RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2013-00397 COUNSEL: NONE HEARING DESIRED: YES ________________________________________________________________ _ APPLICANT REQUESTS THAT: Her Line of Duty (LOD) Determination documents be placed in her medical records in order for the Medical Evaluation Board (MEB) process to continue. ________________________________________________________________ _ APPLICANT CONTENDS THAT: 1. She was diagnosed with a number of medical conditions while on active duty orders when her medical conditions occurred (2008-2010). In accordance with the governing instructions, LOD actions should have been initiated by the medical facility; however, the medical documentation was never placed in her medical records. Therefore, the MEB process was terminated. 2. She was placed on a world-wide mobility restriction without any work related restrictions. Since she was on a profile for 12 months, her medical code changed from “31” (injury/illness resolved within 31-365 days) to “37” (medical condition requires MEB processing). MEB actions were initiated and she met with the counselor to receive her Disability Evaluation System (DES) counseling. Later, she was informed by her base medical group that the MEB process could not be completed because LOD actions were never initiated for any of her disqualifying conditions. 3. In lieu of the MEB process continuing, a Worldwide Duty (WWD) evaluation was initiated, which confirmed the medical conditions that were identified in the Narrative Summary, see Exhibit A, Attachment 3. The WWD evaluation disqualified her for continued military service under AFI 48-123, Medical Evaluations and Standards, and stated that she required processing through the DES. However, her Medical Evaluation Report returned her to duty with the restriction that she could only perform Unit Training Assemblies (UTAs), ATs, and IDTs; however, because she is a Category E reservist she is only authorized to receive pay and points through MPA orders. 4. From June 2007 through June 2012, she averaged 224 days per year in man-days, IDTs, UTAs, and ATs. Her current WWD restriction does not allow her to work any paid days, but yet documentation has returned her to duty with an Assignment Limitation Code (ALC) of “C3”. In support of her request, the applicant provides a copy her AF Form 469, Duty Limiting Condition Report, a copy of her Joint DoD/VA Disability Evaluation Pilot Referral, a memorandum from the 15th Medical Group, a copy of a memorandum from RMG/CC, and a copy of her Points History. Her complete submission, with attachments, is at Exhibit A. ________________________________________________________________ _ STATEMENT OF FACTS: The applicant retired from the Air Force Reserve in the grade of colonel 20 Jun 13. 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 Exhibit C and F. ________________________________________________________________ _ AIR FORCE EVALUATION: AFRC/SG recommends denial stating that regardless of a finding of In the Line of Duty (ILOD) for any of the applicant’s medical conditions, she was found fit and returned to duty. All available documentation reveals that this was a correct medical finding and was consistent with all other similar cases. Further board action or disability processing is not authorized as she has been properly returned to duty. None of the applicant’s medical conditions would have precluded her from performing her duties. In fact, in her own statement, she clearly demonstrates that she does not overcome the presumption of fitness in that she performed numerous in- garrison duties at the Pentagon through much of 2012. A full MEB should not be performed. Her duties as a staff officer would not be negatively impacted by her diabetes, sleep apnea or chronic orthopedic problems that interfered with her ability to perform the fitness assessment. Nevertheless, the applicant’s medical conditions did not interfere with recreational activities as indicated in her medical records, nor her ability to perform her duties as a staff officer, demonstrated by her statement in the petition to the Board. The applicant correctly identifies that she was returned to duty with an ALC C-3 by AFRC/SGP on 14 Aug 12. The ALC code was put into place to protect her from further degradation of her chronic orthopedic problems by inadvertent mobility or deployment. With regard to the applicant’s request to initiate a LOD determination, it is still unclear how her conditions are duty related. Further, it is unclear from the attached documents as to what influence her duties in the Air Force either caused or permanently worsened these conditions beyond their natural progression of the disease process to find any of them ILOD. Finally, the applicant was appropriately returned to duty and should follow the instructions given to her by RMG/IRMS concerning possible LOD inquiry. No injustice has occurred and no relief should be offered. The complete AFRC/SG evaluation is at Exhibit C. ________________________________________________________________ _ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: She provides clarification and a rebuttal to the AFRC/SG advisory opinion stating that due to a year-long profile for her knee problems, the MEB was initiated by her PCM, not her. The RMG/SG performed a Worldwide Duty Evaluation, which instructed her to initiate a LOD “if you believe the onset of your condition occurred during a period of military service, or was aggravated by military service.” All of her conditions were verified by AFRC/SG as occurring while on extended active duty from 2008 through 2010. Her request with the BCMR is to initiate the LOD paperwork IAW the governing instructions, given that all conditions will require continuous medical care. Consequently, formal or informal LOD actions should have been initiated. The applicant’s complete submission is at Exhibit E. ________________________________________________________________ _ ADDITIONAL AIR FORCE EVALUATION: 1. The BCMR Medical Consultant recommends denial stating a medical condition that is “disqualifying” for continued military service and which either results in a Medical Evaluation Board or a WWDE, is not automatically determinative that the condition is [will or should be] also found “unfitting” for continued military service by a Physical Evaluation Board (PEB); and is also based upon a demonstrated ability to perform the duties of the individual’s office, grade, rank, and rating. In this case, the applicant’s performance reports and her physician’s assessment likely resulted in the decision to return her to duty “fit” by a PEB with issuance of an ALC. The applicant submitted a participation waiver; however, it was disapproved. It is likely the applicant was confronted with the choice of an involuntary separation due to medical disqualification or a length of service retirement for which she was eligible to receive. 