RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2013-01109 COUNSEL: NONE HEARING DESIRED: NO ________________________________________________________________ APPLICANT REQUESTS THAT: 1. His records be corrected to reflect that he was medically retired in the grade of captain (O-3) for unfitting and disqualifying medical conditions. 2. His medical retirement be combat related in order to qualify for Combat Related Special Compensation (CRSC). ________________________________________________________________ APPLICANT CONTENDS THAT: The Air Force failed to process him through the Disability Evaluation System (DES) as required by law and governing regulations for disqualifying medical conditions of exercise induced asthma, cold-injury residuals and combat related Post Traumatic Stress Disorder (PTSD) despite a request for a Medical Evaluation Board (MEB) and a narrative summary from his active duty pulmonologist. The Department of Veterans Affairs (DVA) rated him at 80 percent and confirmed his diagnosis of exercise induced asthma and PTSD are service connected. He should have been medically retired with a combined rating of 80 percent In Accordance With (IAW) the Veterans Administration Schedule for Rating Disabilities (VASRD). He was twice non-selected for promotion to the grade of major (O-4) and was separated instead of being processed through the DES. An MEB would have referred him to the Physical Evaluation Board (PEB) which would have recommended him for a disability rating of at least 30 percent and a medical retirement. He would have requested Continuation of Active Duty (COAD) which allows military members with at least 15 years but less than 20 years of active duty service who incurred a disability from combat operations or terrorism to remain on active duty to qualify for military retirement. He has been the victim of an error or injustice that warrants corrective action and he requests the Board to override an administrative separation and permanently medically retire him due to his unfitting conditions. He references several BCMR and a Physical Disability Board of Review (PDBR) Records of Proceedings (ROP) as precedence to support his request for a medical retirement. In support of his requests, the applicant provides a personal statement, statement from his spouse, copies of his DVA rating information, medical documents and other various documents associated with his request. The applicant’s complete submission, with attachments, is at Exhibit A. ________________________________________________________________ STATEMENT OF FACTS: On 13 Jun 1999, the applicant entered this period of active duty as a commissioned officer. He received a referral Officer Performance Report (OPR) for the period of 13 Aug 2002 to 12 Aug 2003. The specific reason for the referral OPR was a Letter of Reprimand (LOR) for threatening and intimidating subordinates. The applicant submitted a rebuttal to the OPR. According to a Medical Narrative Summary, dated, 15 Jun 2004, the applicant presented for an MEB and was diagnosed with mild intermittent asthma which appeared to be exercise related. The physician recommended the applicant undergo an MEB given the diagnosis of asthma with a P4T profile which denotes “not worldwide qualified.” He was prescribed a metered dose inhaler as needed and advised to resume aerobic exercise with a goal of at least 3 sessions per week. Although his medical provider made the MEB and profile recommendations, there is no evidence his commander approved the recommendations which were made less than three months before his date of separation. On 31 Aug 2004, he was released from active duty with a narrative reason for separation of “Non-Selection, Permanent Promotion.” The applicant served 5 years, 2 months and 18 days as a commissioned officer. He served a combined total of 15 years and 7 months on active duty. According to ARPC/DPPS letter, dated 13 Jul 2009, the applicant was eliminated from the Inactive Status List Reserve Section (ISLRS). Although time spent in ISLRS counts toward commissioned service time, it is not considered satisfactory service toward a reserve retirement. Because the applicant did not complete 20 years of active service, he is not eligible for a Reserve retirement. Effective 11 May 2011, the applicant was honorably discharged from all appointments in the United States Air Force. ________________________________________________________________ AIR FORCE EVALUATION: The BCMR Medical Consultant recommends denial. The burden of proof of error or injustice has not been sufficiently met to warrant the desired retroactive change of the record; particularly if based upon the false assumption that a clinical social worker, assigned to a medical center, with mild exercise- induced asthma, with a demonstrated ability to run two miles, and no proven diminution in job performance due to a medical condition would have been found unfit by a PEB, if not already separating for a non-disability reason. The applicant was diagnosed and treated for exercise-induced asthma at least one year prior, although reporting possible symptoms up to three years prior, to his release from active military service; however, there are no profile restrictions supplied to cover this period. There is only the single P4T profile in the narrative summary, dated 15 Jun 2004, which was not transposed onto or validated by a Duty Limiting Condition Report initiated or