RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2011-03294 COUNSEL: NONE HEARING DESIRED: YES ________________________________________________________________ APPLICANT REQUESTS THAT: His medical records be processed for medical disability by a Medical Evaluation Board (MEB). ________________________________________________________________ APPLICANT CONTENDS THAT: He should have been processed as medically disabled in 1996 versus simply retired to allow his family the appropriate benefits. No MEB was conducted and his paperwork was initiated the same day as his surgery. The Veterans Affairs (VA) office continues to omit any review of his active duty medical records and rely solely on their single opinion from their gastroenterologist. Previous symptoms/attacks of his pancreatic and his lifelong Protein S deficiency was unknown prior to his entry to service and was aggravated by his service. These conditions were never considered during his retirement processing or during his VA claim. In support of his appeal, the applicant provides his congressional inquiry, copies of his DVA medical records, excerpts from his master personnel records and other supporting documentation. The applicant’s complete submission, with attachments, is at Exhibit A. ________________________________________________________________ STATEMENT OF FACTS: The applicant enlisted in the Air Force Reserve on 13 January 1977. He received his commission on 9 December 1992. On 27 February 1996, he was medically disqualified for military duty due to Persistent Tracheotomy, Pancreatitis, Myocardial Infarction and amputation of all digits of the right hand. He was placed on the USAF Reserve Retired List effective 12 March 1996. The remaining relevant facts pertaining to this application are contained in the letter prepared by the appropriate office of the Air Force which is at Exhibits B. ________________________________________________________________ AIR FORCE EVALUATION: The BCMR Medical Consultant recommends denial. The applicant previously asserted that his pancreatitis was the result of his elevated lipids profile dating back to a period in which he was characterized as active duty. He now concedes that Sphincter of Oddi dysfunction contributed to or caused his pancreatitis. The Medical Consultant adopts the analysis of the DVA gastroenterologist who opined that the applicant’s recurrent bouts of pancreatitis were due to Oddi dysfunction and that hyperlipidemia did not play a role in the applicant’s pancreatic disease. The existence of hyperlipidemia, a non-ratable and non-compensable risk factor for coronary artery disease does not alone infer or justify service connection for the subsequent myocardial infarction. There is also no basis in science or evidence of record to establish service aggravation of the applicant’s Protein S. deficiency, a genetic defect, notwithstanding his self reported environment, physical and mental stressors which he infers aggravated his condition. The tragic loss of the applicant’s fingers of his right hand was likely the collective result of the low blood flow state during resuscitation efforts to treat systemic shock, use of vasopressors, the impeding compartment syndrome of the right hand and his Protein S deficiency. The latter which also predisposed him to clotting further obstructing the vessels supplying the right and that resulting in the ischemic changes in fingers. In order for the applicant to be eligible for MEB processing and referral for a possible medical retirement, aside from first being disqualifying, the medical condition must be, in the case of a reservist found in the line of duty, or if determined to have existed prior to service, must show permanent aggravation by military service. Stated inversely, individuals with a disqualifying medical condition that is not considered duty related or permanently aggravated by military service are only eligible to enter the military Disability Evaluation System for a fitness-only review and not for disability compensation. Based upon the generous supply of administrative documentation supplied by HQ AFRES/SG, the applicant was considered eligible for DES processing as best determined by individuals most familiar with his medical condition and duty status at the time. He was offered transfer to the Retired Reserve. The applicant completed over 8 years of active service, rendering any conditions which existed prior to service eligible for service incurrence, by law, with the caveat that the condition must also have become unfitting or disqualifying during a period of active service. The Medical Consultant reviewed the applicant’s point credit summary and concedes it is difficult to determine which period of eligibility or ineligibility his chronic recurrent pancreatitis or its causes first began. Regardless of when the applicant’s Sphincter of Oddi dysfunction first began, the current evidence suggests that his pancreatitis and certain secondary disabilities became disqualifying while performing a period of non-active service, without sufficient evidence of permanent service aggravation. The Medical Consultant is sensitive to the life-threatening ordeal the applicant has previously experienced and the surgical procedures he has endured. However, when seeking evidence of error or injustice, the applicant has not met the burden of proof of error or injustice that warrants the desired change of the record. The complete BCMR Medical Consultant evaluation is at Exhibit B. ________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: The applicant responded to the BCMR Medical Consultant and asked the Board consider several issues of his complicated case. He addresses the 8 year rule as it applies to his case and suggests it is the reason he filed this request. He also addresses the conditions from which he suffers and explains how this has affected his life. He requests the Board allow an examination of his records by an MEB to make the determination whether or not his medical condition met standards for continued service. The applicant’s complete response, with attachments, is at Exhibit D. ________________________________________________________________ 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 carefully considered the available evidence of record; however, we found no indication the actions taken to affect the applicant’s transfer to the Retired Reserve was improper or contrary to the provisions of the governing instructions. Therefore we agree with the opinion and recommendation of the BCMR Medical Consultant and adopt his rationale as the basis for our conclusion that the applicant has not been the victim of an error or injustice. Although we are sympathetic to the applicant’s situation, we find no basis to recommend granting the relief sought in this application. 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 that the evidence presented did not demonstrate the existence of material error or injustice; that the application was denied without a personal appearance; and that 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 BCMR Docket Number BC-2011-03294 in Executive Session on 17 May 2012, under the provisions of AFI 36-2603: The following documentary evidence was considered: Exhibit A. DD Form 149, dated 9 May 11, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, AFPC/DPSD, dated 10 Jun 11. Exhibit D. Letter, AFPC/DPSOS, dated 11 Jul 11. Exhibit E. Letter, SAF/MRBR, dated 29 Jul 11. Exhibit F. Applicant’s Response, dated 10 Aug 11. Exhibit G. IMA Medical Advisor, dated 18 Oct 11. Exhibit H. Letter, SAF/MRBR, dated 3 Nov 11. Exhibit I. Applicant’s Response, dated 9 Dec 11.