2. The applicant accurately states that she was not able to participate due to her status in the Reserve because the Readiness Management Group Individual Reserve Guide states, “IMAs participation for pay and points while PIRR participate in IDT and AT for points only or may earn pay and points for performing MPA tours (RPA tours not allowed for PIRR).” Title 10 U.S.C., Section 1214a, is intended to remedy situations when a Reservist is returned to duty fit by a PEB, but later subject to administrative discharge for the same condition for which they were found fit. Such redress would result, at best, in a relook of the applicant’s fitness by a PEB and a new finding of “unfit” for conditions not eligible for processing as compensable through the military Disability Evaluation System (DES); even if the later found the condition was service incurred by the Department of Veterans Affairs (DVA). 3. The applicant has not supplied medical evidence to support her claim. Had she submitted medical documentation, there could have been an independent analysis to find out the relationship between her medical conditions with her military service. In addition, there is no evidence indicating she was treated for either of the conditions presented or that either condition interfered with her military service at the time of the alleged diagnosis that would indicate that an LOD Determination was erroneously not completed during a previous period of service. Further, even if the applicant’s medical conditions were determined service-incurred, this fact would not be determinative of the LOD status during a subsequent period of service. According to the governing Department of Defense instructions, “Any medical condition incurred or aggravated during one period active service or authorized training in any of the Armed Forces that recurs, is aggravated, or otherwise causes the member to be unfit, should be considered incurred in the line of duty, provided the origin of such impairment or its current state is not due to the member’s misconduct or willful negligence, or progresses to unfitness as a result of interning events when the member was not in a duty status.” The applicant has not provided any documentation that indicates her medical conditions progressed to unfitness while serving in a duty status. 4. The Medical Consultant acknowledges the applicant’s implicit desire to have her medical conditions found ILOD and to proceed with an MEB; however, a preponderance of the evidence shows that this would not have been the case, even if her conditions were found ILOD. 5. Although the applicant’s point credit summary indicates that she may have collectively completed 8 years of active service, which would otherwise qualify her for DES processing under 10 U.S.C., 1207a, even if her conditions existed prior to service, it appears that she was not serving a requisite period of active service [31 days or more entitled to basic pay] at the time her medical conditions became disqualifying [or unfitting] for application of this provision of the law; particularly in the context that she was found “fit” and returned to duty. 6. Finally, it is noted that the DVA operating under Title 38 U.S.C., may independently establish service connection for her medical conditions based upon a prior period of service [if properly documented], but without regard to her fitness to serve, eligibility for a MEB processing, duty-status at the time of medical disqualification, or the reason for her release from military service. The BCMR Medical Consultant complete evaluation is at Exhibit F. ________________________________________________________________ _ APPLICANT'S REVIEW OF ADDITIONAL AIR FORCE EVALUATION: A copy of the BCMR Medical Consultant evaluation was forwarded to the applicant on 16 Dec 13 for review and comment within 30 days. As of this date, this office has received no response. ________________________________________________________________ _ 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. After a thorough review of the evidence of record and the applicant’s submission, we find no evidence of an error in this case and we are not persuaded by her assertions, that she has been the victim of an injustice. Neither does the record reveal nor has the applicant provided evidence that would lead us to believe her medical conditions should have been processed through the Disability Evaluation System. Therefore, we agree with the assessment of the Air Force Reserve Command Surgeon and the BCMR Medical Consultant and adopt their rationale expressed as the basis for our decision that the applicant has failed to sustain her burden that she has suffered either an error or an injustice. Therefore, we find no basis to recommend granting the relief sought. 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 AFBCMR Docket Number BC-2013-00397 in Executive Session on 24 Sep 13 and 17 Jan 14, under the provisions of AFI 36-2603: , Panel Chair , Member , Member The following documentary evidence was considered: Exhibit A. DD Form 149, dated 18 Jan 13, w/atchs. Exhibit C. Letter, AFRC/SG, dated 28 Feb 13. Exhibit D. Letter, SAF/MRBR, dated 8 Mar 13. Exhibit E. Letter, Applicant, dated 22 Mar 13. Exhibit F. Letter, BCMR Medical Consultant, dated 25 Nov 13. Exhibit G. Letter, SAF/MRBC, dated 16 Dec 13. 8 9