approved by either the Chief of the Medical Staff, Department Chair, or Chief of Aerospace Medicine. Nevertheless, the BCMR Medical Consultant acknowledges that asthma or airway hyper-responsiveness is a disqualifying condition under Air Force Instruction 48-123, Medical Examinations and Standards, and that the condition may pose an unreasonable health and mission risk in a deployed environment; albeit not universally career ending when retention under an Assignment Limitation Code (ALC) is warranted. The applicant and the Board are reminded that any given diagnosis, although listed as disqualifying under AFI 48-123, does not automatically render an individual unfit for continued military service, as would be determined by a Physical Evaluation Board (PEB). Attention to the following extracts from Department of Defense Instruction (DoDI) 1332.38, paragraphs E3.P3.3.3 and E3.P3.3.4, respectively, may help explain why. Adequate Performance Until Referral: "If the evidence establishes that the Service member adequately performed his or her duties until the time the Service member was referred for physical evaluation [in this case possibly or Jul/Aug 2004], the member may be considered fit for duty even though medical evidence indicates questionable physical ability to continue to perform duty." Cause and Effect Relationship: "Regardless of the presence of illness or injury, inadequate performance of duty, by itself, shall not be considered as evidence of unfitness due to physical disability unless it is established that there is a cause and effect relationship between the two factors." No service evidence is provided to indicate the applicant was not performing duties commensurate with his office, grade, rank, or rating due to asthma; or any of his other medical conditions; until the single "P4T" profile referenced in the NARSUM of 30 July 2004. The Medical Consultant acknowledges there was, nevertheless, an option for placing the applicant on Medical Hold to proceed with the DES and possible subsequent PEB action, under provisions of AFI 36- 3212. Why this was not done is not clear in the record supplied. The BCMR Medical Consultant can only speculate that medical officials did not believe that the asthma warranted processing through the DES, if he was not already separating for a non-disability reason. The applicant's motivation to serve should also not go unnoticed in this scenario, as he indeed proposed retention if found unfit under the Limited Assignment Status (LAS) provision in AFI 36-3212 available at the time. In the past members could be retained under LAS who have at least 15, but less than 20 years of service, when the needs of the Air Force dictated their retention even though found unfit. However, IAW AFI 36-3212, paragraph 6.1 , Basic Eligibility, members who have some type of non-disability retirement or separation pending [would not have been] eligible for LAS, notwithstanding the current attention to recruitment/retention of mental health providers. The applicant and the Board are reminded that the 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 a member unfit for continued active service and were the cause for career termination; and then only for the degree of impairment present at the "snap shot" time of separation and not based on future occurrences. Department of Defense Instruction 1332.32, Physical Disability Evaluation, Enclosure 3, Part 3, Standards For Determining Unfitness Due To Physical Disability Or Medical Disqualification, paragraph E3.P3.2.1, reads:" A Service member shall be considered unfit when the evidence establishes that the member, due to physical disability, is unable to reasonably perform the duties of his or her office, grade, rank, or rating (hereafter called duties) to include duties during a remaining period of Reserve obligation." The evidence does not reflect the applicant was unable to perform his duties due to a medical condition. On the other hand, operating under a different set of laws (Title 38, U.S.C.), with a different purpose, the Department of Veterans Affairs (DVA) is authorized to offer compensation for any medical condition determined service incurred, e.g., the applicant's PTSD, without regard to [and independent of] its demonstrated or proven adverse impact upon a service member's retainability, fitness to serve, or narrative reason for release from military service. With this in mind, Title 38, U.S.C., which governs the DVA compensation system, was written to allow awarding compensation ratings for conditions with a nexus with military service. This is the reason why an individual can be found fit for release from active military service for one reason and yet sometime thereafter receive compensation ratings from the DVA for conditions found service-connected, but which were not proven militarily unfitting at the time of release from service. The DVA is also empowered to conduct periodic reevaluations for the purpose of adjusting the disability rating awards (increase or decrease) as the level of impairment from a given service connected medical condition may vary (improve or worsen, affecting future employability) over the lifetime of the veteran. The complete BCMR Medical Consultant’s evaluation is at Exhibit C. ________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: He has over 15 years of service, to include his service as a prior enlisted combat veteran, which makes him eligible for the