RECORD OF PROCEEDINGS
             AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS


IN THE MATTER OF:      DOCKET NUMBER:  97-02770

      XXXXXXXXXXXX     COUNSEL:  None

      XXXXX HEARING DESIRED:  No


_________________________________________________________________

APPLICANT REQUESTS THAT:

Her discharge be changed to indicate she was separated for  medical  reasons
and she be placed on the Permanent Disability Retired List.

_________________________________________________________________

APPLICANT CONTENDS THAT:

While she was in the service,  her  left  knee  was  injured,  with  a  torn
cartilage-severe.  Her records  include  slipped  disk  (L2-L3)  herniation,
severe hypertension, and stomach ulcers.  This information was shown in  her
service medical records.  She requested additional testing but was  refused.
 Upon separation the  evaluation  at  the  Veterans  Administration  Medical
Center (VAMC) Phoenix verified these  items.   Her  left  knee  surgery  was
accomplished at Offutt AFB hospital on April 8, 1997.  She was told  not  to
lift, squat, or kneel.  Her Magnetic Resonance Imaging  (MRI)  on  her  back
that was requested at this time was canceled.  The MRI  done  on  her  lower
back showed herniation of discs on L2 and  L3.   Further  testing  is  being
done on her lower back.

In support of the appeal,  applicant  submits  MRI  Results,  dated  17 July
1997, and medical records.

Applicant's complete submission is attached at Exhibit A.

_________________________________________________________________

STATEMENT OF FACTS:

The applicant was appointed  to  the  Reserve  of  the  Air  Force  (ResAF),
Medical Corp, on 31 January 1990 in the grade of major.  She was ordered  to
extended active duty on 21 February 1990.

In May 1992, the applicant injured her  left  knee  while  participating  in
combat medicine training, C4 course, and  was  seen  for  this  on  numerous
occasions.

In April 1997, she  underwent  arthroscopy  on  her  left  knee  where  mild
degenerative cartilage changes were found and treated.   She  was  diagnosed
with patellofemoral pain syndrome and treated with medications and  physical
therapy.

A back Computerized Axial Tomography (CAT) scan on 22 November 1996 did  not
disclose any significant abnormality of her back.

On 17 July 1997, a MRI showed mild disc protrusion  without  impingement  on
the spinal cord or nerve roots and its  clinical  significance  was  labeled
“uncertain.”

The applicant was honorably discharged from the USAFR on 30 June 1997  under
AFI 36-3207, Maximum Age.  She served 7 years, 4  months,  and  10  days  of
total active duty and received $32,149.92 in separation pay.

On 18 March 1998, the Department of Veterans Affairs  evaluated  applicant’s
service connected disabilities at a combined evaluation of 50 percent.

            Degenerative joint disease of lumbosacral spine  with  herniated
disc L2-3 - 40 percent.

            Gastroesophageal  reflux  with  history  of  GI  bleeding  -  10
percent.

            Residuals, left knee trauma, status  post  arthoscopic  surgery,
with arthritis - 10 percent.

_________________________________________________________________

AIR FORCE EVALUATION:

The Chief Medical Consultant, AFBCMR, reviewed the  application  and  states
that while the applicant was treated  for  some  ordinary  medical  problems
while on active duty, as will occur in most service members, none  of  these
problems singly, nor any combination of them, was of sufficient severity  to
justify a finding of unfit.  There  is  no  evidence  to  suggest  that  the
applicant  deserved  consideration  for  separation  through   the   Medical
Disability Evaluation System.  Evidence of  record  establishes  beyond  all
reasonable doubt that the applicant was medically  qualified  for  continued
active duty, that the reason for her separation  was  proper,  and  that  no
error or injustice occurred in this case.  The BCMR  Medical  Consultant  is
of the  opinion  that  no  change  in  the  records  is  warranted  and  the
application should be denied.

A complete copy of the Air Force evaluation is attached at Exhibit C.

The  Chief,  Physical  Disability  Division,  Directorate   of   Pers   Prog
Management, AFPC/DPPD, reviewed the application and states that the  purpose
of the military disability system is to maintain a fit and  vital  force  by
separating members who are unable to perform  the  duties  of  their  grade,
office, rank or rating.  Members who are separated or retired for reason  of
physical disability may be eligible, if  otherwise  qualified,  for  certain
disability  compensations.   Eligibility  for   disability   processing   is
established by a Medical Evaluation Board (MEB) when that board  finds  that
the member may  not  be  qualified  for  continued  military  service.   The
decision to conduct an  MEB  is  made  by  the  medical  treatment  facility
providing care to the member.  They have verified  that  the  applicant  was
never referred to or considered  by  the  Air  Force  Disability  Evaluation
System under the provisions of AFI 36-3212.  A  review  of  the  applicant’s
case file revealed no mental or physical defect which would  have  made  her
unfit for  continued  military  service  at  the  time  of  her  involuntary
separation. The applicant has not submitted any  material  or  documentation
to show  that  she  was  unfit  due  to  a  physical  disability  under  the
provisions of Title 10 USC at the  time  of  her  involuntary  release  from
active duty.  They recommend denial of the applicant’s request.

