ADDENDUM TO RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBERS: BC-2010-02555 COUNSEL: HEARING DESIRED: YES ________________________________________________________________ _ APPLICANT REQUESTS THAT: 1. Her date of separation (DOS) be adjusted by seven months to allow her to retire with 20 years of total active service; or; allow her back onto active duty to serve at least another seven months. 2. Block 7 of her Air Force Form 356, dated 5 May 2009, be corrected to reflect 19 years rather than 18 years – WITHDRAWN SEE EXHIBIT J. ________________________________________________________________ _ STATEMENT OF FACTS: The applicant is a former member of the Regular Air Force who served on active duty and was progressively promoted to the grade of master sergeant (E-7). On 5 May 2009, an Informal Physical Evaluation Board (IPEB) reviewed the applicant’s medical board for diagnosis of Crohn’s Disease and recommended permanent retirement with a disability rating of 30 percent. On 11 May 2009, the applicant concurred with the recommendation of the IPEB. As a result, she was released from active duty effective 27 July 2009 and medically retired effective 28 July 2009 with a disability rating of 30 percent. She served 19 years, 5 months, and 20 days on active duty. On 23 February 2011, the Board considered and partially granted the applicant’s initial application. The Board denied her request to change her DOS or to reinstate her to active duty; however, the Board approved her request to award her the Defense Meritorious Service Medal (DMSM). For an accounting of the facts and circumstances surrounding the applicant’s earlier appeal; and, the rationale of the decision by the Board, see the Record of Proceedings (ROP) at Exhibit E with Exhibits A through D. On 29 May 2012, the applicant appealed to the Board for reconsideration; however, her request was denied based on the fact that her submission did not meet the criteria for reconsideration of her appeal. On 20 June 2013, the applicant submitted another request for reconsideration of her appeal to correct her DOS to allow her a 20-year active duty retirement or to allow her to return to active duty to complete 20 years of active duty service. In addition, the applicant requests Block 7 of her Air Force Form 356, dated 5 May 2009, be corrected to reflect 19 years rather than 18 years. On 6 May 2014, the applicant withdrew her request to correct Block 7 of her Air Force Form 356 from 18 years to 19 years. A copy of her email request is at Exhibit J. ________________________________________________________________ _ BCMR MEDICAL CONSULTANT’S EVALUATION: The BCMR Medical Consultant recommends denial. The Medical Consultant acknowledges the new medical evidence from the applicant’s gastroenterologist and the implicit reasoning or premise that had she been diagnosed with Irritable Bowel Syndrome or Disease (IBS or IBD), instead of Crohn’s Disease, that the decision of the IPEB would have been different or, perhaps, an Medical Evaluation Board (MEB) would never have been conducted; thus justifying her current desired change of record. Also acknowledged is that it is uncommon for an individual to be released from military service for medical reasons so close to length of service retirement eligibility; particularly if the medical condition does not interfere with the individual’s duties or alternative duties; or would only result in severance pay. Many who are eligible and undergo an MEB during the 12 months approaching an approved retirement date are presumed fit and are returned to duty. If the applicant’s condition was IBS, her condition was in remission, and she and her commander desired retention, the IPEB would likely have found her fit and returned her to duty; noting her proximity to retirement. However, in the case under review, the applicant has not supplied clinical objective evidence that her medical condition was in remission or the expected durability of that remission. Instead, the limited supplied medical evidence suggests the applicant’s medical condition did interfere with her ability to perform her military duties; albeit exacerbated by external occupational stressors beyond her span of control. While refuting a statement in the Commander’s Recommendation Letter alleging that she “requested to be moved and given minimal duties in civil engineering, commensurate with those of a junior airman, the applicant did not refute the portion stating “It is apparent that even the most routine stressors in the office environment cause her severe mental and physical debilitation.” The fitness to serve was not necessarily brought into question based solely upon the possible errant nomenclature (Crohn’s Disease) assigned to her medical condition, but that other clinical factors, to include her poor response to treatment efforts and the history of recurrent exacerbations due to external stressors, contributed significantly to the unfit decision by the IPEB. Even if the applicant’s diagnosis was IBS instead of Crohn’s Disease, her retainability would still likely have been brought into question and could very well have resulted in an MEB and an unfit finding. There is no evidence to indicate the applicant argued for being returned to duty, as it was her right to do in rebuttal to the MEB; and prior to any IPEB action. While there may have been an error in her clinical diagnosis assigned during her military service, based upon the opinion of her current gastroenterologist, the burden of