length of service retirement. The evidence in his medical records is unequivocal that he was diagnosed and treated for symptoms in 2003 while stationed at Langley Air Force Base (AFB), VA. His healthcare provider never initiated a P4T profile or MEB to evaluate his condition and did not properly execute a disposition. This grossly misrepresented his health and worldwide deployability status to his commanders. He is confident that had an MEB been conducted in 2003 when he was initially diagnosed with asthma, as required by governing law and AFI, he would have been referred to the PEB and be given a combined disability rating higher than 30 percent for his conditions, and with more than 15 years of active military service, he would have been medically retired. He can only speculate that his health care provider did not champion his disqualifying condition by initiating a P4T profile and MEB because Langley AFB, an Air Combat Command (ACC) base with a high operations tempo needed every airman to be readily available for deployment. Additionally, they were severely understaffed and manned at only 60 percent for mental health providers and he was the only Family Advocacy Officer (FAO) for a wing-level program. The preponderance of evidence shows that his medical condition was not completely considered at the time of his discharge and his MEB for asthma was stopped at the military treatment facility based presumably on the pending separation. Therefore, his case should have been processed for “dual action” review and forwarded to the Secretary of the Air Force Personnel Council (SAFPC) which did not happen. There is precedence that MEBs referred members to PEBs for diagnosis of mild, persistent asthma and PEBs recommended medical discharge/retirement based on the diagnosis. In the interest of justice he requests the Board correct his records to show he was found unfit and that he be medically retired in the grade of Captain (O-3) and that he be assessed as combat related in order to qualify for compensation under CRSC. The applicant states that at the time of his separation, he had no reliable counsel to advise him on his rights and options. He was ill-advised and misled concerning his options and decisions and was not informed that he was eligible for a medical retirement rather than separation. The applicant’s completion submission, with attachments, is at Exhibit E. ________________________________________________________________ ADDITIONAL AIR FORCE EVALUATION: AFRC/SG recommends denial. The applicant has failed to provide any documentation that would allow SG to offer an opinion that would support the need for a MEB and recommends no change to his disability processing but defers to the Board to determine if the Air Force Personnel Center or the Air Force Disabilities Branch could better answer for the decisions of the Regular component. His designation as a Reserve officer is solely based on his separation from the Regular component and placement into the Inactive Ready Reserve (IRR). A courtesy review of the medical documents provided does not support a level of disability that would prevent the applicant from performing his in-garrison work as a clinical social worker. If his case was submitted to SGP for adjudication with the submitted documents, he would be returned to duty with an Assignment Limitation Code (ALC) C-3, not recommended for medical separation. Any DVA disability rating is wholly separate from this action and not indicative of his ability to meet duty, rank, grade or rating requirements. The complete SG evaluation is at Exhibit F. ________________________________________________________________ APPLICANT’S REVIEW OF ADDITIONAL AIR FORCE EVALUATION: He is confused by the recommendation of the command surgeon who advises no relief should be offered. He has never served in an Air Force reserve unit and has no reserve medical records for him to base his recommendation on. He provides another copy of his rebuttal, dated 28 May 2013, and is hopeful that this persuasive evidence will provide a compelling basis to grant a medical retirement. The applicant’s complete response, with attachments, is at Exhibit H. ________________________________________________________________ ADDITIONAL AIR FORCE EVALUATION: The BCMR Medical Consultant presents additional facts and evidence in response to the applicant’s rebuttal in an effort to facilitate an unbiased Board decision. As a reminder, the applicant was involuntarily separated due to being twice deferred for promotion to the grade of major and notes he received a LOR and Unfavorable Information File (UIF) with markdowns in leadership on his final OPR. Nevertheless, confounding this separation is evidence that the applicant had been diagnosed with exercise-induced asthma and had been under consideration for an MEB in 2004, a board which was not pursued. The question confronting the BCMR Medical Consultant and the Board is to determine whether this apparent failure to consummate the MEB, and to implicitly find him unfit, represented an error or injustice to him. The evidence shows he had a disqualifying medical condition, albeit characterized as “mild” over the final period of his service (2002 to 2004); noting his reported ability to run up to three to four miles as recent as his Mar 2004 clinic visit. Moreover, other than the applicant’s final OPR and the likely resultant of his non-selection for promotion, he