fitness for duty determination for the diagnosis of Bipolar Disorder.  On 23 Oct 13, AFRC/SGO found her medically disqualified and submitted the case to the Informal Physical Evaluation Board for a fitness for duty adjudication.  On 31 Jan 14, a Formal Physical Evaluation Board found the applicant fit for duty.  In accordance with Air Force Instruction (AFI) 41-210, TRICARE Operations and Patient Administration Functions, the case was returned to AFRC/SGP for placement of appropriate ALC resulting in the applicant receiving an ALC C3 on 21 May 14.  On 25 Mar 16, the applicant’s case was reviewed by AFRC/SGO for renewal and she was continued in ALC C3 status.

The C3 is the most restrictive of the ALCs.  Per AFI 41-210, paragraph 4.76.2.1.3., member should not be deployed or assigned away from specialty medical capability required to manage their unique medical condition.  In addition, AFI 41-210, paragraph 4.75.5., also notes Reserve Component ALCs are assigned by the applicable ARC/SGP “who will provide profiling instructions and other guidance on AF Form 422 completion.”  As such, AFRC/SGO restricts all members on a C3 to Unit Training Assemblies (UTA) and Annual Tour (AT) at home station.  Any duties outside of these established parameters require approval by AFRC/SGO.  There is a well-defined process by which a waiver to perform duty outside the restrictions of the C3 may be requested.  Multiple requests have been received and adjudicated by AFRC/SGO for the applicant. On 12 Aug 16, her request to attend technical school was approved; however, all other requests have thus far been denied.

The applicant withheld information about the diagnosis for several years, and clearly knows it is in her self-interest regarding her military career to negate or minimize her prior history as well as to underreport recent or current symptoms.  Bipolar Disorder is still an active diagnosis on her problem list in the Joint Legacy Viewer, both as Department of Defense and Veterans Affairs (VA) diagnoses, and the applicant still has a 30 percent VA disability rating.

A complete copy of the AFRC/SGO evaluation is at Exhibit C.

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

The applicant provided additional information disputing the diagnosis of Bipolar Disorder.  She additionally disputes comments regarding her withholding medical information, and stated she provided copies of her medical records after the originals were lost.  Finally, the applicant presents it is less realistic that she was able to hide a debilitating disorder than the symptoms being related to her struggle with alcoholism.

A complete copy of the Applicant’s Rebuttal is at Exhibit E.

AIR FORCE EVALUATION:

BCMR Medical Advisor recommends denial, indicating there is no evidence of error or injustice.

The Medical Advisor refers to Air Force Instruction 41-210, TRICARE Operations and Patient Administration, in support of his recommendation to deny the applicant’s request to overturn the issued ALC code, and suggests consideration to overturn requires the opinion of a Mental Health Consultant.

Addressing the applicant’s contention that her diagnosis of Bipolar Disorder was an error and the symptoms the result of alcohol habituation, the Medical Advisor acknowledges error or change in diagnosis may occur.  Additionally, diagnostic opinions may vary among providers given the same information during the same period of time.  Further, a change in diagnosis may occur following a greater period of observation; individuals may experience symptoms that are shared by more than one clinical diagnosis; and two or more mental disorders may co-exist concurrently.  Therefore, the Medical Advisor opines the fact that a different diagnostic conclusion has been reached, while compelling, is insufficient to invalidate the initial evaluation and treatment.

A complete copy of the BCMR Medical Advisor evaluation is at Exhibit F.

AIR FORCE EVALUATION:

BCMR Mental Health Advisor recommends denial, indicating there is no evidence of error or injustice.

Whether the cause of the applicant’s mood disorder was caused by Bipolar Disorder or alcohol use is moot.  She is currently serving in the military with a condition that would have disqualified her from re-entering or further serving in the military service.  To attenuate the risk, the applicant was assigned an ALC-C3 which limits her travel where there are facilities available to treat her should she decompensate.  This was, and continues, a reasonable decision to the problem.

