RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2011-02259 COUNSEL: NONE HEARING DESIRED: NO ________________________________________________________________ APPLICANT REQUESTS THAT: His diagnosis of follicular carcinoma of the thyroid, with subsequent total thyroidectomy, be included in his Air Force disability rating computation. _______________________________________________________________ APPLICANT CONTENDS THAT: His misdiagnosed sleep apnea was used during his Medical Evaluation Board (MEB) process. His diagnosis of follicular carcinoma of the thyroid should have been used for the MEB. In support of his request, the applicant provides copies of his medical records and a statement from the Endocrinology, Diabetes and Metabolism clinic. The applicant's complete submission, with attachments, is at Exhibit A. _______________________________________________________________ STATEMENT OF FACTS: Special Order ACD-00787 issued 11 Mar 2009 established 26 May 2009 as the applicant’s temporary retirement date. He was subsequently permanently retired in the grade of technical sergeant via Special Order ACD-01300 on 5 May 2010 with an effective date of 25 May 2010. The remaining relevant facts pertaining to this application are contained in the letters prepared by the appropriate offices of the Air Force at Exhibits C and E. _______________________________________________________________ AIR FORCE EVALUATION: HQ AFPC/DPSD recommends denial of the applicant's request to have his condition included in his Air Force disability rating computation. Conversely, DPSD agrees with the applicant's contention that his condition should have been included in his original MEB and been reviewed by the IPEB as a potentially unfitting condition. However, after reviewing new evidence provided by the applicant pertaining to his thyroid condition, DPSD does not believe the Informal Physical Evaluation Board (IPEB) would have found this condition to be separately unfitting. The IPEB has traditionally not found other members with this condition unfit for continued military service. Under Title 10, USC, Physical Evaluation Boards must determine if a member's condition renders him unfit for continued military service relating to their office, grade, rank or rating. In this particular case, his thyroid condition was not submitted by the MEB as a boardable condition. HQ AFPC/DPSD states, the IPEB first adjudicated the applicant's case on 23 Feb 2009. The applicant received an overall rating of 90 percent for the conditions adjudicated as unfitting by the IPEB and was placed on the Temporary Disability Retired List (TDRL). These conditions were all classified as combat related. The applicant's thyroid condition was not rated by the IPEB since it was not included in his MEB package. Additionally, the IPEB did not see other medical documentation to indicate his thyroid condition was potentially unfitting. The IPEB reviewed his completed TDRL reevaluation on 19 Apr 2010, and recommended permanent retirement with an overall disability rating of 80 percent. Since the thyroid condition was not found to be unfitting during his initial IPEB adjudication, this condition was not reviewed or rated during the TDRL reevaluation. DPSD states, the applicant could have appealed the IPEB findings to the Formal Physical Evaluation Board. The applicant did not exercise this appeal right. The complete DPSD evaluation is at Exhibit C. The BCMR Medical Consultant recommends the administrative adjustment of the applicant's AF Form 356, Findings and Recommended Disposition of the USAF Physical Evaluation Board, to reflect his thyroid condition was considered by the IPEB, but with denial of its inclusion as an unfitting condition in the military disability rating computation; neither initially or at the time of his removal from the TDRL. The Medical Consultant agrees the applicant's follicular carcinoma of the thyroid, and residual requirement for thyroid replacement should have been considered by the IPEB, but emphatically believes the condition would not have been found individually unfitting for inclusion in his military disability rating computation. The Medical Consultant, otherwise, opines the applicant has not met the burden of proof of an error or injustice that warrants the completely desired change of the record. The Consultant opines the condition should have been included in the MEB, even if only to document that the condition existed, that the applicant had received surgical treatment, and that he required leva-thyroxine (Synthroid) replacement therapy; although, again, likely listed among conditions not considered unfitting on the AF Form 356. Therefore, the Medical Consultant recommends an administrative correction of the record amending the applicant's AF Form 356 to reflect the following listed under Category II, a compensable condition that is currently not unfitting: "Hypothyroidism, under replacement therapy (Synthroid), status-post total thyroidectomy and 1-131 ablation, for follicular carcinoma." The complete BCMR Medical Consultant’s evaluation is at Exhibit E. _______________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: Copies of the Air Force evaluations were forwarded to the applicant on 10 Feb 2012 and 26 Mar 2012, for review and comment within 30 days. As of this date, this office has received no response (Exhibits C and 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 of an error or injustice regarding the applicant’s request to include his diagnosis of follicular carcinoma of the thyroid, with subsequent total thyroidectomy, in his Air Force disability rating computation. 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 their rationale as the basis for our conclusion the applicant’s condition at the time of his discharge does not warrant a change in his disability rating computation. 4. Notwithstanding our findings above, we believe sufficient evidence has been presented to warrant partial relief. In this regard, we note the BCMR Medical Consultant recommends the applicant’s AF Form 356, be administratively adjusted to add the applicant’s medical condition of follicular carcinoma to Category II of his AF Form 356 and we agree with his assessment in this case. Therefore, we recommend his 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 reflect his AF Form 356, Findings and Recommended Disposition of USAF Physical Evaluation Board, dated 23 Feb 2009, Block 9A, Diagnosis, Category II, “Conditions that can be unfitting but are not currently compensable or ratable:” be amended to add "Hypothyroidism, under replacement therapy (Synthroid), status- post total thyroidectomy and 1-131 ablation, for follicular carcinoma.” _______________________________________________________________ The following members of the Board considered this application in Executive Session on 10 May 2012, under the provisions of AFI 36-2603: , Panel Chair , Member , Member The following documentary evidence was considered in AFBCMR BC- 2011-02259: Exhibit A. DD Form 149, dated 17 May 2011, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, HQ AFPC/DPSD, dated 26 Jan 2012. Exhibit D. Letter, SAF/MRBR, dated 10 Feb 2012. Exhibit E. Letter, BCMR Medical Consultant, dated 26 Mar 2012. Exhibit F. Letter, SAF/MRBC, dated 26 Mar 2012. Panel Chair AFBCMR BC-2011-02259 MEMORANDUM FOR THE CHIEF OF STAFF Having received and considered the recommendation of the Air Force Board for Correction of Military Records and under the authority of Section 1552, Title 10, United States Code, it is directed that: The pertinent military records of the Department of the Air Force relating to the APPLICANT be corrected to reflect his AF Form 356, Findings and Recommended Disposition of USAF Physical Evaluation Board, dated 23 Feb 2009, Block 9A, Diagnosis, Category II, “Conditions that can be unfitting but are not currently compensable or ratable:” be amended to add "Hypothyroidism, under replacement therapy (Synthroid), status-post total thyroidectomy and 1-131 ablation, for follicular carcinoma.” Director Air Force Review Boards Agency