had otherwise demonstrated the ability to perform his professional military duties unimpeded by his mild exercise-induced asthma. The applicant is correct regarding the health and mission risks this medical condition imposes under operational considerations. Although disqualifying under AFI 48-123, a diagnosis of asthma does not universally result in an unfit finding by a PEB. In the applicant’s case, when collectively considering his occupation, Air Force Specialty Code (AFSC), years of service, total duration of his symptoms without impediment to duty or a profile prohibiting worldwide qualification until the end of his career, his expressed desire and apparent ability to perform continued service and the “mild” characterization of his disease; circumstances are created under which a PEB might have also found him fit to return to duty; but not for his involuntary separation. Alternatively, had the applicant indeed completed a MEB in 2004 and was found unfit by a PEB, considering he would have been concurrently the subject of an involuntary release from service, his case would have been referred to the Secretary of the Air Force Personnel Council (SAFPC) for a final disposition; specifically, to decide which [medical versus administrative] was the appropriate basis for his release from service. The SAFPC would be confronted with identification of any causal or mitigating relationship between the applicant's medical condition and the reason for his administrative release from service in deciding the final disposition; of which the Consultant found none. However, the SAFPC would also likely consider the comparative gravity and duration of the applicant's medical condition viewed against the reason for his discharge; bearing in mind that each of the aforementioned scenarios are purely hypothetical for the Board's consideration. The evidence of record is sufficient to have justified a MEB at or about the end of 2003, if not earlier; but notes that neither the applicant nor his providers pursued earlier introduction of worldwide duty restrictions. Should the Board decide that an injustice occurred in the applicant’s case warranting a medical separation, then based upon his pulmonary function results, and the fact that he was prescribed an inhaled anti-inflammatory medication, he would have qualified for a medical retirement with a 30 percent disability rating under the VASRD code 6602. The BCMR Medical Consultant’s complete evaluation is at Exhibit I. ________________________________________________________________ APPLICANT’S REVIEW OF ADDITIONAL AIR FORCE EVALUATION: He does not believe the Air Force meant to commit the wrong his records bear but he does believe he has been the victim of an error and injustice in the administrative processing of his discharge. His rebuttal demonstrates the burden of proof of an error or injustice has been sufficiently met to warrant a favorable consideration and retroactive change of his records to permanent disability retirement. The legal guidance that airmen who have disabilities acquired in the line of duty be offered orders extending them until the disability is corrected, or completion of the DES was not followed. Although AFI 48-123 states a diagnosis of asthma is an unfitting and disqualifying condition that is unacceptable for continued military service he was not evaluated by an MEB. If he would have been evaluated by an MEB, he would have been referred to the PEB and he would have been permanently retired for disability. Furthermore, because he was pending an administrative discharge, his case would have been processed for “dual action” and forwarded SAFPC. The SAFPC would have likely found that his medical condition (combat related PTSD) may have influenced or mitigated his conduct that resulted in the LOR. In more than 15 years of decorated and honorable military service, this was the first and only time; he received an LOR and UIF. In a similar BCMR case, the BCMR Medical Consultant states that it is plausible to view the pattern of behavior exhibited by the applicant as consistent with the beginnings of PTSD. Receiving an LOR for actions outside of his normal functioning in more than 15 years of active military service and subsequent to combat duty in the Persian Gulf appears to have been consistent with characteristics associated with PTSD. The BCMR Medical Consultant is contradicted in his statements because precedent is unequivocal that MEB’s have recommended applicants to an IPEB based on diagnosis of asthma, mild, persistent. Moreover, FPEBs have overwhelmingly upheld the findings and he offers BCMR ROPs highlighting precedence to support his request for a medical retirement. The applicant’s complete response, with attachments, is at Exhibit K. ________________________________________________________________ THE BOARD CONCLUDES THAT: 1. The applicant has exhausted all remedies provided by existing law or regulations. 