proof has not been met to justify supplanting her unfit finding and medical retirement with an extension of her military service until she reaches (or would have reached) length of service retirement eligibility or to change her retirement date to 28 February 2010. A complete copy of the BCMR Medical Consultant’s evaluation, with attachment, is at Exhibit G. ________________________________________________________________ _ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: The Medical Consultant appears to agree with her position regarding the misdiagnosis of her medical condition of Crohn’s Disease, which lead to her medical retirement. However, the Medical Consultant’s opinion that she could have been medically retired anyway, even if she had not been misdiagnosed is purely speculative. She is submitting a legal brief from her attorney as well as four letters providing the opposite and far more credible opinions of three Air Force officers and a Chief Master Sergeant, highly qualified to state an opinion on the issue. Granted she could well have been prevented from reaching 20 years of service by all kinds of things, but that does remedy the error made in her medical retirement. She has never been crippled by her disease, but almost by the treatment of it. She was put on 72-hours quarters once because she was on a high dose of steroids that her body reacted badly to, but that is only because her disease was not showing any signs of remission. She worked full shifts and was rarely absent while working at her military job. Her health improved after changing positions and her symptoms are almost gone. She has performed in civilian jobs since being medically retired which are just as demanding, if not more so, than those she held on active duty, thus showing she is medically fit to work. The applicant’s complete rebuttal, with attachments, is at Exhibit I. ________________________________________________________________ _ THE BOARD CONCLUDES THAT: 1. The applicant has exhausted all remedies provided by existing law or regulations. 2. The application was timely filed. 3. We note that on two previous occasions, the Board has denied the applicant’s request to correct her record to change her date of separation or to reinstate her to active duty. However, after thoroughly reviewing the additional documentation submitted in support of her appeal, we believe the applicant has overcome the rationale expressed in previous decisions. After a review of the additional documentation, we have reached a conclusion different from the BCMR Medical Consultant in this matter. We are persuaded the applicant has provided the necessary and appropriate documentation to sustain her burden that she has been the victim of an error or injustice and that it is likely that she was misdiagnosed with Crohn’s disease. Although the applicant did experience medical issues, we believe given her close proximity to a length of service retirement, she would have likely been retained on active duty until she reached retirement eligibility if not for her misdiagnosis of Crohn’s disease. Our reasoning is supported by the BCMR Medical Consultant’s comments that it is uncommon for an individual to be released from military service for medical reasons so close to a length of service retirement eligibility. Additionally, based on the numerous letters of support that conclude her referral to a MEB/PEB would not have occurred if not for the misdiagnosis, we believe the applicant would have continued to serve. Therefore, based on the foregoing, we believe a preponderance of the evidence presented warrants favorable consideration of her request and recommend her records be corrected to the extent indicated below. With regard to the applicant’s request to correct Block 7 of her Air Force Form 356, dated 5 May 2009, to reflect 19 years rather than 18 years, we note the applicant has withdrawn this request effective 6 May 2014. Therefore, Board action on this request is not required. 4. The applicant's case is adequately documented and it has not been shown that a personal appearance with or without counsel will materially add to our understanding of the issues involved. Therefore, the request for a hearing is not favorably considered. ________________________________________________________________ THE BOARD RECOMMENDS THAT: The pertinent military records of the Department of the Air Force relating to APPLICANT be corrected to show that: a. She was not found unfit for duty on 5 May 2009 by an Informal Physical Evaluation Board and medically retired on 27 July 2009, but was continued on active duty through 28 February 2010. b. She was released from active duty on 28 February 2010 and retired with a length of service retirement effective 1 March 2010. ________________________________________________________________ The following members of the Board considered AFBCMR Docket Number BC-2010-02555 in Executive Session on 20 March 2014, under the provisions of AFI 36-2603: , Panel Chair , Member , Member All members voted to correct the records, as recommended. The following documentary evidence for AFBCMR Docket Number BC-2010- 02555 was considered: Exhibit E. Record of Proceedings, dated 21 Mar 11, with atchs A through D. Exhibit F. DD Form 149, dated 20 Jun 13 w/atchs. Exhibit G. Letter, BCMR Medical Cnslt, dated 5 Nov 13, w/atch. Exhibit H. Letter, SAF/MRBC, dated 7 Nov 13. Exhibit I. Letter, Applicant, dated 6 Dec 13, w/atchs. Exhibit J. Email, Applicant, dated 6 May 14. Panel Chair