RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2008-00598 INDEX CODE: 108.04 COUNSEL: NONE HEARING DESIRED: YES ________________________________________________________________ _ APPLICANT REQUESTS THAT: She be granted a full medical retirement. ________________________________________________________________ _ APPLICANT CONTENDS THAT: She did not receive a final medical examination prior to her discharge. She continues to have medical issues that include partial facial paralysis, chronic neurological and heart issues. While she was on active duty she was diagnosed with a life threatening neurological condition. In support of her request, applicant provided a Narrative Summary (Clinical Resume), documentation extracted from her medical records, a Department of Veterans Affairs (DVA) decision dated 12 September 2005, a Secretary of Defense memorandum dated 26 June 2008, and a Neurology Medical Evaluation Board (MEB) Consultation dated 29 September 2004. Her complete submission, with attachments, is at Exhibit A. ________________________________________________________________ _ STATEMENT OF FACTS: Applicant was voluntarily discharged from the Regular Air Force on 31 July 2005, at the expiration of her term of service after serving on active duty for 14 years, 7 months and 25 days, in the grade of staff sergeant (E-5). ________________________________________________________________ _ AIR FORCE EVALUATION: The BCMR Medical Consultant recommends denial. The Medical Consultant states that on or about 7 June 2005, the applicant submitted a request for a pre-discharge compensation and pension examination. She listed medical conditions for which she sought service connected disability ratings through the Department of Veterans Affairs (DVA). The Medical Consultant is of the opinion that, noting the applicant’s retention was largely affected only by her facial muscle weakness; her disability rating would not have reached the threshold to qualify her for the medical retirement she desires. Additionally, although the DVA granted the applicant disability compensation for a number of unrelated medical conditions, in addition to her reported lower extremity symptoms, based upon the applicant’s demonstrated functionality, it is unlikely that her lower extremity function would have been found separately unfitting nor would it have been included in the final disability rating computation. The Medical Consultant noted that the disability rating criteria for the applicant’s residual incomplete severe paralysis of the facial muscle would have likely received a discharge with severance pay with a 20% disability rating. Medical Consultant’s evaluation is at Exhibit C. ________________________________________________________________ _ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: Applicant provides a personal letter which captures her rationale for requesting a full medical retirement after serving over 14 years in the Regular Air Force. She reviewed the BCMR Medical Consultant's response and states that she continues to suffer from the effects of Guillain-Barre Syndrome (GBS) and that the symptoms never completely resolved. She has enclosed a photograph of her before and after GBS which reflects the damage caused by the disease. She contends that not all of her medical issues have been addressed by the Medical Consultant. She met all the criteria for GBS except for finding Cerebrospinal Fluid (CSF). Her case did not meet the Military Evaluation Board (MEB) due to her Neurologist wanting to give her time to recover under the assistance of the Air Force medical system. She contends that her doctor did not recommend her for the MEB because he felt she would be left with little access to medical care; ultimately leaving her with inadequate medical treatment. She was concerned about a heart problem, continuing muscle spasms, and neurological pain which are documented in her medical records. Four days into her diagnosis, she had heart palpitations which were never identified or adequately treated while on active duty. She visited the DVA and was diagnosed and then placed on heart medication to control her heartbeat. The Medical Consultant evaluation states that a person retained with a 4P designation after a 12 month period would ordinarily generate an MEB. The applicant wants to know why she did not meet the MEB as she was placed on a continuous profile from initial diagnosis of the GBS in 2001. A new temporary profile was accomplished by the profile officer on 10 March 2005 and expired on 1 May 2005. She states that the reason she did not get a medical and dental examination prior to her separation is because she was tired of trying to get the medical help that she needed. In support of her submission, the applicant provided a personal statement dated 10 August 2008, three pages of medical reports, one photograph undated and one photograph dated 13 August 2008, and an article on GBS. Her 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. Sufficient relevant evidence has been presented to demonstrate the existence of an error or injustice warranting a measure of relief. Applicant requests that her records be corrected to show that she was medically retired from the Air Force citing numerous medical conditions that existed at the time of her voluntary separation and the continuing symptoms she experiences. As noted by the BCMR Medical Consultant, the applicant was referred to MEBs because of her partial facial paralysis, but was returned to duty. After our review of the evidence of record along with the applicant's submission, we believe reasonable doubt has been established as to whether or not her partial facial paralysis received appropriate consideration during her MEB processing. Noting her attending neurologist's recommendation that she be medically separated from the Air Force and the BCMR Medical Consultant's determination that her condition would have warranted a maximum 20 percent disability rating for incomplete paralysis, we believe that benefit of doubt in this matter should be resolved in her favor. Finding no evidence that her remaining conditions met the criteria for a determination of unfitness warranting consideration by the disability evaluation system, we recommend her records be corrected only to the extent 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 issue 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 XXXXXXXXXX be corrected to show that: a. On 30 July 2005, she was found unfit to perform the duties of her office, rank, grade, or rating by reason of physical disability, incurred while she was entitled to receive basic pay; that diagnosis in her case was partial facial paralysis VASRD code 8207, rated at 20%; that the compensable percentage was 20%; that the degree of impairment was permanent; that the neglect; that the disability was not incurred during a period of unauthorized absence; and that the disability was received in the line of duty, but not as a direct result of armed conflict or caused by an instrumentality of war. b. On 31 July 2005, she was not discharged for unsuitability, but on that date she was honorably discharged by reason of physical disability, with entitlement to disability severance pay. ________________________________________________________________ _ The following members of the Board considered AFBCMR Docket Number BC-2008-00598 in Executive Session on 28 August 2008, under the provisions of AFI 36-2603: XXXXXXXXXXXXXXX Panel Chair XXXXXXXXXXXXXXX Member XXXXXXXXXXXXXXXX Member By a unanimous vote, the Board voted to grant the request. The following documentary evidence was considered: Exhibit A. DD Form 149, dated 3 March 2008, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, BCMR Medical Consultant, dated 9 July 2008. Exhibit D. Letter, SAF/MRBR, dated 18 July 2008. Exhibit E. Letter, Applicant, 10 August 2008, w/atchs.