RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2013-03317 COUNSEL: NO HEARING DESIRED: YES _________________________________________________________________ APPLICANT REQUESTS THAT: He be given a full Medical Evaluation Board (MEB). _________________________________________________________________ APPLICANT CONTENDS THAT: During his Gulf War deployment, he acquired health illnesses to include undifferentiated connective tissue; fatigue; fibromyalgia; lupus; sjogren’s syndrome; gastrointestinal disorders; and Post-Traumatic Stress Disorder (PTSD) which caused his health to rapidly deteriorated upon his return from Iraq. In support of his appeal, the applicant provides a copy of his DD Form 214, Certificate of Release or Discharge from Active Duty; medical records, letters of support, and other various documents associated with his request. The applicant's complete submission, with attachments, is at Exhibit A. _________________________________________________________________ STATEMENT OF FACTS: According to the AFRC/SGP memorandum, dated 22 Apr 10, the applicant was medically disqualified from continued military duty in accordance with AFI 48-123, Medical Examination and Standards due to Lupus (an autoimmune disease), Sjogren’s Syndome, chronic myalgia and requiring extensive drug therapy. The applicant’s case was forwarded to AFRC/A1KK for continued processing. On 14 Jul 10, the Informal Physical Evaluation Board (IPEB) reviewed the applicant’s case and found him unfit to perform the duties of his office, grade, rank or rating due to Lupus Erythematosis with chronic myalgia and Sjogren’s Syndrome. On 9 Aug 10, the applicant was notified of the IPEB’s findings. On 15 Aug 10, the applicant waived his right to a Formal PEB hearing. On 26 Oct 10, the applicant requested he be transferred to the Retired Reserve in lieu of an administrative discharge, effective 30 Jan 11. On 27 Oct 10, Headquarters AFRC Military Personnel Division (AFRC/A1KK) notified the applicant of their intent to initiate his discharge from the Air Force Reserve for Physical Disqualification under the provisions of AFI 36-3209, Separation and Retirement Procedures for Air National Guard (ANG) and Air Force Reserve (AFR) Members. The applicant’s unit commander recommended to the 610 Regional Support Group commander (610 RSG/CC) that the applicant be allowed to retire since he was eligible with pay at age 60. The 610 RSG/CC concurred with the unit commander’s recommendation. According to Reserve Order EK-0985, dated 18 Nov 10, the applicant was relieved from the 610 Security Forces Squadron (610 SFS), Carswell, Texas, assigned to the Retired Reserve Section and placed on the Air Force Reserve Retired List effective 30 Jan 11. _________________________________________________________________ AIR FORCE EVALUATION: AFRC/SG recommends denial. At the time of processing, the IPEB determined the applicant’s case was Line of Duty (LOD) NA. The applicant never asserted any LOD connection when the case was worked and there was no evidence of a LOD requirement in the case as submitted. A review of the documents submitted as part of his AFBCMR request does not change the fact that this is not a duty related condition according to AF guidance. The latency of 16 years between the alleged nexus of Gulf War I to a sudden onset of a connective tissue disorder a decade later is not medically supported by any long-term epidemiologic studies. The same medical rationale applies to potential exposures to “burn pits” or depleted uranium during Operation ENDURING FREEDOM. No objective studies have found a link to chronic fatigue, hematologic disorders, breathing disorders or connective tissue diseases. Thus none of these conditions are In the Line of Duty (ILOD) as applied to Air Force disability retirement. This finding is in accordance to generally accepted medical principals. SG does not dispute the presence of the applicant’s condition, nor his right to Department of Veteran’s Affairs (DVA) healthcare and disability compensation from the DVA. However, just like our veterans from Vietnam, the applicant should pursue medical care and disability benefits from the DVA as his form of relief. Doing so would uphold the proper finding of LOD NA as well as allowing appropriate care and compensation under the independent interpretation of “service-connection” applied by the DVA to conditions with no clear nexus or epidemiologic connection to service, but found by the DVA to be “service- connected” as part of catastrophic illnesses or ongoing longitudinal studies of veterans. The complete SG evaluation is at Exhibit C. AFRC/AIK makes no recommendation. AIK states the applicant’s request does not fall within the purview of authority for the programs managed by their staff. Instead, his concerns all appear to be medically related and as such, possibly could be more appropriately addressed by a medical authoritative source. AIK deferred the applicant’s case to AFPC/DPSDD and/or AFRC/SG for a medical determination on whether or not the applicant meets the requirements for a MEB review. The complete A1K evaluation is at Exhibit D. The BCMR Medical Consultant recommends denial. The applicant believes that had he not declined a review by the FPEB, he might have been ruled eligible for a MEB and ultimately received a medical retirement, under AFI 36-3212. However, for an Air Reserve Component (ARC) member to become eligible for a MEB, the condition must have been found ILOD. The applicant’s medical condition was determined non-duty related and not ILOD. The Medical Consultant acknowledges that, operating under Title 38, United States Code (USC), the DVA has identified several medical conditions that are now presumed to be service- connected, by virtue of a veteran’s previous assignment or exposure in a given area of operations during a given timeframe (i.e. Diabetes in individuals who served in Vietnam with exposure to Agent Orange or an unexplained chronic multisystem illness (i.e. Fibromyalgia and chronic fatigue syndrome), in individuals who served in the Gulf War after Aug 90 and other environmental exposures (i.e. burn pits), thereafter. The Medical Consultant opines the evidence is insufficient to establish a retroactive ILOD finding and eligibility for compensable disability processing via a MEB review and subsequent PEB action, in accordance with AFI 36-3212, Physical Evaluation for Retention, Retirement, and Separation or Title 10 USC, chapter 61, Retirement or Separation for Physical Disability. The complete BCMR Medical Consultant 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 Jan 14, for review and comment within 30 days (Exhibit F). As of this date, this office has not received a response. _________________________________________________________________ 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 injustice. We took careful notice of the applicant's complete submission in judging the merits of the case; however, we agree with the opinions and recommendations of AFRC/SG and the BCMR Medical Consultant and adopt the rationale expressed as the basis for our conclusion the applicant has not been the victim of an error or injustice. In view of the above and in the absence of evidence to the contrary, we find no basis upon which to recommend granting the relief sought in this application. 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 issue(s) involved. Therefore, the request for a hearing is not favorably considered. _________________________________________________________________ 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-2013-03317 in Executive Session on 6 May 14, under the provisions of AFI 36-2603: Panel Chair Member Member Although chaired the panel, in view of her unavailability, has signed as Acting Panel Chair. The following documentary evidence pertaining to AFBCMR Docket Number BC-2013-03317 was considered: Exhibit A. DD Form 149, dated 2 Sep 13, w/atchs. Exhibit B. Applicant's Available Personnel Records. Exhibit C. Letter, AFRC/SG, dated 4 Oct 13. Exhibit D. Letter, AFRC/A1K, dated 18 Oct 13. Exhibit E. Letter, BCMR Medical Consultant, dated 9 Jan 14. Exhibit F. Letter, SAF/MRBR, dated 10 Jan 14. Acting Panel Chair