AIR  FORCE BOA?,D  FOR CORRECTION OF M I L I T A R Y   RECORDS 

2 E C O R C   OF 2R.aCEEDINGS 

L X  'THE  MATTER OF: 

D3ZKET NUMBER:  98-01145 

CZ',iNSEL :  NONE 

APPLICANT REQUESTS THFiT: 
Her  disability  rating  of  40%  he  increased  by  adding  brain  tumor 
to her basic  seizure disorder. 

APPLICAN"  CONTENDS THAT : 
The Medical Board Report  (AF ? o z x   618) found generalized seizures 
as the  reason  for retirement.  She Delieves  it  should also  list 
the  iesiDn/tumor  that  was  menyioned  on  the  supporting  document 
(Standard Form  502)  as  a  cause  f c r   these  seizures.  The  lesion 
h a s   subsequently  been  surgically  removed  and  has  caused  other 
deficits. 

I;i  scpport  of  her  request,  -,k?-z  applicant  subrn-ts  copies  of 
medical  reports from 
AFE  and letters from her neurologist 
and neurosurgeon  (Exhibit A). 

STATEMENT OF FACTS: 

- 
L - + L u g ~ ~ t  

- P  

t h e   Feguiar  Air  Force  on 

Applicant's military  personnel  recozds  reflect  that  she enl,sted 
1986.  ShiJ was  releaseu 
i i i  
Trrorr~ active  duty  in  t h e   qr-ade 3 r   staff  sergeant  'E-5) cn  6 Nay 
1396  f o r   n h y s i c a l   disability  a n d   her  name  was  placed  OR  the 
Temporary  Disability  Retlrement  List  (TDRL) ,  with  a  compensable 
rating  of  40%, effective  7  May  1996. 
Subsequen:  to  her  TDRL 
evaluation by the IPEB on 30 September 1997, the applicant's  name 
was  removed  from  the  TDRL  or?  24 November  1997,  and  she  was 
permanently  retired  w i t h   a  corrpensable  rating  of  40%.  She  was 
zredited with  a total of 9 years, 6 months  and  11 days of active 
Sel-T.rlce. 

?he  Lreievant  facts pertaining  to this  application  are  contained 
ir,  the  letters  prepared  by  the  appropriate  offices  of  the  Air 
Force.  Accordingly,  there  1s  no  need  to  recite  these  facts  in 
this Record of Proceedings. 

Fcrther  research with  the  Department  of Veteran' s AdIninistratlori 
reveals  that  the  applicant  was  gr6nted  a  20%  disability  ratin9 
lor a  seizure disorder. 

AIR  FORCE EVALUATION: 

- 

The AFBCMR Chief Medical Consultant  reviewed this application and 
is of the opinion that no change In the records is warranted  and 
the application  should be d e n i m .   The AFBCMR  Medical  Consultant 
stated that the applicant sufferec a generalized grandma1 seizure 
on  December  15,  1995,  and  - ~ z s  caluated,  findin?  an  zrea  ~t 
abnormality on her brain s c a n s / Y R I s .   Treatment w i t  h  Dilantin was 
xitiated, and she suffered no furcher seizures.  Close follow-up 
by  neurology  with  MRIs  did  not  disclose  changes  in  the  brain 
abnormality  over  time,  and  varicus  etiologies  of  the  mass  were 
considered.  The decision was rrLa+  zs observe her Iurther and, in 
the meantime,  she underwent Medical Evaluation Boaid and Physical 
Evaluatian  Board  processing  and  was  placed  on  the  Temporary 
T O R L )   on  9  May  1996  w i t h  
Disability  Retirement  List 
a 
campensade  rating  of  110%. 
2 g n t e e n   months  -ater,  a  TDRI, 
evaluatim  was  accomplished  and  permanent  disability  retiremert 
hTas  recommended  and  approved.  During  this  time,  her  follow-up 
had  not  disclosed  changes  in  t n e   brain  findings,  however,  in 
early  1998,  an  MR! 
disclosec  some  alterations  that  prompted 
neurosurgical  intervention  when  malignancy  of  the  mass  was 
determined. 
in  some  impairment  of  her 
\ i i s i o n   and because of the nzitare of the lesion, fuitner treatment 
is  now  mderway. 
Because  cf  The  new  findj ngs,  the  applicant 
seek:s  aaditlonal compensatim IS! her disabiliry ret irerrient award. 
The AFBCMR  Medical  Consultant  inaicated  that  once  an  individual 
has been  declared  u n f i  :,  the Sezi-ize Secretaries are  required q 
lsw to rate t h e   condition basec  upon the degree of  disability at 
the  time  of  permanent  dlsposition  and  not  on  futiire  events.  NG 
change  in  di s a b i i i t y  
ratings  can  occur  af-er  permanent 
disposition,  even  though  the  condition  may  became  better  OL 
w c r s e . 
However,  Title  38,  :Si“  authorizes  the  Department  o+ 
TJewrens Affairs  i DVA, 
tc  increase  or  decrease>  compensation 
ratings  based  upon  tne  indiviciual’s  condition  at  the  time  of 
f u t x e   evaluations  and  the  appXcant’s  recoiirse  tc  tnis 
entitlement  is  available.  The AFRCMR  Medical  Consultant  stated 
the  fact  that  the  lesion  that  was  responsible  for  her  seizure 
disorder  was not  definitively identified earlier ir, the course of 
her disease was in keeping with proper medical principles and her 
stated desire to not proceed with an earlier biopsy  as notea in a 
clinical  entry,  dated  15  July  1997,  on  one  of  h e r   follow-up 
vislts  (Exhibit C). 
_-  

