RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2010-01948 COUNSEL: NONE HEARING DESIRED: NO ________________________________________________________________ THE APPLICANT REQUESTS THAT: His compensable disability rating of “70” percent be increased to “100” percent. ________________________________________________________________ THE APPLICANT CONTENDS THAT: In accordance with the Veterans Affairs Schedule for Rating Disabilities (VASRD), the disability rating for a platelet count of less than 20,000 requiring treatment with medication is 100 percent. On 31 Dec 07, his platelet count was 17,000 and he was started on 60 milligrams of Prednisone per day. His disability rating should have been based on his initial 17,000 platelet count and not what they were after being on the Prednisone. In support of his appeal, the applicant provides extracts from his service medical records, a copy of his retirement order and other supporting documents. The applicant’s complete submission, with attachments, is at Exhibit A. ________________________________________________________________ STATEMENT OF FACTS: Prior to the events under review, the applicant had completed over 11 years of active service. The applicant underwent a Medical Evaluation Board (MEB) and was diagnosed with Idiopathic Thrombocytopenia Purpura (ITP), Asymptomatic, and Polycystic Kidney Disease (PKD), and was subsequently returned to duty. In 2008, another MEB was conducted and his case was referred to an Informal Physical Evaluation Board (IPEB). The IPEB recommended permanent retirement, with a rating of 60 percent for the ITP and 30 percent for the PKD, for a combined rating of 70 percent. The applicant did not concur with the findings of the IPEB and requested his case be reviewed by the Formal PEB (FPEB). The FPEB recommended a compensable disability rating of 70 for the ITP. However, they did not find the PKD unfitting, compensable or ratable. The applicant concurred with the FPEB findings and the Secretary of the Air Force Personnel Council recommended he be permanently retired with a compensable rating of 70 percent. The applicant was relieved from active duty and medically disability retired, on 29 Aug 08, under the provisions of AFI 36-3212, with a compensable disability rating of 70 percent. He was credited with 25 years, 6 months, and 16 days of active service. ________________________________________________________________ THE AIR FORCE EVALUATION: AFPC/DPSD recommends denial. They note the Department of Defense (DoD) and the Department of Veterans Affairs (DVA) disability evaluation system operates under two separate laws. PEBs must determine if a member’s condition renders them unfit for continued military service relating to their office, grade, rank, or rating. The fact that a person may have a medical condition does not mean that the condition is unfitting for continued military service. To be unfitting, the condition must be such that it alone precludes the member from fulfilling their military duties. If the board renders a finding of unfit, the law provides appropriate compensation due to the premature termination of their career. Further, it must be noted the USAF disability boards must rate disabilities based on the member’s condition at the time of evaluation; in essence a snapshot of their condition at that time. It is the charge of the DVA to pick up where the AF must, by law leave off. Under a separate title, the DVA may rate any service-connected condition based upon future employability or reevaluate based on changes in the severity of a condition. This often results in different ratings by the two agencies. The complete AFPC/DPSD evaluation is at Exhibit C. The BCMR Medical Consultant recommends denial. Under the ITP rating criteria for 100 percent an individual must indeed have a platelet count below 20,000. However, in order to earn the 100 percent disability rating the condition must also be manifested through bleeding requiring a blood transfusion. The BCMR Medical Consultant found no evidence that the applicant ever experienced spontaneous bleeding or that he ever required a blood transfusion. Based upon these facts alone, the BCMR Medical Consultant opines that the applicant has not met the burden of proof to justify the requested change of the record. The BCMR Medical Consultant notes the applicant’s frequent fluctuations in platelet count and concedes that placement on the TDRL might have been justified, noting the frequent fluctuations suggests his condition was not stabilized. However, the applicant’s dependable and consistent responses to treatment with Prednisone over a 2 or more year period, a pattern of platelet count and treatment was well established to the extent that warranted a final disposition in the case. With reference to the applicant’s PKD, he reminds the applicant that the Military Disability Evaluation System, operating under Title 10, United States Code (USC), can by law only offer compensation for the illness or injury that is the cause for career termination; and then only to the degree of impairment present at the time of final disposition. There is no evidence that the PKD diagnosis interfered with the applicant’s ability to perform military service and did not contribute to cutting short his military career. The complete BCMR Medical Consultant evaluation, with attachment, is at Exhibit D. ________________________________________________________________ APPLICANT'S REVIEW OF THE AIR FORCE EVALUATION: Copies of the Air Force evaluations were forwarded to the applicant on 16 February 2011 for review and comment within 30 days. The applicant’s case was considered by the Board on 15 March 2011, but held in abeyance pending his response to the evaluation. However, as of this date, no response has been received by this office (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 error or injustice. We took notice of the applicant's complete submission in judging the merits of the case. The applicant requests his disability rating be increased to 100 percent to correspond with the rating he received from the DVA. However, based on a preponderance of the evidence the applicant’s disability rating of 70 percent was properly adjudicated and we find no evidence which would lead us to believe that his disability rating was in error or contrary to the governing Air Force instructions. The applicant’s case has undergone an exhaustive review by the office of primary responsibility and the BCMR Medical Consultant and we did not find the evidence provided sufficient to overcome their assessment of the case. Therefore, we agree with the recommendations and adopt the rationale expressed as the basis for our decision that the applicant has failed to sustain his burden 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-2010-01948 in Executive Session on 15 March 2011, under the provisions of AFI 36-2603: , Panel Chair , Member , Member The following documentary evidence was considered: Exhibit A. DD Form 149, dated 15 May 10, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, AFPC/DPSD, dated 17 Aug 10. Exhibit D. Letter, BCMR Medical Consultant, dated 14 Feb 11. Exhibit E. Letter, SAF/MRBR, dated 16 Feb 11. Panel Chair