RECORD OF PROCEEDINGS
         AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:      DOCKET NUMBER:  BC-2002-00661
            INDEX CODE:  131.09

            COUNSEL:  NONE

            HEARING DESIRED:  NO

_________________________________________________________________

APPLICANT REQUESTS THAT:

He be promoted to the grade of senior master sergeant (E-8).

_________________________________________________________________

APPLICANT CONTENDS THAT:

He  was  treated  for  an  anterior  wall  myocardial  infraction   on
13 Apr 94.  He was put on a medical profile pending a determination of
his medical condition.  In Jun 94, he  was  put  in  a  vacant  senior
master sergeant position but not promoted.  On 3 Nov 94, his  personal
physician stated that he was medically qualified to serve worldwide in
the Air Force Reserve.  He was also able to return to his civilian job
as a letter carrier.  In May 95, the Air Force  Medical  Review  Board
determined that he was medically disqualified for worldwide duty.   He
asked whether he would be put on active duty for  out-processing,  and
he was advised that he would not, and  that  he  would  have  to  out-
process on his own time.  He believes that since he was placed in an E-
8 position from Jun 94 until  he  was  discharged,  his  own  personal
physician said he was qualified for worldwide service, and he  had  to
out-process on his own time, he should have been promoted to the grade
of senior master sergeant.

In support of his appeal, the applicant provided an expanded statement
and statements from his medical doctor and first sergeant.

Applicant’s complete submission, with attachments, is at Exhibit A.

_________________________________________________________________

STATEMENT OF FACTS:

Applicant was relieved from his Reserve assignment and assigned to the
Retired Reserve Section and his name was placed on the Reserve Retired
List, effective 30 Jun 95, by reason of his physical  disqualification
from continued service in the Air Force Reserve.  He is  eligible  for
retired pay at age 60, in the grade of master sergeant.

The remaining  relevant  facts  pertaining  to  this  application  are
contained in the letters prepared by the appropriate  offices  of  the
Air Force.

_________________________________________________________________

AIR FORCE EVALUATION:

AFRC/DPM recommended denial indicating  that  the  applicant  has  not
demonstrated any injustice or  improper  handling  of  his  promotion.
AFRC/DPM noted the applicant’s assertion that he was selected to  fill
a senior master sergeant position contingent upon his clearance  by  a
medical board, and,  that  the  medical  board  found  him  unfit  for
continued military duty.

AFRC/DPM indicated that AFI 36-2502,  table  4.2.,  defines  promotion
eligibility criteria.  Among the criteria are three that the applicant
did not demonstrate he  met  at  the  time.   They  were:   supervisor
recommendation, commander approval,  and  satisfactory  participation.
Since the applicant was meeting a medical evaluation board at the time
of the alleged injustice, he would have  been  medically  profiled  as
unfit for military duty and, therefore, unable to participate for  pay
or points.

A complete copy of the AFRC/DPM evaluation is at Exhibit C.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

A copy of the Air Force evaluation was forwarded to  applicant  on  26
Apr 02 for review and response.  As of this date, no response has been
received by this office (Exhibit D).

By letter, dated 6 Feb  03,  the  Board’s  staff  requested  that  the
applicant provide any and all pertinent records that  he  had  in  his
possession, as well as any  medical  documentation  from  any  private
physicians who may have provided him medical treatment (Exhibit E).

By  letter,  dated  11  Feb  03,  the  applicant  provided  additional
documentary evidence, which is attached at Exhibit F.

_________________________________________________________________

ADDITIONAL AIR FORCE EVALUATION:

