RECORD OF PROCEEDINGS

IN THE MATTER OF:	DOCKET NUMBER: BC-2019-04581

XXXXXXXXXXXXXX	COUNSEL: NONE
	
	HEARING REQUESTED: NO

APPLICANT’S REQUEST

Increase her permanent disability retirement compensable percentage for physical disability from 60 percent to 80 percent.  

APPLICANT’S CONTENTIONS

Her Iron Deficiency Anemia, rated at 10 percent disability, should have been rated at 30 percent.  She cites evidence shows she was required intravenous iron infusions 4 or more times per 12-month period meeting the Veterans Affairs Schedule for Rating Disabilities (VASRD) 30 percent disability rating.  Once corrected, a 50 percent rating for Unspecified Depressive Disorder (Major Depressive Disorder), plus the 30 percent disability rating for Iron Deficiency Anemia, equates to a combined compensable percentage of 80 percent.  

The applicant’s complete submission is at Exhibit A.

STATEMENT OF FACTS

The applicant is a retired Air Force senior master sergeant (E-8).

On 11 July 2019, an Informal Physical Evaluation Board (IPEB) found the applicant’s medical condition Unspecified Depressive Disorder (Major Depressive Disorder), prevents her from reasonably performing the duties of her office, grade, rank or rating, recommending she be permanently retired with a disability rating of 50 percent in accordance with (IAW) VASRD guidelines.  

On 22 July 2019, the applicant disagreed with the IPEB findings and requested a formal hearing of her case.  

On 6 August 2019, a Formal Physical Evaluation Board (FPEB) found the applicant’s Unspecified Depressive Disorder (Major Depressive Disorder), and Iron Deficiency Anemia, prevent her from reasonably performing the duties of her office, grade, rank and rating.  Accordingly, the FPEB recommended she be permanently retired with disability rating of 60 percent (50 percent, 10 percent respectively) IAW the VASRD guidelines.

On 1 October 2019, SAF/MRBP, on behalf of the Secretary of the Air Force, directed the applicant be permanently retired with a disability rating of 60 percent under the provisions of Title 10, USC, Section 1201.  This disability rating was determined based on the VASRD in IAW the National Defense Authorization Act (NDAA) of 2008.  

On 7 October 2019, the applicant submitted to the Department of Veterans Affairs (DVA), Providence Regional Office DES Rating Activity Site, a “One Time Only Rating Reconsideration.”  She asked for her 10 percent disability rating for Iron Deficiency Anemia, be increased to 30 percent.  She stated she had undergone 4 or more intravenous iron infusions in a 12-month period in order to treat the anemia as well as her blood disorder (Essential Thrombocythemia—7718).  

On 8 October 2019, AFLOA/CLSA (The Office of Airmen’s Counsel) on behalf of the applicant, submitted a request for “One Time Only Rating Reconsideration.” to the Department of Veterans Affairs (DVA), Providence Regional Office DES Rating Activity Site.  They opined the severity of the applicant’s Iron Deficiency Anemia condition entitles her to a higher disability rating of 30 percent instead of 10 percent.  

On 12 December 2019, the Decision Review Officer, Integrated Disability Evaluation System (IDES) Team, Disability Activity Site (DRAS), determined no change was warranted in the prior decision of proposed evaluation of 10 percent.  Their review of the medical evidence provided showed the applicant had not provided current medical evidence showing the applicant received 4 or more intravenous iron infusions per 12-month period within the last 12 months; IAW 38 CFR 4.117.  

On 30 March 2020, the applicant was relieved from active duty, and effective 31 March 2020, permanently disability retired with compensable percentage for physical disability of 60 percent.  

For more information, see the excerpt of the applicant’s record at Exhibit B and the advisory at Exhibit C.

AIR FORCE EVALUATION

BCMR Medical Advisor recommends partially granting the application by granting a change in disability rating for Iron Deficiency Anemia.  Evidence, in the form of an Air Force (AF) Form 356, Findings and Recommended Disposition of USAF [Formal] Physical Evaluation Board, shows the applicant was assigned a 50 percent disability rating for Unspecified Depressive Disorder (Major Depressive Disorder) and a 10 percent disability rating for Iron Deficiency Anemia.  In accordance with (IAW) the VASRD guidelines, the applicant was permanently retired with a disability rating of 60 percent.  The applicant submitted new evidence, which was apparently too late to include in the proceedings of her Formal Physical Evaluation Board.  The objective evidence provided shows the applicant was prescribed the treatment for her Iron Deficiency Anemia that would qualify for the 30% disability.  Specifically, a 4 October 2018 progress note in the applicant’s medical records indicates, “status post Venofer 200mg x 4 treatments for her Iron Deficiency Anemia in June 2018,” as implicit evidence she did receive 4 treatments in a 12-month period, that would qualify for the 30 percent disability rating.  However, IAW the Veterans Affairs Combined Rating Chart, the applicant’s 50 percent disability rating for her Unspecified Depressive Disorder (Major Depressive Disorder) combined with a 30 percent disability rating for Iron Deficiency Anemia, achieves a 70 percent disability rating, not an 80 percent disability rating the applicant is requesting.  

