RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2014-01239 COUNSEL: NONE HEARING DESIRED: NO ________________________________________________________________ APPLICANT REQUESTS THAT: Her records be corrected to reflect her medical retirement was due to instrumentality of war or related to war. ________________________________________________________________ APPLICANT CONTENDS THAT: She was permanently medically retired from the military for post-traumatic stress disorder after multiple deployments into a war environment. The applicant’s complete submission, with attachments, is at Exhibit A. ________________________________________________________________ STATEMENT OF FACTS: The applicant is a former member of the Air National Guard who was permanently disability retired in the grade of master sergeant effective 28 September 2013. ________________________________________________________________ AIR FORCE EVALUATION: AFPC/DPFD recommends denial. On 16 July 2013, the Informal Physical Evaluation Board (IPEB) reviewed her medical board for PTSD with anxiety disorder and recommended permanent retirement with a 30% disability rating. The IPEB noted the service member is an aerospace medical service specialist with a history of PTSD related to a 2010 deployment to Afghanistan where she was exposed to mortar attacks. She experienced no physical injuries. However, she reported uncharacteristic rage behavior, flashbacks and anxiety triggers on return; she did not report PTSD until 2011. She was initially diagnosed with anxiety disorder, in part based apparently on both personal and duty- related stress but ultimately both civilian and military psychiatric providers defined chronic Axis I PTSD associated with marked military impairment. Her condition initially appeared unresponsive to several trial of psychotropic medication and psychotherapy and would require indefinite intervention to maintain functioning, particularly if military triggers should continue. Accordingly, the IPEB found her unfit and recommended permanent retirement with a 30% disability rating and deemed it non-combat/fear-easing standard. If the applicant felt her PTSD with anxiety disorder happened in a combat zone, she had two opportunities to appeal and she did not exercise her appeal options. Based on the definition, the facts and circumstances involved, the IPEB noted that her PTSD with anxiety disorder happened in the combat zone, but was not combat related. On 25 July 2013, the applicant concurred with the IPEB findings and her retirement date was established as 28 September 2013. Per AFI 36-3212, section 3.26, attachment 1, states Armed Conflict – Conflict between nations or other contestants entailing the physical destruction, or injury to, one another’s armed forces. Armed Conflict exists if the direct use of physical force endangers the lives or safety of members of the armed services of a nation, belligerent power, coalition or faction. Armed conflict includes war, expedition, occupation of an area or territory, battle, skirmish, raid, invasions, rebellion, insurrection, guerrilla action, riot, or any other action in which Air Force military personnel engage a hostile or belligerent nation, faction or force. It also includes involving a member while interned as a prisoner of war or while detained against his or her will in custody of a hostile or belligerent force or while escaping or attempting to escape from such confinement, POW or detained status. Instrumentality of War – a vehicle, vessel or device designed primarily for Military Service and intended for used in such Service at the time of the occurrence of the injury. It may also be a vehicle, vessel or device subjects the individual to a hazard peculiar to Military Service. This use or occurrence differs from the use or occurrence under similar circumstances in civilian pursuits. There must be a direct causal relationship between the use of the instrumentality of war and the disability and the disability must be incurred incident to a hazard or risk of service. AFI 36-3212, section 3.21.21 states the IPEB will make a combat- related disability determination for: Armed Conflict, Extra Hazardous Service, Conditions Simulating War and Instrumentality of War. The preponderance of the evidence reflects that no error or injustice occurred during the disability process. The complete DPFD evaluation is at Exhibit C. ________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: The applicant finds several discrepancies with the Air Force advisory. The reason for her request does not specifically state knee replacement – yet, to correct the reasons for her forced retirement from the military. The initiating reason for her medical discharge was due to PTSD of such severity that an active duty medical officer told her that not only was she not suited for military service, but that she would need permanent supportive therapy in order for her to function normally. The letter states her condition initially appeared unresponsive and continues to be unresponsive to date. She has tried several medications, psychotherapy and even sought help from a local church. Nothing has helped. In fact, she feels that has time goes by the best thing for her is to spend time alone. The applicant recounts that she was aerospace medical service and assigned to a flying unit. Being a 7-level, her training required her to perform duties akin to an independent medical technician. Among those duties was to treat very traumatic injuries. During her most recent deployment, she was showering at the onset of an attack. She had no weapon at the time. She quickly donned her uniform and protective gear and fell down the two story metal stair case and did incur injuries to her right knee. She jumped up from her fall and did a self-check. She could hear the sound of gunfire very close to her location. She left the cover of her hut and made her way to the clinic in order to obtain a bag of medical supplies. As she did, gun shelling’s fell on top of her and the buildings. After obtaining supplies, she made her way back toward the sound until she was stopped by a military policeman who instructed her to take cover. The attack lasted several hours. There were deaths and other traumatic injuries. A few weeks after that attack she began to notice she did not feel quite right and the inability to sleep began. The further in the deployment the more her commander asked about her. As for having two opportunities to appeal, she was only made aware of one of them. She was told that if she disagreed with the findings, she would have to file a formal appeal by traveling to the medical board. She could not have done that then and still cannot now. There was no explanation of the guidelines and she felt it was best to sign the findings report. She asks that her injuries be considered combat related as if it were not for being physically present more than once in a war environment, she would not have the problems that will forever require her to seek help. The applicant’s complete response 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. Insufficient relevant evidence has been presented to demonstrate the existence of an error or injustice. The applicant's complete submission, to include her rebuttal comments, were thoroughly reviewed. However, we find the evidence submitted is insufficient to determine that she has been the victim of error or injustice. Additionally, evidence has not been submitted which would lead us to believe that the combat related determinations made at the final disposition were improper. Therefore, we agree with the opinion and recommendation of the Air Force office of primary responsibility and adopt its rationale as the basis for our conclusion that the applicant has not been the victim of 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-2014-01239 in Executive Session on 8 January 2015, under the provisions of AFI 36-2603: The following documentary evidence pertaining to AFBCMR Docket Number BC-2014-01239 was considered: Exhibit A. DD Form 149, dated 20 Sep 13, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, AFPC/DPSD, dated 7 May 14. Exhibit D. Letter, SAF/MRBR, dated 20 Sep 14. Exhibit E. Letter, Applicant’s Response, 10 Oct 14.