The  surgery  resJ:i:ea 

The  Chief,  Physical  Disability  Division,  HQ  AFPC/DPPD,  stateu 
that-  a Medical  Evaluation Board  (MEB) was convened  at  E g l i n   A F B ,  
Florida,  on  30  January  1996,  and  referred  to  the  Informal 
Physical  EvaliJation  Board  (IPER).  On 14 February  1996, the IPEB 
f o u n d   the  n?ember  unfit  for  continued  military  service  for  a 
diaqnosl s  of  “generalized  seizure,  etiology  unknown”  and 
recommended  she be  placed  on the Temporary  Qisability  Retirement 
L-st  (TDZL), w i t h   a  40 percent  disability rating.  The applicant 
a g r e e d   with  the  findings  and  recommendations  of  the  IPEE  on 
12 Narch  1996,  and  subsequently, officials within  the  Office  of 

2 

53 8 - 0 11 4 5 

the  Secretary  of  the  Air  Force  directed  that  the  app;xar!t  be 
placed  on the  TDKL,  with  a  4@%  disability  raEing.  While  on  the 
the  a 
ant  was  scheduled  for  periodic  physical 
TDRL, 
evaluation .*at 
Based  on  the  medical 
evidence  provided,  the  IPEB  found  her  condition  nad  stabilized 
and recommended thar she be removed  from the TDRL  and permanently 
retired  w i t h   a  40%  disability  rating.  The  applizant  concurred 
w i t h   the  findings  and  recommendatisns  of  t h e   I P E B   on  2 0   October 
1597, and the applicant was removed from the TDRL  and permanently 
retired effective 24 November  ? 9 Y .  

. 

Following  a  thorough  review  of  the AFBCMR  case  file,  DPPD  finds 
n o   error  or  injustice  that  would  merit  a  change  to  the 
applicant’ s  record. 
DPPD  stated  that  the  applicant  has  not 
submitted  any  material  or  documentation  to  show  that  she  was 
inappropriately  rated  or  processed  under  the  provisions  of 
disability  law  and  departmental  policy  at  the  time  of  her 
disability  retirement.  DPPD  recarmended  the  applicant’s  request 
be denied  (Exhibit D) . 

