RECORD OF PROCEEDINGS
             AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:      DOCKET NUMBER:  01-01032
            INDEX CODE:  128.02
            COUNSEL:  NONE

            HEARING DESIRED:  NO

_________________________________________________________________

APPLICANT REQUESTS THAT:

She be reimbursed for temporary duty (TDY) travel expenses in the amount  of
$1,590.96.

_________________________________________________________________

APPLICANT CONTENDS THAT:

In 1993, while stationed at Dover AFB,  DE,  she  had  an  elective  surgery
procedure that was performed at the Malcolm Grow Medical  Center  (MGMC)  at
Andrews AFB, MD.  Although the procedure was elective,  she  was  placed  on
TDY orders and  reimbursed  for  her  travel  expenses.   She  is  currently
stationed at Altus  AFB,  OK.   In  January  2001,  she  noticed  a  problem
resulting from the surgical procedure that was performed in 1993.  Dr.  S---
, a military physician at Altus AFB, advised her that the  complication  was
major and that referral to the Wilford Hall Medical Center (WHMC)  or  to  a
civilian specialist was necessary.  She was later advised  that  service  at
WHMC was not immediately available.  Therefore, she was  put  on  a  waiting
list and told that it could take several months before she  could  be  seen.
Dr. S--- provided her a referral  sheet  so  that  TRICARE  personnel  could
arrange for treatment at another military installation or  with  a  civilian
specialist.  She was advised by Ms. W---, of the TRICARE  office,  that  the
only available solution was referral to  a  general  surgeon  instead  of  a
specialist.

She contacted Dr. W---, the physician at  Andrews  AFB  that  performed  the
surgery in 1993, and he advised her  that  a  general  surgeon  most  likely
would  not  be  able  to  perform  the  surgery  and  that  he  would   make
arrangements to perform the procedure within the following two months.   She
contacted Ms. W--- to make travel arrangements and  was  advised  that  they
would not pay for travel or per diem because it was  out  of  their  region.
She inquired about shuttle arrangements from Altus AFB to  Andrews  AFB  and
was told by Ms. W--- that she could be flown to  WHMC  but  as  far  as  she
knew, there was no shuttle from WHMC to Andrews AFB.  It was recommended  by
SrA M---, of Dr. W---'s  office,  that  her  husband  should  accompany  her
because after the surgery she would not be able to  drive  or  lift  objects
weighing more than 5 or 6 pounds.

She purchased her  tickets  through  the  Scheduled  Airline  Ticket  Office
(SATO) at the military rate for unofficial travel.  She arrived at  MGMC  on
9 Feb 01.  She spoke to the TRICARE office at Andrews AFB and was told  that
her travel should have been at no cost to her and that  there  was  a  daily
shuttle that departs from WHMC to Andrews AFB.  She departed Andrews AFB  on
15 Feb 01,  after  her  surgical  procedure,  and  contacted  the  Chief  of
Hospital Operations  at  Altus  AFB,  Dr.  D---  and  informed  her  of  the
situation.  Dr. D--- agreed that she  had  been  misinformed  and  that  she
would have approved her TDY travel costs.  She told her  that  Lt.  B---  of
the TRICARE office would  contact  her  and  accomplish  amendments  to  her
orders.   However,  Lt  B----  did  not  agree  that  she   was   authorized
reimbursement for the elective surgery  travel  expenses  and  only  allowed
reimbursement for her actual travel, reduced  proportional  rate  per  diem,
and for her billeting costs.

Her original procedure was elective, it was done  at  a  Military  Treatment
Facility (MTF), and funded by the Air Force.  The most  recent  surgery  was
required as it was corrective surgery, not elective.  She  and  her  husband
spent well over $1,600 and were reimbursed only $582.

In support of her request applicant provided, documents associated with  her
1993 TDY for surgery, documents associated with her 2001  TDY  for  surgery,
MGMC preoperative admission instructions, lodging receipts,  airline  travel
receipts, her rental  car  receipt,  and  medical  invoices.   Her  complete
submission is at Exhibit A.

