RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2014-02724 COUNSEL: NONE HEARING DESIRED: NO APPLICANT REQUESTS THAT: 1. He be placed on Medical Continuation (MEDCON) orders from 1 Sep 12 to present. 2. He receives a DD Form 214, Certificate of Release or Discharge from Active Duty for this period. APPLICANT CONTENDS THAT: He was on Title 10 orders in support of Operation ENDURING FREEDOM (14 Jan -1 Sept 2012) to Afghanistan. He sustained an In the Line of Duty (ILOD) eye injury and should have been placed on MEDCON after his deployment. He was unaware of the MEDCON program and used his civilian sick leave and insurance to cover the expense of his treatment. In support of his requests, the applicant provides a personal statement, copies of DD Form 261, Report of Investigation, Line of Duty (LOD) and Misconduct Status; AF IMT 348, LOD Determination; AF Form 469, Duty Limiting Condition Report; special orders, medical records, and various other documents associated with his requests. The applicant’s complete submission, with attachments, is at Exhibit A. STATEMENT OF FACTS: The applicant was on active duty orders from 1 Jan 12 through 1 Sep 12. According to AF Form 469, dated 7 Dec 13, the applicant was on duty/mobility restrictions from 8 Apr 14 through 6 Dec 14. AF IMT 348, dated 8 Apr 14, indicates on 16 July 2013, the applicant was treated for an eye injury that was found ILOD. A DD Form 261, dated 29 May 14, also indicates the applicant’s injury was ILOD. IAW AFI 36-3202, Separation Documents, if a member is being separated because of completion of 90 continuous calendar days or more of active duty, a DD Form 214 is prepared. AIR FORCE EVALUATION: AFPC/DPFA recommends denial. There is no evidence the government or organizations within the government made a mistake in this case. On 8 Jul 14, the applicant submitted a request for MEDCON and on 6 Aug 14, he met eligibility. He was provided MEDCON for the period 12 Aug 14 through 24 Sep 14. However, there is no clear evidence reflecting his eligibility for MEDCON prior to 6 Aug 14. According to Secretary of the Air Force (SAF) MEDCON guidelines, dated Aug 12, an airman may be eligible for MEDCON orders when an injury, illness, or disease is incurred or aggravated while serving on orders and that condition renders the airman unable to perform military duties. MEDCON eligibility requires a LOD determination and a finding by a credentialed military health provider that the condition requires treatment and renders the airman unable to meet retention or mobility standards in accordance with AFI 48-123, Medical Examinations and Standards. In order to qualify for MEDCON the member must show the injury occurred while in a military status and the injury prevents the member from performing military duties, a key component to the MEDCON request and eligibility is a medical treatment plan provided by a credentialed medical provider. A complete copy of the AFPC/DPFA evaluation is at Exhibit C. APPLICANT'S REVIEW OF AIR FORCE EVALUATION: He disagrees with AFPC/DPFA’s recommendation to deny his request. He would have been eligible for MEDCON starting at the latest 15 Jul 13, to present, if an LOD was completed. He met all the requirements through his treatment plan, follow-up appointments and multiple surgeries. He was unaware his eye injury had occurred due to his left eye compensating for his sight. It was not until he came up for his five-year Physical Health Assessment (PHA) was his eyesight change noted. Once noted, he sought civilian medical care and was no longer covered under the Transition Assistance Management Program (TAMP). He used his civilian insurance and sick leave for follow-up appointments and surgeries. He was unaware a LOD was required to be eligible for MEDCON or Incapacitation (INCAP) Pay. The applicant’s complete response is at Exhibit E. ADDITIONAL AIR FORCE EVALUATION: The BCMR Medical Consultant recommends denial indicating the applicant has not met the burden of proof of an error or injustice that warrants establishment of MEDCON orders from 1 Sep 12 to the present. However, there is reasonable medical evidence to support active orders covering the intense period of treatment from 16 Jul 13 to 18 Nov 13. Evidence from the applicant’s commander and/or civilian employer if any, along with performance and efficiency reports during the period of his Duty Limiting Condition Report [7 Dec 14 through 6 Dec 15] would be helpful in determining whether active duty orders should have covered all or an additional portion of this period as well. Aside from the ILOD requirement, there must be an impairment of the applicant’s ability to perform his or her military duties due to the illness or injury; or in the case of INCAP Pay, the condition adversely impacts civilian earnings. The