The complete advisory opinion is at Exhibit C.

APPLICANT’S REVIEW OF AIR FORCE EVALUATION

The Board sent a copy of the advisory opinion to the applicant on 29 October 2020 for comment (Exhibit D), and the applicant replied on 1 December 2020.  In her response, the applicant contended she did in fact receive intravenous iron infusions, receiving four intravenous Venofer infusion treatments in June 2018.  Because she did not tolerate the side effects associated with Venofer, her infusion treatments have been switched to Feraheme.  In support of her contention, she submitted a letter from her Hematologist/Oncologist verifying her intravenous infusion treatments.  

The applicant’s complete response is at Exhibit E.

FINDINGS AND CONCLUSION

1.  The application was timely filed.

2.  The applicant exhausted all available non-judicial relief before applying to the Board.

3.  After reviewing all Exhibits, the Board concludes the applicant is the victim of an error or injustice.  The Board concurs with the rationale and recommendation of BCMR Medical Advisor and finds a preponderance of the evidence substantiates the applicant’s contentions in part.  Specifically, the applicant’s medical records indicate she did receive 4 treatments in a 12-month period, qualifying for the 30 percent disability rating for her Iron Deficiency Anemia, which is sufficient to justify granting the applicant’s request to increase her Iron Deficiency Anemia disability rating from a 10 percent disability rating to a 30 percent disability rating.  When the 30 percent disability rating for Iron Deficiency Anemia is combined (not added) with the 50 percent disability rating for Unspecified Depressive Disorder (Major Depressive Disorder), a combined disability rating of 70 percent is achieved per the Veterans Affairs Combined Rating Chart.  However, for the remainder of the applicant’s request, the evidence presented did not demonstrate an error or injustice, and the Board therefore finds no basis to recommend granting that portion of the applicant’s request.  Therefore, the Board recommends correcting the applicant’s records as indicated below.

RECOMMENDATION

The pertinent military records of the Department of the Air Force relating to the APPLICANT be corrected to show: 

	a.  On 6 August 2019, she was found unfit to perform the duties of her office, rank, grade, or rating by reason of physical disability, incurred while she was entitled to receive basic pay; that the diagnosis in her case was Unspecified Depressive Disorder (Major Depressive Disorder), that her condition was under VASRD code 9434, rated at 50% and Iron Deficiency Anemia, under VASRD code 7720, rated at 30% rather than 10%; that the degree of impairment was permanent; that the disability was not due to intentional misconduct or willful neglect; that the disability was not incurred during a period of unauthorized absence; and that the disability was not received as a direct result of armed conflict or caused by an instrumentality of war. 

	b.  On 30 March 2020, she was released from active duty by reason of physical disability with a combined [not added] disability rating of 70 percent, and permanently retired effective 31 March 2020.

However, regarding the remainder of the applicant’s request, the Board recommends informing the applicant the evidence did not demonstrate material error or injustice, and the application will only be reconsidered upon receipt of relevant evidence not already considered by the Board.

CERTIFICATION

The following quorum of the Board, as defined in Air Force Instruction (AFI) 36-2603, Air Force Board for Correction of Military Records (AFBCMR), paragraph 1.5, considered Docket Number BC-2019-04581 in Executive Session on 16 December 2020:

, Panel Chair 
, Panel Member
, Panel Member

All members voted to correct the record.  The panel considered the following:

Exhibit A:	Application, DD Form 149, w/atchs, dated 8 October2019.
Exhibit B:	Documentary evidence, including relevant excerpts from official records.
Exhibit C:	Advisory opinion, BCMR Medical Advisor, dated 14 August 2020.  
Exhibit D:	Notification of advisory, SAF/MRBC to applicant, dated 29 October 2020.
Exhibit E:	Response, Applicant, w/attch, dated 1 December 2020.  

Taken together with all Exhibits, this document constitutes the true and complete Record of Proceedings pertaining to Docket Number BC-2019-04581, as required by AFI 36-2603, paragraph 4.11.9.