2. The application was not timely filed; however, it is in the interest of justice to excuse the failure to timely file. 3. Insufficient relevant evidence has been presented to demonstrate the existence of an error or an injustice. After reviewing the evidence of record, we are not persuaded that the applicant's records are in error or that he has been the victim of an injustice. In this respect, we note that during the applicant's military service, he was seen and treated for a variety of medical conditions. He was subsequently diagnosed with asthma, cold injury residuals [of the extremities] and combat-related PTSD. The applicant states that the, Air Force violated regulations in failing to process him through the DES for his service incurred unfitting disqualifications. However, there is no documentation in the applicant's records showing that any of his medical conditions prevented him from performing his assigned duties. Instead the evidence reflects that he was twice deferred for promotion to the grade of major and as a result was involuntarily separated IAW governing Air Force directives. We also note that DoDI 1332.38, Physical Disability Evaluation, in effect at the time of the applicant's release from service paragraph E3.P3.3.3. states “If the evidence establishes that the Service member adequately performed his or her duties until the time the Service member was referred for physical evaluation, the member may be considered fit for duty even though medical evidence indicates questionable physical ability to continue to perform duty.” Further, paragraph E3.P3.3.4, states “Regardless of the presence of illness or injury, inadequate performance of duty, by itself, shall not be considered as evidence of unfitness due to physical disability unless it is established that there is a cause and effect relationship between the two factors. Based on a thorough review of the evidence of record and noting the comments of the BCMR Medical Consultant that he found no relationship between the applicant's medical condition and his administrative release from service, it is our opinion that there was no error or injustice in the processing of his involuntary separation. We note the BCMR Medical Consultant states that had the applicant indeed completed a MEB in 2004 and was found unfit by a PEB, his case would have been referred to SAFPC for a final disposition. However we disagree. While the applicant’s separation was involuntary, the evidence reflects that he was separated due to his two nonselections for promotion to the grade of major; therefore, we do not believe his case would have been processed as a dual action. The applicant’s assertions that his combat related PTSD may have influenced or mitigated his conduct are duly noted, however, we do not find his uncorroborated assertions, in and by themselves sufficiently persuasive to override the evidence of record. Although the applicant states that the DVA rated him at 80 percent and confirmed his diagnosis of exercised induced asthma and PTSD were service-connected, we note, the Military Disability Evaluation System (MDES) only offers compensation for the medical condition that is the cause for career termination; and then only to the degree of impairment present at the time of final disposition or military separation. Conversely, the Department of Veterans Affairs (DVA) operates under a separate set of laws which takes into account the fact that a person can acquire physical conditions during military service that, although not unfitting at the time of separation, may later progress in severity and alter the individual's lifestyle and future employability. Therefore, in view of the forgoing the applicant has failed to sustain his burden of proof that he has been the victim of an error or injustice. In view of the above and in the absence of persuasive evidence to the contrary, we find no basis to recommend granting any of the relief sought in this application. 4. The applicant also asserts, in essence, that relief is warranted based on precedence and cites several AFBCMR cases he believes supports his request. However, we disagree. Every case before this Board is considered on its own merit since the circumstances of each case are seldom identical. After a careful review of the cases provided by the applicant we find all of them distinguishable from the applicant’s request as none of the cases are comparable. Although, the applicant states that the IPEB has consistently recommended that other applicant’s be medically discharged, the evidence reflects that these applicants were determined unfit and referred to the MEB, whereas the applicant in this case was not. Additionally, the applicant in the case under review requests a combat-related medical retirement in the grade of captain. In contrast, the applicant’s in BC-2002-02199, BC-2007-00886, BC-2009-02501, BC- 2003-02027, BC-2007-00886 and BC-2002-01096, requested their records be corrected to show that they were fit and returned to active duty or allowed to re-enlist in the Air Force which are the complete opposite of the applicant’s request for a medical retirement. Therefore, we do not find the cases he references supports his request for a medical retirement. 5. Although we are not bound by decisions of the Physical Disability Board, we reviewed PD2009-00221 and noted that the applicant in PD2009-00221 requested the Board increase her disability rating of 10 percent for asthma to 30 percent and the PDBR granted the applicant’s request. We find that the decision in PD2009-0021 is distinguishable from the applicant’s case. In this respect, we note that the applicant in PD2009-00221 was initially referred to the PEB for asthma, mild persistent and found unfit for continued military service and separated with a 10 percent disability rating, whereas in the case before us, there is no evidence the he was unable to perform his duties due to a medical condition, rather the evidence reflects that he was involuntarily separated due to his two-time nonselections for promotion to the grade of major. Moreover, the applicant in the current case is requesting that his record be corrected to show that he was medically retired whereas the applicant in PD200909221 requested an increase in her disability rating. In view of the foregoing, we do not find that the case he references supports his request for a medical retirement. 