APPLICANT ’ S  REVIEW OF AIR  FORCE  EVALUATION: 
?he  applicant  reviewed  the  advisoz-1; opinions  and  indicated  that 
upon her retirement, she contimed to see the neurclogist ana the 
neurosurgeons  at 
She  was  informed  m a t  because  of 
the deptn and location of the lesio:? it was too risky Lo  perform 
a biopsy unless there was a change.  On 20 November 1997, she had 
an  M R I   at  a  civilian  facility  and,  on  21  November  1997,  her 
civilian  neurologist  recommer,ded  surgery 
On 
25 November  1997, she saw the neurosurgeon  at 
and he 
informed  her  that  they would  go  in with  the intent_ to  remove as 
much  as possible and not  solell. z.  biopsy.  He asked  for O P , ~  more 
N R I   ir.  February  1998 and  surger?’ was  scheduled  for 6  April  1998. 
k Grade  11 Astrocytoma  was  resecyed  as  a  result of  this  surgery; 
dnd  she  has  been  l e f t   with  e  right  visual  field  deficir,.  Or, 
2 :   J u l y   1998,  she  completed  s i x   weeks  of  radiation  Therapy  at 
Keesler A F B .  
She  was  removed  from TDRL  on  24  November  1997,  j--1st  three  days 
after  her  civilian doctor  discovered  the  change.  There was  not 
enough  time  for  the board  to  see  the  details  in her  case.  But 
the  l e s i m  was  seen  prior  to  her  being  permanent-1-y retired  and 
no:  considered a cause of the seizure.  The change fron lesion to 
tumor occurred betweer, July 1997 and November  1997, while she was 
FB fel:  surgery was 
sxill on TDRL. 
important  but  it  had  to  wait  until  both  neurosurqeons  would  be 
present  -  April  6 was the first, date available. 
She  requested  a  disability  rating  f o r   the  lesion  itself,  since 
t h e   doctors had informed her that  it was a  problem not  related to 
L h e   seizure  that  she had  (reference visit  with  Dr. 
Chief, Neurology,  on  16 January  1996, which  occurred  while  still 
en  active  duty).  She  is  requesting  it  be  looked  at  from  tne 
point  of being a Grade I1 Astrocytoma  unrelated to the seizure. 

The neurosurgeon  at 

3 

9 8 -- 0 11 4 5 

A complete copy of this response is appended at Exhibit F. 

THE BOARD CONCLUDES THAT: 

1.  The applicant has exhausted 211.1 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.  In 
this regard, we  reviewed the applicant’s complete  submission  and 
t h e   evidence  of  record  in  judging  the  merits  of  :his  case.  In 
our  opinion,  the  applicant s  disability  case  was  properly 
evaluated,  appropriately  rated  and  received  full  consideration 
under  the  appropriate  regulations. 
All  levels  of  review 
considered the entire medical record in determining her unfitting 
medical  condition.  Once  an  individual  has  been  declared  unfit, 
the  Service  Secretaries  are  required,  by  law,  to  rate  the 
condition  based  upon  the  degree  cf  disability  at  the  time  of 
permanent  disposition  and  not  on  future  events. 
We  are 
unpersuaded by the evidence presented that, at the time permanent 
disposition  was  made,  the  applicant’s  medical  condition  was 
misdiagnosed by Air  Force medical  personnel  or that her case was 
not processed properly.  We therefore agree with the opinions and 
recommendations  of  the  respective  Air  Force  offices  and  adopt 
their  rationale  as  the  basis  f o r   concluding  that  the  applicant 
has  not  been  the victim  of  an error  or injustice.  Accordingly, 
we  find no compelling basis to recommend  favorable action on her 
request. 

THE BOARD DETERMINES THA.T_: 

The  applicant  be  notified  that  t h e   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  applicatl-on will  only  be  reconsidered 
upon  the  submission  of  newly  discovered  relevant  evidence  not 
considered with this application. 

The following members of the Hoard consi.dered this application in 
Executive  Session  on  10  December  1998, under  the  provisions  of 
AFI  36-2603: 

Mr. Henry C .  Saunders, Panel Chair 
Ms. Ann 1,. Heidig, Member 
Ms. Sophie A. Clark, Member 

The following documentary evidence was considered: 

4 

98-01145 

Exhibit A.  DD F o r m   1 4 9 ,   dated 2 0   Apr 98, w/atchs. 
Exhibit B.  Applicant's Master Personnel Records. 
Exhibit C.  Letter, AFBCMR  Medical  Consultant, dated 
Exhibit D .   Letter, HQ A F P C / D P P D ,   dated 1 3   Jul 98. 
Exhibit E.  Letter, SAF/MIBR, dated 3 Aug  98. 
Exhibit F .   Letter from 

18 Jun 98. 

5 

98-01145