RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2012-02365 COUNSEL: NONE HEARING DESIRED: NO _________________________________________________________________ APPLICANT REQUESTS THAT: His compensable disability rating of 10 percent for Crohn’s Disease be increased to 30 percent to qualify for a medical retirement. _________________________________________________________________ APPLICANT CONTENDS THAT: His Medical Evaluation Board (MEB) disability rating is unjust for multiple reasons. All of his medical records were not included in his MEB and only the information from his base physician was reviewed. The Crohn’s disease specialist’s notes should have been added. He requested the information be included in the MEB process, but was informed the information would not be included. He was hospitalized twice during the MEB process and that information was not included for review. His medical records from St Mary’s hospital indicate Crohn’s disease infected his organs. Although infections are not normal symptoms of Crohn’s, it proves the unique severity of the disease. He was removed from Cimzia injections, a medication used for moderate to severe Crohn’s disease; however, he has not entered remission. He feels his disability rating is low based on the severity of Crohn’s disease and how the autoimmune process affected him. He received high doses of prednisone which has multiple negative long term effects. He would like a specialist to review his records to reevaluate his disability rating. The applicant’s complete submission, with attachments, is at Exhibit A. _________________________________________________________________ STATEMENT OF FACTS: On 1 Aug 00, the applicant enlisted in the Regular Air Force. According to DPSD’s letter, dated 3 July 2012, on 11 Jan 11, the applicant’s case was reviewed by an Informal Physical Evaluation Board (IPEB) for Crohn’s disease. The IPEB recommended his discharge with severance pay and a 10 percent disability rating under other than Chapter 61, that the conditions existed prior to service. On 7 Feb 11, the applicant non-concurred with the IPEB findings and requested a formal hearing with counsel. On 9 Mar 11, the Formal Physical Evaluation Board (FPEB) reviewed the applicant’s case and recommended he be discharged with severance pay and a 10 percent disability rating. On 19 Jan 12, the Secretary of the Air Force Personnel Council (SAFPC) concurred with the findings and recommendations of the IPEB and FPEB and directed the applicant be discharged with severance pay with a disability rating of 10 percent. On 27 Apr 12, the applicant was honorably discharged for disability, severance pay, non combat. He served 11 years, 8 months and 27 days on active duty. _________________________________________________________________ AIR FORCE EVALUATION: AFPC/DPSD recommends denial. DPSD states the USAF disability boards must rate disabilities based on the member’s condition at the time of evaluation; in essence, a snapshot of their condition at that time. While the member’s contention that his Crohn’s disease was well-controlled by his medication, he felt that his overall condition was not well described by the rating schedule. He wanted his fatigue, malnutrition, hemorrhoids, depression and immunosuppression considered when his disability was rated. SAFPC appreciated the combined effects of the conditions, but could not rate them separately because there was no medical documentation that the conditions were separately unfitting. A review of the applicant’s Veterans Administration Schedule for Rating Disabilities (VASRD) code 7323 revealed a rating of 10 percent disability when the symptoms are “moderate with infrequent exacerbations.” This rating best described his symptoms under his current treatment plan. On 1 Dec 11, during the applicant’s visit to his primary care provider, there was no other mention of symptoms of Crohn’s Disease. The complete DPSD evaluation is at Exhibit C. _________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: In a three-page response, the applicant reiterates much of his earlier contentions. He also notes the VASRD code 7323 indicates that to receive a 30 percent disability rating an individual would need to have moderately severe disease with frequent exacerbations while a 10 percent rating consists of a moderate disease with infrequent exacerbations. He notes the entire four months prior to his last medical appointment was spent visiting emergency rooms, multiple doctors or specialist, the intensive care unit, on quarters or hospital admission due to the exacerbations of Crohn’s disease. The applicant’s complete submission is at Exhibit E. _________________________________________________________________ ADDITIONAL APPLICANT'S REVIEW OF AIR FORCE EVALUATION: The applicant states the Department Veteran’s Affairs (DVA) rated his Crohn’s disease at 30 percent. The DVA did not rate his autoimmune disorder which is a part of Crohn’s. He submits a copy of this DVA Rating decision for review. The applicant’s complete submission, with attachment, is at Exhibit F. _________________________________________________________________ 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. The applicant contends that his disability rating is unjust and that all the medical records were not included in the MEB process. However, after a careful review of the evidence of record, we do not find that the evidence supports his contentions. Therefore, we agree with the opinion and recommendation of the Air Force office of primary responsibility and adopt the rationale expressed as the basis for our decision that the applicant has failed to sustain his burden that he has suffered either an error or an injustice. While the applicant argues that all of his medical documentation was not considered by the MEB, he has not provided sufficient evidence to substantiate his claim. The evidence reflects the MEB considered his fatigue, malnutrition, hemorrhoids, depression and immunosuppression when rating his disabilities; stating they could not be rated separately as there was no medical documentation that these diseases were separately unfitting. Therefore, only his Crohn’s disease was rated unfitting (10 percent) and we agree that this rating best describes the applicant’s condition at the time of his separation. In further support of his request, the applicant provides a copy of his DVA rating decision and notes the DVA rated his disease at 30 percent using the same guidelines and information as the Air Force. The applicant must realize that while the Air Force is required to rate disabilities in accordance with the DVA Schedule for Rating Disabilities, the DVA operates under a totally separate system with a different statutory basis. In this respect, the DVA rates for any and all service-connected conditions, to the degree they interfere with future employability, without consideration of fitness. Whereas, the Air Force, upon a finding of unfitness, rates a member's disability based on the degree of severity at the time of separation. In view of the above, we find that the applicant's case was properly evaluated and that he received full and fair consideration under the applicable directives. Absent persuasive evidence that the applicant was denied rights to which entitled, appropriate regulations were not followed, or appropriate standards were not applied, we find no basis upon which to favorably consider this application. _________________________________________________________________ THE BOARD DETERMINES THAT: The applicant be notified that the evidence presented did not demonstrate the existence of material error or injustice; that the application was denied without a personal appearance; and that 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 this application in Executive Session on 20 Feb 13, under the provisions of AFI 36- 2603: , Panel Chair , Member , Member The following documentary evidence was considered in AFBCMR BC- 2012-02365: Exhibit A. DD Form 149, dated 27 Apr 12, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, AFPC/DPSD, dated 3 Jul 12. Exhibit D. Letter, SAF/MRBR, dated 26 Jul 12. Exhibit E. Letter, Applicant, dated 2 Aug 12, w/atchs. Exhibit F. Letter, Applicant, undated, w/atchs. Panel Chair