6. In BC-2006-01369, the applicant requested pay, allowances, and service credit from 7 Sep 2002 to 29 Apr 2005, reimbursement for attorney fees and back-pay for the years of lost promotion opportunities and expenses incurred as a result of not having health coverage as a reservist who was demobilized. The Board partially approved the request because the applicant was unavailable for world-wide duty and the Air Force Reserve did not extend the applicant on active duty for evaluation by the Disability Evaluation System (DES). In the case under review, the applicant is requesting a medical retirement. Therefore, we do not find that this case is identical to the applicant’s or that it supports his request for a medical retirement. 7. The cases noted below were all denied by the Board, as such, we do not find that any of the cases are identical to the applicant’s nor do they support his request for a medical retirement. Nonetheless, the following is noted: In BC-2006-03835, the applicant requested his general discharge be changed to a medical discharge. After careful review of the evidence, the Board agreed with SAFPC that they found no link between the applicant’s conduct and his asthma, therefore, the Board denied his request. In BC-2007-00068, the applicant requested a review of the MEB which had found the applicant unfit with a disability rating of 20 percent. The Board denied the applicant’s request citing they believed the SAFPC review of the completed MEB package was sufficient to make a fair and equitable decision on the case and that the applicant had not provided any new medical documentation to warrant another review of the MEB findings. In BC-2005-01141, the applicant requested his disability discharge with a 10 percent disability rating be changed to a 30 percent retirement based on his DVA rating. The Board denied the applicant’s request agreeing with the BCMR Medical Consultant that the medical evidence, MEB, IPEB and FPEB supported a disability discharge with 10 percent disability rating and his conditions of chronic pansinusitus and seasonal allergic rhinitis were not considered compensable or ratable. In BC-2004-03351, the applicant requested his discharge with severance pay rated at 10 percent be changed to a medical retirement with a rating of 30 percent. The Board denied the applicant’s request stating they did not believe the disability processing and the rating assigned at final disposition were contrary to the governing Air Force instruction and the law. With respect to BC-2004-02625, the applicant requested her 10 percent disability rating when she was removed from the Temporary Disability Retired List (TDRL) be changed to 30 percent to qualify for medical retirement. The Board denied the applicant’s request stating the evidence did not support a change to her disability rating. With respect to BC-2005-01947, the applicant requested that her separation reason be changed to “Disability – Did not exist prior to service” and she receives severance pay. The Board denied the applicant’s request citing the medical evidence supported the applicant’s discharge of “Disability – Existed prior to service, PEB – no severance pay.” With respect to BC-2002-01740, we note the applicant in this case requested his RE Code 2Q which denotes “Medically Retired or Discharged” be changed to RE Code 3K which denotes “Reserved for use by HQ AFPC or AFBCMR for Correction of Military Records when no other reenlistment eligibility code applies” stating he did not have an anxiety disorder. In 2001, the applicant petitioned the BCMR to remove his diagnosis of asthma and the Board recommended that his reason for separation be changed from asthma to an anxiety disorder. 8. Although the preceding cases referenced by the applicant include asthma as a factor, we do not find that any of these cases are identical to the applicant’s and in our opinion they add no credence to his request for a medical retirement. Therefore, in the absence of evidence that the applicant was treated differently than others similarly situated we find no equitable basis to grant any of the relief sought in 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 AFBCMR Docket Number BC-2013-01109 in Executive Session on 20 Feb 2014, under the provisions of AFI 36-2603: , Panel Chair , Member , Member The following documentary evidence was considered: Exhibit A. DD Form 149, dated 1 Mar 2013, w/atchs. Exhibit B. Applicant’s Master Personnel Records Exhibit C. Letter, BCMR Medical Consultant, dated 20 May 2013. Exhibit D. Letter, SAF/MRBC, dated 21 May 2013, w/atch. Exhibit E. Letter, Applicant, dated 28 May 2013, w/atchs. Exhibit F. Letter, AFRC/SG, dated 29 May 2013. Exhibit G. Letter, SAF/MRBC, dated 10 Jun 2013, w/atch. Exhibit H. Letter, Applicant, dated, 14 Jun 2013, w/atch. Exhibit I. Letter, BCMR Medical Consultant, dated 8 Oct 2013. Exhibit J. Letter, SAF/MRBC, dated 9 Oct 2013, w/atch. Exhibit K. Letter, Applicant, dated 22 Oct 2013, w/atch. Panel Chair