RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2014-02275 COUNSEL: NONE HEARING DESIRED: NO APPLICANT REQUESTS THAT: Her diagnosis of Multiple Sclerosis (MS) be found in the Line of Duty (LOD). APPLICANT CONTENDS THAT: In October 2013, she was diagnosed with MS. She immediately submitted a LOD determination and it was denied. The Informal LOD reflects “Member’s current diagnosis is MS, genetic disorder, obviously present until manifestation. Not related to or exacerbated by recent sustainment training. Not consistent with LOD, member should undergo World Wide Duty (WWD) evaluation.” The LOD determination is in error because MS is not a genetic disease and she did not experience any signs or symptoms before March 2013 to justify the conclusion. The treating neurologist noted her symptoms began in March 2013 before her 3 June 2013 orders. The congressional inquiry is also in error simply because she was on active duty at the time. She left for Basic Military Training (BMT) on 15 January 2013, returned home on 1 May 2013 and took her mandatory leave until 11 May 2013. She then completed her Seasoning Training Program (STP) on 3 June 2013. In support of her request, the applicant provides copies of AFRC IMT 348, Informal Line of Duty Determination, dated 23 October 2013; letters from two neurologists, SAF/LL letter dated 20 February 2014, Memorandum for Record (MFR, dated 2 November 2013, AF Forms 938, Request and Authorization for Active Duty Training/Active Duty Tour and various other documents associated with her request. The applicant’s complete submission, with attachments, is at Exhibit A. ? STATEMENT OF FACTS: The applicant is currently in the Air Force Reserve in the grade of Senior Airman (SrA, E-4). The Military Personnel Data System (MILPDS) reflects an Assignment Limitation Code (ALC) of “37” which denotes “Pending Medical Evaluation Board (MEB) or WWD.” According to the applicant’s DD Form 214, Certificate of Release or Discharge from Active Duty, on 15 January 2013, she entered the Air Force and on 11 May 2013, she was discharged with a narrative reason for separation of “Completion of Initial Active Duty Training.” According to a subsequent DD Form 214, she served another period of active duty from 3 June 2013 to 24 March 2014 and was released from active duty with a narrative reason for separation of “Completion of Required Active Duty Training.” According to the AF Form 348 dated 23 October 2013, the applicant was diagnosed with MS and it was determined that it Existed Prior to Service (EPTS) and an LOD was not applicable. AIR FORCE EVALUATION: AFRC/SGP recommends denial. It is likely the applicant would have developed MS regardless of her order status. There is nothing in her exceptionally limited military service history to suggest otherwise, and there is no relationship to her training and diagnosis. It is all a matter of timing. In this regard, the not in the LOD finding makes absolute sense. One could conceivably argue she “developed” MS on the weekend breaks in the initial orders period as easily as one could reasonably argue she got it on the first day of her orders. From a medical perspective, AFRC/SGP agrees the diagnosis should not be found in the LOD. Medical documents show that she was seen in the Portland, Oregon emergency department on 9 October 2013 with complaints of three weeks of visual changes. She reported episodic numbness in March and August 2013. The pathogenesis of MS is much debated in medical literature. It is thought to involve the immune system and there are multiple theories about triggering events. There are also noted environmental factors, and it is likely this is a multifactorial disease process. A complete copy of the AFRC/SGP evaluation is at Exhibit C. The BCMR Medical Consultant concurs with the recommendation of AFRC/SGP to deny the applicant’s request. The Medical Consultant acknowledges and agrees with the opinions rendered by two neurologists, who established that the applicant’s medical condition was not of a genetic origin and that she was serving on active duty when symptoms were first reported. However, in view of the recognized relapsing and remitting nature of this chronic disorder, the Medical Consultant opines the actual pathological process that resulted in her symptoms in March 2013, two months after her entry to a period of active service, is at least likely as not EPTS. AFRC/SGP did not recommend a change in the EPTS LOD not applicable finding. In Accordance With (IAW) DODI 1332.18 Disability Evaluation System, the Secretaries of the Military Departments will presume that diseases or injuries incurred by Service members on continuous orders to active duty specifying a period of more than 30 days were incurred or aggravated in the LOD unless the disease or injury was noted at time of entry into service. The Secretaries of the Military Departments may overcome the presumption that a disease or injury was incurred or aggravated in the LOD only when clear and unmistakable evidence indicates the disease or injury existed prior to their current period of military service and was not aggravated by their current period of military service. Clear and unmistakable evidence is defined in the instruction as undebatable information that the condition EPTS or if increased in service was not aggravated by military service. In other words, reasonable minds could only conclude that the condition EPTS from a review of all the evidence in the record. A complete copy of the BCMR Medical Consultant’s evaluation is at Exhibit D. APPLICANT'S REVIEW OF AIR FORCE EVALUATION: Copies of the Air Force evaluations were forwarded to the applicant on 17 September 2015 for review and comment within 30 days (Exhibit E). As of this date, no response has been received by this office. 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 in judging the merits of the case; however, we agree with the opinions and recommendations of the Air Force offices of primary responsibility and adopt the rationale expressed as the basis for our conclusion the applicant has failed to sustained her burden of proof that she has been the victim of an error or injustice. 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-2014-02275 in Executive Session on 29 October 2015 under the provisions of AFI 36-2603: , Panel Chair , Member , Member The following documentary evidence was considered: Exhibit A. DD Form 149, dated 3 June 2014, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Memorandum, AFPC/SGP, dated 3 July 2014. Exhibit D. Memorandum, BCMR Medical Consultant, dated 14 September 2015. Exhibit E. Letter, SAF/MRBR, dated 17 September 2015.