RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2013-01763 COUNSEL: NONE HEARING DESIRED: NO ________________________________________________________________ _ APPLICANT REQUESTS THAT: Her 20 percent disability rating for Complex Regional Pain Syndrome (CRPS) be changed to a minimum of 30 percent. ________________________________________________________________ _ APPLICANT CONTENDS THAT: The Department of Veterans Affairs (DVA) rated her at 40 percent disabled. In support of the applicant’s appeal, she provides documentation from the DVA. The applicant's complete submission, with attachments, is at Exhibit A. ________________________________________________________________ _ STATEMENT OF FACTS: The applicant with 13 years, 11 months and 19 days of active service was honorably discharged on 31 October 2011 in the grade of technical sergeant. On 29 September 2009, a Medical Evaluation Board (MEB) convened and referred the applicant's case to an Informal Physical Evaluation Board (IPEB) with a diagnosis of complex regional pain syndrome. The IPEB found her unfit for further military service and recommended discharge with severance pay with a disability rating of 20 percent for a diagnosis of complex regional pain syndrome. The applicant did not agree with the findings and recommended disposition of the IPEB and requested a formal hearing. The Formal Physical Evaluation Board (FPEB) reviewed the case and recommended discharge with severance pay with a disability rating of 10 percent for complex regional pain syndrome. On 26 July 2010, the applicant requested her case be reviewed by the Secretary of the Air Force Personnel Council (SAFPC). On 18 August 2011, SAFPC directed that the applicant be discharged and receive severance pay with a disability rating of 20 percent under the provisions of Title 10, United States Code, Section 1203. SAFPC noted the applicant’s medical record reflected insufficient evidence to find her conditions were separately unfitting or resulted in her inability to perform her duties or deploy. The applicant contended she should be rated at a 40 percent disability with a code of 8799-8720. The board acknowledged the applicant’s subjective symptoms of pain and physical exam sensory disturbances, but failed to find sufficient medical record evidence or objective findings of excruciating pain, muscle atrophy and loss of reflexes to meet the higher rating threshold. According to VASRD code 8720 her condition most appropriately corresponded to the moderate incomplete paralysis rating with a disability rating of 20 percent. ________________________________________________________________ _ AIR FORCE EVALUATION: AFPC/DPFD recommends denial. DPFD states as background, the Department of Defense and the DVA disability evaluation systems operate under separate laws. Under Title 10, U.S.C., Physical Evaluation Boards must determine if a member’s condition renders them unfit for continued military service relating to their office, grade, rank or rating. The fact that a person may have a medical condition does not mean that the condition is unfitting for continued military service. To be unfitting, the condition must be such that it alone precludes the member from fulfilling their military duties. If the board renders a finding of unfit, the law provides appropriate compensation due to the premature termination of their career. Further, it must be noted the USAF disability boards must rate disabilities based on the member’s condition at the time of evaluation; in essence of snapshot of their condition at that time. It is the charge of the DVA to pick up where the AF must, by law, leave off. Under Title 38, the DVA may rate any service-connected condition based upon future employability or reevaluate based on changes in the severity of a condition. This often results in different ratings by the two agencies. The preponderance of evidence reflects that no error or injustice occurred during the disability process. The DPFD complete evaluation is at Exhibit C. The AFBCMR Medical Consultant recommends denial. The AFBCMR Medical Consultant states the Disability Evaluation System (DES), operating under Title 10, United States Code (U.S.C.), can only, by law, offer compensation for an illness, disease, or injury that is the cause for career termination; and then only to the degree of impairment present at the time of final military disposition, and not based upon subsequent post-service changes, unless in TDRL status. Although the evidence reflects the applicant experienced other medical conditions that were found connected with her military service, e.g., migraine headaches, and a separate rating for pain disorder, the evidence was insufficient to reflect these as separate bases for career termination; as would be reflected in profile restrictions or duty limiting condition reports specifically directed at these additional conditions. Addressing the applicant’s request for a 40 percent disability rating for CRPS, attention is directed to an extract from section 4.124 of 38 CFR outlining the policy for rating neuralgia [pain] of cranial or peripheral nerve origin, which reads: “Neuralgia, cranial or peripheral characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the same scale, with a maximum equal to moderate incomplete paralysis.” Thus, in this instance, assignment of a 20% disability rating is consistent with the policy outlined. The AFBCMR Medical Consultant’s complete evaluation is at Exhibit D. ________________________________________________________________ _ APPLICANT'S REVIEW OF AIR FORCE EVALUATIONS: The applicant reviewed the evaluations and states the military is behind the curve in understanding her condition and rating it under the wrong category. Her condition should have been rated at 40 percent. During her FPEB her lawyer provided documentation stating her pain clinic provider was wrong in delaying her care to involve mental health for depression that is a result of having her condition not a separate diagnosis. She was considered at 40 percent by the Air Force but it was decided to award a 20 percent. Clearly, it was seen initially that she should have been rated 40 percent. It appears that since her injury did not occur in a war zone but instead in a teaching position, she was denied the assignment to a patient squadron. The military treats this condition extremely opposite of the civilian sector. The applicant’s complete response, with attachments, 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. After a thorough review of the evidence of record and the applicant’s submission, we are not persuaded the applicant’s disability rating should be increased. Her contentions are duly noted; however, we do not find these assertions sufficient to override the rationale provided by the office of primary responsibility and the BCMR Medical Consultant. We therefore agree with the opinion and recommendation of the office of primary responsibility and the BCMR Medical Consultant and adopt their rationale as the basis for our conclusion that the applicant has not been the victim of an error or injustice. Therefore, in the absence of evidence to the contrary, we find no basis to recommend favorable consideration of this request. ________________________________________________________________ _ THE BOARD DETERMINES THAT: The applicant be notified the evidence presented did not demonstrate the existence of an error or injustice; the application was denied without a personal appearance; and 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-2013-01763 in Executive Session on 7 January 2014, under the provisions of AFI 36-2603: The following documentary evidence pertaining to AFBCMR Docket number BC-2013-01763 was considered: Exhibit A. DD Form 149, dated 8 April 2013, w/atchs. Exhibit B. Applicant’s Master Personnel Records. Exhibit C. Letter, AFPC/DPFD, dated 21 June 2013. Exhibit D. Letter, AFBCMR Medical Consultant, dated 17 July 2013. Exhibit E. Letter, SAF/MRBC, dated 23 July 2013. Exhibit F. Letter, Applicant, dated 23 July 2013, w/atchs. 4 5