RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2015-01254 COUNSEL: NONE HEARING DESIRED: NO APPLICANT REQUESTS THAT: His medical discharge be changed to a retirement. APPLICANT CONTENDS THAT: He was medically discharged from active duty due to Type 1 Diabetes Mellitus with a 20 percent disability rating. Subsequently, he filed with the Department of Veterans Affairs (DVA), and they increased his disability rating to 40 percent, with an overall disability rating of 70 percent, effective the date of his separation. The applicant’s complete submission, with attachments, is at Exhibit A. STATEMENT OF FACTS: The applicant initially entered the Regular Air Force on 11 Jul 00. In Dec 10, the applicant was sent back from a deployment in Korea after being diagnosed with Diabetes Mellitus, Type I. On 4 Aug 11, the applicant scored an overall “Excellent” rating on his Fitness Assessment (FA). On 28 Dec 11, an Informal Physical Evaluation Board (IPEB) determined the applicant had a medical condition which prevents him from reasonably performing the duties of his office, grade, rank, or rating, and recommended he be discharged with severance pay with a 20 percent physical disability rating. On 10 May 12, the Air Force Personnel Council, on behalf of the Secretary of the Air Force, considered the applicant’s contention that he should receive permanent retirement with a 40 percent disability rating, but determined the applicant was to be furnished a discharge with severance pay with a disability rating of 20 percent. The rationale for this decision was, in part, the cautions and advisements given to the applicant were no different or more restrictive than those given to all new onset diabetics, his AF Form 469, Duty Limiting Condition Report, stated “no physical limitations,” and he passed his Air Force Fitness Test with a score of “Excellent” with no exemptions. On 28 Jun 12, the applicant was furnished an honorable discharge, with a narrative reason for separation of “Disability, severance pay, non-combat (enhanced),” and was credited with 11 years, 11 months, and 18 days of total active service. The remaining relevant facts pertaining to this application are contained in the memorandum prepared by the Air Force office of primary responsibility (OPR), which is attached at Exhibit C. AIR FORCE EVALUATION: The BCMR IMA Medical Consultant recommends denial indicating there is no evidence of an error or an injustice. Records indicate that the DVA disability rating decision was increased to 40 percent in Jun 12 on appeal by the applicant. During the first DVA determination in Dec 11, records indicate the rationale for the initial 20 percent assignment was based upon the requirement for insulin, an oral hypoglycemic agent and restricted diet and that “a higher evaluation (40 percent) is not warranted unless insulin, restricted diet and regulation of activities are required.” The matter of “Regulation of Activities” represents the distinguishing factor. Records indicate the applicant’s repeated persistent efforts to be maintained on active duty following completion of the Disability Evaluation process. In a memorandum to the FPEB, dated 28 Feb 12, entitled “Request for Summary Adjudication,” the advocate for the applicant’s continuation on active duty states, “(The applicant) is a new onset diabetic who only after a few months of treatment, is well controlled. With his new knowledge about this disease process and with good monitoring and control, I don’t see any reason why he would have any limitations in duty except to be stationed in facilities capable of monitoring this chronic condition,” and the memorandum further states, “since that time (the applicant) has achieved astounding control of his condition and brought his A1C down to what is considered “normal” levels.” Closing statements indicate, “(The applicant) has his Diabetes under control beyond any reasonable expectations, works out and eats properly to ensure continued control, has successfully passed his Physical Fitness Test (PFT) and works hard to ensure he maintains military standards.” Given the sustained trend of continued good or excellent performance in fitness testing, outstanding duty performance and the continued efforts by the applicant to remain on active duty, the medical reviewer opines there is insufficient valid evidence of any substantive duty or activity restrictions or regulation of activities either duty related or socially. The medical reviewer observes no error or injustice in the assignment of a 20 percent service connecting in accordance with the findings of the physical evaluation boards. In addition, there is no conclusive supportive evidence of “Regulation of Activities” around the period of administrative separation which is required for a higher disability rating (40 percent) consistent with a medical retirement. Addressing the applicant’s implicit desire for a medical separation/retirement, the military Disability Evaluating System (DES), established to maintain a fit and vital fighting force, can by law, under Title 10, United States Code (U.S.C.), only offer compensation for those service incurred diseases or injuries which specifically rendered the member unfit for continued military service and were the cause of career termination; and then only for the degree of impairment present at the time of separation and not based on future occurrences. However, operating under a different set of laws, Title 38, U.S.C., the DVA is authorized to offer compensation for any medical condition with an established nexus with military service, without regard to its proven or demonstrated impact upon a member’s retainability, fitness to serve, or the narrative reason for release from military service. The DVA is also empowered to conduct periodic reevaluations for the purpose of adjusting the disability rating award [decrease or increase] as the level of impairment from a given medical condition may vary [improve or worsen] over the lifetime of the veteran. A complete copy of the BCMR IMA Medical Consultant evaluation is at Exhibit C. APPLICANT'S REVIEW OF AIR FORCE EVALUATION: In further support of his request, the applicant submitted a personal statement in which he takes exception to the BCMR IMA Medical Consultant’s evaluation, and provides additional medical documentation. The VASRD states, “Diabetes Mellitus requiring insulin and restricted diet, or oral hypoglycemic agent and restricted diet warrants a 20 percent rating. Diabetes Mellitus is rated at 40 percent when requiring insulin, restricted diet, and regulation of activities.” There is sufficient medical evidence in his records prior to his separation which show he met the requirements for a 40 percent rating. The FPEB noted Diabetes has no cure, and ”requires constant attention to diet, exercise, blood sugar levels, insulin dosage, and is very difficult to control.” Three separate medical professionals from within the Department of Defense advised him on how to regulate his activities. It is not common practice for the VA to back date ratings unless there is evidence to prove the rating should have been higher to begin with. When he was initially diagnosed with Diabetes he had an A1C of 16.3 percent. It would have been impossible for him to bring that down to a somewhat normal range without medication and regulation of activities. His regiment while on active duty included insulin (minimum 4 times a day), restricted diet, oral hypoglycemic, and there is satisfactory evidence he required regulation of activities. The criteria for the higher rating of 40 percent for diabetes under VASRD 7913 are met. A complete copy of the applicant’s rebuttal, with attachments, 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. 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; however, we agree with the opinion and recommendation of BCMR IMA Medical Consultant and adopt his rationale as the basis for our conclusion the applicant has not been the victim of an error of 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-2015-01254 in Executive Session on 27 Jan 15 under the provisions of AFI 36-2603: Panel Chair Member Member The following documentary evidence pertaining to AFBCMR Docket Number BC-2015-01254 was considered: Exhibit A.  DD Form 149, dated 20 Mar 15, w/atchs. Exhibit B.  Applicant's Master Personnel Records. Exhibit C.  Memorandum, BCMR IMA Medical Consultant, dated 27 Oct 15. Exhibit D.  Letter, SAF/MRBR, dated 28 Oct 15. Exhibit E.  Letter, Applicant, dated 16 Nov 15, w/atchs