A complete copy of the BCMR Mental Health Advisor evaluation is at Exhibit G.

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

In response to the BCMR Medical Advisor’s evaluation, the applicant provides the following:

The applicant holds her contention the diagnosis of Bipolar Disorder is inaccurate.  She corrects the advisory in stating she did not re-enter military service as she had no break in service and the Formal Physical Evaluation Board determined she was fit for duty.

In support of her contention, the applicant provides information from the Diagnostic and Statistical Manual of Mental Disorders V, as well as several other medical references, and points out her successful performance of her duties disputes the criteria found in these references.  Instead she refers back to her substance abuse diagnosis, and the symptoms of which have been resolved during her abstinence and not persisted.

Finally, the applicant refers to the preponderance of evidence standard for the Board and asks if it is more likely than not that she concealed a debilitating disease while maintaining a successful career, marriage, and social relationships or that she was misdiagnosed.

A complete copy of the applicant’s rebuttal is at Exhibit I.

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

In response to the BCMR Medical Advisor and Mental Health Advisor evaluations, the applicant provides the following:   

The applicant reiterated she self-identified and sought treatment for alcohol use and, since receiving treatment, has performed successfully in her career.  She also emphasized she did not have a break in service when transferring to the Air Force Reserve, and did not conceal information regarding her condition.  Additionally, the applicant stated AFRC/SG misused their discretion regarding disapproval of waivers to her ALC-C3 restriction by being more prohibitive than the Air Force Instruction.  Finally, the Formal Physical Evaluation Board found her “fit for duty” with AFRC/SG left to determine deployability.  Per the applicant, AFRC/SG made clear they would not change her ALC-C3 code unless directed by a higher authority.

A complete copy of the applicant’s rebuttal is at Exhibit K.

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.  We took notice of the applicant’s complete submission in judging the merits of the case; however, we agree with the opinion and recommendation of the BCMR Medical Consultant and the BCMR Mental Health Advisor and adopt their rationale as the basis for our conclusion the applicant has not been the victim of an error or injustice.  While responses to the BCMR Medical and BCMR Mental Health Advisor evaluations are noted, she has not provided substantial evidence which, in our opinion, successfully refutes the assessment of her case by the aforementioned evaluations.  Therefore, in the absence of evidence to the contrary, we find no basis to recommend granting the requested relief.

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 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-2016-02604 in Executive Session on 20 Mar 18 and 16 Aug 18 under the provisions of AFI 36-2603:

	, Panel Chair
	, Member
	, Member

The following documentary evidence pertaining to AFBCMR Docket Number BC-2016-02604 was considered:

	Exhibit A.  DD Form 149, dated 22 Jun 16, w/atchs.
	Exhibit B.  Excerpt from Personnel Records.
	Exhibit C.  Memorandum, AFRC/SGO, dated 8 Jan 18.
	Exhibit D.  Letter, SAF/MRBC, dated 24 Jan 18, w/atch.
	Exhibit E.  Letter, Applicant Rebuttal, dated 20 Mar 18,
w/atchs.
	Exhibit F.  Memorandum, BCMR Medical Advisor, dated 9 May 18.
	Exhibit G.  Memorandum, BCMR Mental Health Advisor, dated
14 May 18.
	Exhibit H.  Letter, SAF/MRBC, dated 11 Jun 18.
	Exhibit I.  Letter, Applicant Rebuttal, dated 28 Jun 18,
w/atchs.
	Exhibit J.  Letter, SAF/MRBC, dated 18 Jul 18.
	Exhibit K.  Letter, Applicant Rebuttal, dated 3 Aug 18.

Pursuant to paragraph 1 of AFI 36-2603 (Title 32 Code of Federal Regulations, Part 865.1), it is certified a quorum was present at the Board's review and deliberations regarding AFBCMR Docket Number BC-2016-02604, and the foregoing is a true and complete record of the Board's proceedings in the above entitled matter.