RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2013-02395 COUNSEL: NONE HEARING DESIRED: NO ________________________________________________________________ APPLICANT REQUESTS THAT: His Honorable discharge be changed to a medical retirement. ________________________________________________________________ APPLICANT CONTENDS THAT: He had an undiagnosed medical condition prior to his separation which was the cause of his discharge. His initial Department of Veterans Affairs (DVA) medical appointment in Feb 13 identified the fact that he is diabetic. His primary care physician was extremely surprised he had never been told he was diabetic because his blood sugar level was twice the limit for someone without diabetes. This should have been diagnosed prior to his separation. The applicant’s complete submission, with attachment, is at Exhibit A. _________________ ______________________________________________ STATEMENT OF FACTS: The applicant initially entered the Regular Air Force on 18 Oct 95. On 4 Aug 10, 17 Nov 10, and 24 May 11, 2 Nov 11, and 6 Apr 12, the applicant failed consecutive Fitness Assessments (FA) with scores of 38.5, 54.3, 68.6, 59.3, and 72.75, respectively. On 14 Oct 11, his commander notified him he was recommending he be discharged with an Honorable characterization of service for failure to meet minimum fitness standards. The applicant requested a hearing before an administrative discharge board (ADB). On 25 Oct 11, the applicant’s commander recommended his discharge without probation or rehabilitation. On 7 Nov 11, an ADB recommended and the discharge authority directed he be administratively discharged and denied lengthy service probation. On 5 Jun 12, the Secretary of the Air Force Personnel Council (PERSCOUNCIL), acting on behalf of the Secretary of the Air Force, directed the applicant be administratively discharged, and denied lengthy service probation. On 15 Jun 12, the applicant was discharged with Honorable character of service, a narrative reason for discharge of “Physical Standards,” a reentry (RE) code of 2C, and was credited with 16 years, 7 months, and 28 days of active service. The remaining relevant facts pertaining to this application are described in the letters prepared by the Air Force offices of primary responsibility (OPR) which are included at Exhibits C and E. ________________________________________________________________ AIR FORCE EVALUATION: AFPC/DPSOR recommends denial, indicating there is no evidence of an error or injustice. In accordance with (IAW) AFI 26-3208, Administrative Separation of Airmen, Airmen who fail to meet minimum standards for fitness for reasons not amounting to disabilities may be discharged. At the applicant’s Wing, commanders were instructed to make a discharge or retention recommendation to the Wing Commander when an individual received four unsatisfactory FA scores in a 24-month period. The applicant not only failed four FAs in a 24-month period, he consistently failed to meet minimum fitness standards since 2004. Thus, his discharge was warranted, consistent with the procedural and substantive requirements of the discharge instruction, and within the discretion of the discharge authority. A complete copy of the AFPC/DPSOR evaluation is at Exhibit C. ________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: A copy of the AFPC/DPSOR evaluation was forwarded to the applicant on 26 Aug 13 for review and comment within 30 days (Exhibit D). ________________________________________________________________ ADDITIONAL AIR FORCE EVALUATION: The AFBCMR Medical Consultant recommends the applicant be granted a medical separation with severance pay set at a 20 percent disability rating. The applicant was seen by the Department of Veteran’s Affairs (DVA) and diagnosed with Diabetes Mellitus (DM) [high blood sugar], presumably not insulin-dependent, and this was diagnosed shortly after discharge. The applicant clearly exceeds the American Medical Association (AMA) recommended weigh goals, by virtue of his body mass index (BMI) over 29. Obesity is a leading cause of non-insulin dependent DM. The Medical Consultant opines that if the applicant did have undiscovered DM it would not have caused the applicant’s excessive abdominal circumference (AC) but rather the excessive AC would have been the result of his excess weight. The applicant’s post discharge diagnosis of DM had no cause or effect on the applicant’s fitness failures, and furthermore his DM would not have been found unfitting for continued military service. However, the applicant has had issues with his knees. Although he clearly denied any issues on his Physical Health Assessment (PHA), his medical records note “knee pain for 3x years.” The applicant may well have benefitted by the review of a Medical Evaluation Board (MEB), and the MEB would likely have found him unfit for duty. Therefore, recommend the applicant’s discharge be changed to a medical separation and the applicant be granted separation and severance pay at 20 percent disability rating for knee pain. A complete copy of the AFBCMR Medical Consultant’s evaluation is at Exhibit E. ________________________________________________________________ APPLICANT'S REVIEW OF THE ADDITIONAL AIR FORCE EVALUATION: A copy of the AFBCMR Medical Consultant evaluation was forwarded to the applicant on 20 Aug 13 for review and comment within 30 days. In response the applicant asks the Board members to disregard the statement in the AFBCMR Medical Consultant’s evaluation that says “Obesity is a leading cause of non-insulin dependent diabetes mellitus, the preponderance of clinical evidence validates that as BMI increases, blood sugar also increases,” and submits a progress note from his medical records, dated 20 Aug 13, which states “patient is taking human insulin glargine inj since 25 Feb 13 to control his diabetes” (Exhibit G). ________________________________________________________________ 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, to include his rebuttal response to the advisory opinion, in judging the merits of the case. The Board agrees with the BCMR Medical Consultant’s opinion and recommendation to deny the applicant’s request to change his separation to a medical retirement based upon his being diagnosed with diabetes mellitus after his separation from the Air Force, and we adopt the Medical Consultant’s rationale as the basis for our conclusion the applicant has not been the victim of an error or injustice in this regard. Moreover, while the Board notes the BCMR Medical Consultant’s recommendation to correct the applicant’s records to reflect that he was furnished a disability discharge with a disability rating of 20 percent due to his knee pain, we are not convinced by the evidence provided or included in the records before us that the knee pain the applicant experienced was the cause of his multiple fitness assessment failures or that it should have served as a basis for a disability separation. In this respect, we note that AFI 36-2905, Fitness, requires a commander to have a member’s medical records reviewed prior to recommending discharge to rule out a causal relationship between a potential medical condition and a member’s FA failures. After a thorough review of the evidence of record, there is no evidence that the applicant was not afforded said review while the commander was contemplating this action. Furthermore, we note that the applicant’s discharge was subject to review by an administrative discharge board where he could have presented evidence that his knee pain precluded him from attaining a passing FA score, or should somehow form the basis of a disability separation in lieu of an administrative separation. Therefore, in the absence of evidence to the contrary, we find no basis to recommend granting the requested relief. ________________________________________________________________ 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-2013-02395 in Executive Session on 18 Mar 14, under the provisions of AFI 36-2603: Panel Chair Member Member The following documentary evidence pertaining to AFBCMR Docket Number BC-2013-02395 was considered: Exhibit A.  DD Form 149, dated 13 May 13, w/atch. Exhibit B.  Applicant's Master Personnel Records. Exhibit C.  Letter, AFPC/DPSOR, dated 24 Jul 13. Exhibit D.  Letter, SAF/MRBR, dated 26 Aug 13. Exhibit E.  Letter, AFBCMR Medical Consultant, dated 19 Aug 13. Exhibit F.  Letter, SAF/MRBC, dated 20 Aug 13. Exhibit G.  Letter, Applicant, dated 26 Aug 13, w/atch. Panel Chair 1