mere fact that the applicant may have experienced a traumatic event during training or while deployed, which was later formally diagnosed and proven to require medical and surgical intervention, does not justify retroactive restoration of active duty orders from the time of his demobilization [remobilization]. It was not until a May 2013 PHA that the reduced visual acuity of the right eye was noted. Even then “no bells and whistles” went off; reportedly due to the recognized accommodation of the reduced right eye visual acuity by the normal left eye visual acuity, when both eyes are open at the same time. More challenging in identifying a specific period of functional impairment is the fact that the severity of the applicant’s symptoms appeared to wax and wane over the course of CY13 and CY14; as demonstrated in follow-up periodic visits when his symptoms were reportedly worse than other times. The applicant’s AF Form 469 was initiated on 7 Dec 13, whereas on 18 Nov 13, the provider noted: “Edema has resolved and visual acuity has improved from 20/70 to 2/40 with pinhole testing. He was able to test and qualify for his firearms permit (which he could not do pre-op). So visual acuity and depth perception are improved sufficient for him to return to work, which he has done.” Thus, based upon the applicant’s demonstrated [and self- reported] capacity to perform his military duties, from the time of his remobilization [demobilization] up to the time he was formally diagnosed in May 13 and treated in Jul 13, would not justify full retroactive active duty orders. On the other hand, additional medical and surgical intervention followed the intraocular steroid injection received on 16 Jul 13 to treat macular edema. The record indicates that this then led to a cascade of other problems, which appears to have sufficiently resolved or stabilized at follow-up on 18 Nov 13; when the provider recommended return to duty. While the DLC Report is often utilized as a critical document to indicate the start of a detectable impairment of duty, for purposes of establishing orders, it is not proof the individual was unable to perform military or civilian duties. The complete BCMR Medical Consultant evaluation is at Exhibit F. APPLICANT'S REVIEW OF ADDITIONAL AIR FORCE EVALUATION: A copy of the additional Air Force evaluation was forwarded to the applicant on 11 Aug 15 for review and comment within 30 days (Exhibit G). 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 to warrant changing his DD Form 214 from 1 Sep 12 to present or to show that he was on MEDCON for this period. We took notice of the applicant’s complete submission in judging the merits of the case; however, we agree with the opinion and recommendation of the BCMR Medical Consultant and adopt his rationale as the basis for our conclusion that changing the record in the manner requested would not be appropriate. Therefore, in the absence of evidence to the contrary, we find no basis to recommend granting the relief sought in this portion of the application. 4. Notwithstanding the above, sufficient relevant evidence has been presented to demonstrate the existence of an error or injustice warranting partial relief. Having carefully reviewed this application, we agree with the BCMR Medical Consultant that there is reasonable medical evidence to support active orders covering the period of treatment from 16 Jul 13 to 18 Nov 13. Based on the recommended corrections to show that he completed over 90 continuous calendar days of active duty, IAW AFI 36- 3202, the applicant should receive a DD Form 214 for this period of service. Therefore, we recommend his record be corrected to show that he was placed on active duty, for the purpose of medical continuation from 16 Jul 13 to 18 Nov 13 and issued a DD Form 214. Accordingly, we recommend the applicant's records be corrected to the extent indicated below. THE BOARD RECOMMENDS THAT: The pertinent military records of the Department of the Air Force relating to APPLICANT be corrected to show that he was placed on active duty, for the purpose of medical continuation for the period of 16 Jul 13 through 18 Nov 13 and issued a DD Form 214, Certificate of Release or Discharge from Active Duty for this period. The following members of the Board considered AFBCMR Docket Number BC-2014-02724 in Executive Session on 1 Oct 15 under the provisions of AFI 36-2603: , Panel Chair , Member , Member The following documentary evidence was considered: Exhibit A. DD Form 149, dated 1 Jul 14, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, AFPC/DPFA, dated 3 Oct 14. Exhibit D. Letter, SAF/MRBR, dated 26 Jan 15. Exhibit E. Letter, Applicant, dated 17 Feb 15. Exhibit F. Letter, BCMR Medical Consultant, dated 30 Jul 15. Exhibit G. Letter, SAF/MRBR, dated 11 Aug 15.