A complete copy of the Air Force evaluation is attached at Exhibit C.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

The applicant reviewed the Air Force evaluations and states  that  there  is
nothing in the discussion section that suggests that anyone, anytime, on  an
on-going basis, inquired whether she was well enough to perform her  duties.
 She is a physician and a person of high moral  standards.   She  could  not
abandon her patients because she was in  chronic  pain.   Consequently,  she
was prescribed by the military doctor  anti-inflammatory  medications  which
have controlled some of the pains but which had a  negative  effect  on  her
general health causing serious GI problems.  The medications given  for  her
knee masked the disc injury to her back.  These medications would  not  have
been necessary had she not suffered a serious fall (which was downplayed  by
the  military  medical  doctors)  aftermath  of  the   C4   exercise.    The
consequence of all this has been  and  is  still  chronic,  unrelenting  and
debilitating pain.  Don’t try to use the fact that she was recruited at  age
54, that did not deter the military from  assigning  her  to  full  military
duties.  A thorough  physical  examination  revealed  that  except  for  her
controlled hypertension, she was  in  good  physical  health.   She  had  no
limited mobility.  She could  walk,  jump,  climb,  run,  and  did  all  the
military exercises well.  This  was  all  prior  to  injuries  she  suffered
during  the  C4  exercise.   Because  the  injury  to  her  left  knee   was
misdiagnosed, she was advised  to  continue  exercises  to  her  quadenricep
muscles. She was still  on  prescription  anti-inflammatory  medicine  which
masked the pain therefore aggravating the severe damaged  cartilage  on  her
left knee.  She continues to do physical activity.   Because  she  continued
physical activity and carrying heavy back pack during  exercises  and  still
taking pain medication, the injury to her back did  not  become  immediately
apparent.  Prior to leaving the service she was scheduled  for  a  MRI,  but
this was canceled because she was fully scheduled  in  the  office  and  the
commander refused to permit her the three days to  go  to  another  facility
for the test.  A CAT scan was done but is less accurate  and  did  not  show
the damage to the L2 and L3 discs.  Had an MRI  been  done,  she  would  not
have further injured herself by lifting and other physical activities  which
she should have refrained from had she  been  properly  diagnosed.   Despite
repeated requests for a medical review  and  more  definitive  testing,  the
military involuntarily discharged her.

Applicant's complete response, with attachments, is attached 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  probable  error  or  injustice.   We  note  that  a  member’s
eligibility  for  disability  processing  is  established   by   a   Medical
Evaluation Board when that board finds the member may not be  qualified  for
continued  military  service.   The  applicant  was  not  referred   to   or
considered by the Air Force Disability Evaluation  System  and  evidence  of
record indicates that she  was  medically  qualified  for  continued  active
service at the time of her separation.  We note that while  it  appears  the
applicant had some medical problems while  on  active  duty,  they  did  not
prevent her from performing her duties.  We  also  note  that  the  Veterans
Affairs has evaluated the applicant’s service connected  disabilities  at  a
combined evaluation of 50 percent.  Nonetheless, the  VA  operates  under  a
totally separate system with a  different  statutory  basis.   Specifically,
the VA rates for any and all service connected  conditions,  to  the  degree
they interfere with future employability, without consideration of  fitness.
 In view of the foregoing, we are not persuaded that the applicant’s  reason
for separation was improper or that an  error  or  injustice  has  occurred.
Therefore, in the absence of substantial evidence to the contrary,  we  find
no compelling basis to recommend granting the relief sought.

_________________________________________________________________

THE BOARD DETERMINES THAT:

The applicant be notified that the evidence presented  did  not  demonstrate
the existence of probable 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 16 December 1998, under the provisions of AFI 36-2603:

      Panel Chair
      Member
      Member

The following documentary evidence was considered:

      Exhibit A. DD Form 149, dated 9 Sept 97, w/atchs.
      Exhibit B. Applicant's Master Personnel Records.
      Exhibit C. Letter, BCMR Medical Consultant, dated 4 Mar 98.
      Exhibit D. Letter, AFPC/DPPD, dated 17 Apr 98.
      Exhibit E. Letter, AFBCMR, dated 27 Apr 98.
      Exhibit F. Applicant’s Response, dated 8 Jun 98, w/atchs.





                             Panel Chair