_________________________________________________________________

STATEMENT OF FACTS:

Applicant contracted her initial enlistment in the Regular Air Force  on  10
Dec 86.  She has continually  served  on  active  duty,  entering  her  last
enlistment on 30 Jun 98, when she reenlisted for a period of 4  years.   She
has been progressively promoted to the grade of technical  sergeant,  having
assumed that grade effective and with a date of rank of 1 May 99.

Additional relevant facts pertaining to  this  application,  extracted  from
the applicant’s military records, are contained in the  letter  prepared  by
the appropriate office of the Air Force.  Accordingly, there is no  need  to
recite these facts in this Record of Proceedings.

_________________________________________________________________

AIR FORCE EVALUATION:

The  Chief,  Compensation  and  Entitlement  Policy,  USAF/DPRCC,   reviewed
applicant's request and recommended the  application  be  evaluated  by  the
medical community and states that TDY entitlements for her spouse should  be
a separate application (see Exhibit C).

The BCMR Medical Consultant, reviewed applicant's request  and  states  that
she underwent a breast augmentation procedure in 1990  and  had  replacement
of inserts performed in 1991 and 1993.  In 2001, when  one  of  the  inserts
became asymmetric compared to the other, she sought another  revision.   Her
TDY orders initially indicated she was to pay  for  all  expenses  but  were
later revised to allow $400 for travel and $182.50 for  per  diem  expenses.
Review of her records determined that she felt  she  could  not  wait  until
this elective procedure could be arranged more  locally  and  took  it  upon
herself to seek other avenues for a quicker  resolution.   It  appears  some
misinformation was relayed in use of the aeromedical evacuation system  that
worked detrimentally against her.   It  is  debatable  whether  or  not  her
husband should have been named  as  a  non-medical  attendant  (NMA),  which
increased the costs of travel by virtue of his being active  duty  military.
Much of the expense could have been avoided  had  she  simply  waited  until
service was available at WHMC (see Exhibit D).

The Assistant Surgeon General, Medical Programs  and  Resources,  USAF/SGMA,
reviewed  applicant's  request  and  concurs  that  her  records  should  be
corrected to reflect that the TDY to Andrews  was  authorized  as  medically
indicated and that a request  for  a  NMA  was  approved  by  an  authorized
representative of the Air  Force.   The  care  she  received  was  medically
indicated.  She did require an  NMA.   The  unfortunate  misinformation  she
received about her TRICARE benefits and about  her  ability  to  access  the
aeromedical evacuation system  prevented  her  from  using  the  most  cost-
effective means of transportation (see Exhibit E).

The Legal Advisor to the Surgeon  General,  USAF/SGJ,  reviewed  applicant's
request and states that she is not  entitled  to  reimbursement  for  travel
related to elective care.  Neither she nor  her  husband  should  have  been
placed on TDY orders, or reimbursed  even  partially  for  travel  expenses.
Other options were made available to her, yet she chose to  travel  for  her
care.  The fact that her care was "authorized" does not  affect  her  travel
status.

She is precluded from recovery by the Federal Tort Claims Act by  the  Feres
Doctrine for allegations of tort against the  Air  Force.   Any  relief,  if
appropriate  would  have  to  be  found  administratively.   There  were  no
statements to support or contradict her contentions concerning what she  was
told or led to believe.  If given the benefit of the doubt,  however,  there
would still be no justification for travel reimbursement for this care,  nor
is there any justification  for  any  reimbursement  for  her  husband  (who
should be a separate party from this action).  The Air Force medical  system
is not one in which beneficiaries can pick and choose  an  "ideal"  facility
they would like  to  be  treated  in  and  then  expect  the  government  to
reimburse them for the  expenses  of  travel,  especially  in  the  case  of
elective care and sequelae of that care.

However, if the Medical Treatment Facility (MTF) at Altus AFB, were to  make
a declaration that the care she received  was  urgently  needed,  that  care
could only be provided by a sub-specialist not locally available, that  such
sub-specialist  used  was  the  most  reasonably  expedient  one  under  the
circumstances, and that military transport was not readily  available;  then
it may be appropriate to consider travel funding consistent with normal  TDY
reimbursement (see Exhibit G).

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Copies of the Air Force evaluations were forwarded to the  applicant  on  24
Aug 01 and the USAF/SGJ evaluation was forwarded to her on  3  Oct  01,  for
review and response within 30 days.   As  of  this  date,  this  office  has
received no response.

_________________________________________________________________

THE BOARD CONCLUDES THAT:

1.  The applicant has exhausted all remedies provided  by  existing  law  or
regulations.

2.  The application was timely filed.

3.  Sufficient relevant evidence  has  been  presented  to  demonstrate  the
existence of a probable injustice.  Given the circumstances  of  this  case,
it appears that she  was  properly  compensated  for  her  travel  expenses.
Nonetheless, in light  of  the  Air  Force  advisory  opinions  that  opined
differing assessments of her entitlements and  the  conflicting  information
that was provided to the applicant, the  Board  majority  believes  that  an
injustice may exist; and accordingly, it would be in the  best  interest  of
the Air Force and the applicant to favorably consider her request.  We  note
that the applicant seeks reimbursement  for  expenses  her  military  spouse
incurred as a non-medical attendant.  However, without a formal  application
from her military spouse, we are unable to act  upon  that  portion  of  her
request.  Therefore, it is the Board majority's opinion  that  in  order  to
provide her fair and equitable relief her records  should  be  corrected  as
indicated below.

_________________________________________________________________

THE BOARD RECOMMENDS THAT:

The pertinent military records of the Department of the Air  Force  relating
to APPLICANT be corrected to show that competent authority  determined  that
the medical treatment she received at Andrews AFB, MD, during the period  of
9 February 2001 through 15 February 2001, was urgently  needed,  care  could
only be provided by a sub-specialist that was not  locally  available,  care
at the Andrews AFB Medical Treatment Facility (MTF) was the most  reasonably
expedient means under the circumstances; and, that  military  transport  was
not readily available.

It is further recommended that she be  entitled  to  full  reimbursement  of
travel expenses that she incurred which  are  normally  authorized  for  TDY
travel related to non-elective medical care.

_________________________________________________________________

The following members of the Board considered this application in  Executive
Session on 27 Nov 01, under the provisions of AFI 36-2603:

      Mr. Patrick R. Wheeler, Panel Chair
      Mr. Billy C. Baxter, Member
      Mr. James W. Russell III, Member

The Board majority voted to correct the record, as recommended.  Mr.  Baxter
voted to deny the applicant’s request but elected not to submit  a  minority
report.  The following documentary evidence was considered:

     Exhibit A.  DD Form 149, dated 4 Apr 01, w/atchs
     Exhibit B.  Applicant's Master Personnel Records
     Exhibit C.  Letter, USAF/DPRCC, dated 18 May 01
     Exhibit D.  Letter, BCMR Medical Consultant, dated 26 Jun 01
     Exhibit E.  Letter, USAF/SGMA, dated 17 Aug 01
     Exhibit F.  Letter, SAF/MRBR, dated 24 Aug 01
     Exhibit G.  Letter, USAF/SGJ, dated 27 Sep 01
     Exhibit H.  Letter, SAF/MRBC, dated 3 Oct 01




                                  JAMES W. RUSSELL III
                                  Acting Panel Chair


AFBCMR 01-01032




MEMORANDUM FOR THE CHIEF OF STAFF

      Having received and considered the recommendation of the Air Force
Board for Correction of Military Records and under the authority of Section
1552, Title 10, United States Code (70A Stat 116), it is directed that:

      The pertinent military records of the Department of the Air Force
relating to APPLICANT, be corrected to show that competent authority
determined that the medical treatment she received at Andrews AFB, MD,
during the period of 9 February 2001 through 15 February 2001, was urgently
needed, care could only be provided by a sub-specialist that was not
locally available, care at the Andrews AFB Medical Treatment Facility (MTF)
was the most reasonably expedient means under the circumstances; and, that
military transport was not readily available.

      It is further directed that she be entitled to full reimbursement of
travel expenses incurred which are normally authorized for TDY travel
related to non-elective medical care.





                                        JOE G. LINEBERGER
                                        Director
                                        Air Force Review Boards Agency