The Medical Consultant  recommended  denial  noting  that  no  primary
medical documentation was available for  review.   He  indicated  that
based on a 3 May 94  medical  statement,  the  applicant  suffered  an
anterior myocardial infarction (heart attack, clot forms in an  artery
supplying the heart muscle with oxygen and the heart  muscle  supplied
by that artery dies, in this instance the area of the heart that faces
the front of the body) on 13 Apr 94, while not on active duty  status.
He  was  treated  with  a  thrombolytic  medication  (medication  that
dissolves the clot in the coronary artery and  limits  the  amount  of
heart muscle damage).  While still hospitalized, he underwent  cardiac
catheterization to evaluate his coronary artery disease.  He was shown
to have anterior wall hypokinesis (reduced  heart  muscle  contraction
consistent with death of heart muscle tissue resulting  in  impairment
of normal heart contraction  in  the  affected  area).   The  coronary
artery  supplying  that  affected  area  of  the  heart  was  “patent”
(indicating successful dissolution  of  the  clot)  but  had  proximal
dissection (a flap of the inner lining of  the  artery  had  partially
torn off).  Complete details of the applicant’s coronary  anatomy  and
extent of coronary disease  was  otherwise  absent  from  the  medical
statement.  He was treated with Coumadin (blood thinner)  and  aspirin
to prevent recurrent coronary thrombosis and the formation of  a  clot
inside the heart next to the damaged heart muscle wall (a complication
of anterior wall myocardial infarctions).  He was  also  treated  with
Procardia XL (calcium channel blocker) and Lopressor (a beta  blocker)
to prevent angina  (chest  pain),  cardiac  rhythm  disturbances,  and
recurrent heart attack.  The cardiology medical statement listed  work
restrictions (no driving, no lifting, etc).

The  Medical  Consultant  noted  that  the  applicant’s  heart  attack
triggered medical disqualification by the Air Force Reserve.   An  Air
Force Form 422, Physical Serial Report, dated 18 May 94 (expiration 18
August 1994), indicated that  the  applicant  was  formally  medically
disqualified due to anterior wall infarction (P4), not  qualified  for
deployment (DIN KCC, “41”) and not qualified for reassignment (DIN ABA
“31”).  On the form was a boilerplate statement that  explains  policy
and procedure, which read “I have been  advised  of  my  disqualifying
medical/dental  condition  and   of   the   requirement   to   provide
medical/dental information from my  private  physician/dentist  to  my
supporting Reserve medical  unit  to  aid  in  the  evaluation  of  my
medical/dental  condition.   I  understand  that  while  I  have  this
profile, I may not participate in the Reserve program, whether for pay
or points, until the “4” has been removed from my profile.  I  further
understand that HQ AFRES/SGP will make the final determination  on  my
medical qualifications for continued military  duty.   If  I  fail  to
provide the requested medical/dental documentation  to  my  supporting
medical unit within 60 days from the date of initial request, my  case
will be immediately forwarded to HQ AFRES/SGP for appropriate action.”
 Another AF Form 422, dated 7 Sep 94 (expiration  13  Oct  94),  again
continued  his  medical  disqualification  (P4)   for   mobility   and
reassignment and contained the same  limitation  codes  and  the  same
boilerplate statement.

A medical statement, dated 3 Nov 94, from the applicant’s cardiologist
indicated that the applicant was diagnosed with atherosclerotic  heart
disease, status post anterior wall myocardial infarction.  As  of  the
last appointment on 25 Oct 94, the applicant  was  engaging  in  usual
activities “without significant symptoms.”  The applicant underwent an
exercise test but the protocol used was not specified and limited  the
reviewer’s interpretation of the results, but the test was reported as
a satisfactory result with good exercise tolerance and no evidence  of
ischemic changes on electrocardiogram (consistent with adequate  blood
flow to the heart muscle).  No overt signs of heart failure were noted
on the physical examination.  The cardiologist recommended  continuing
his current medications that included the blood  thinner  Coumadin  as
well as Procardia XL, Lopressor, and aspirin.  Tapering  and  possible
discontinuation of medications was planned after six  months,  but  no
further medical information was available for review.  The applicant’s
civilian cardiologist released him back to his civilian occupation  as
a postal carrier and stated he was qualified to return to duty in  the
Reserve.

The Medical Consultant noted that the applicant was selected to fill a
senior master sergeant position contingent upon medical clearance.  HQ
AFRES/SGP determined he was unfit for  continued  duty  in  accordance
with AFI 48-123.  He was medically profiled as unfit for military duty
beginning on 18 May 94 and was not allowed to participate for  pay  or
points since that date.  Although profiles continuously  covering  the
entire time since his heart attack and his retirement are not evident,
it was clear that his unit was aware that his retention and  promotion
was contingent on a final determination by HQ AFRES/SGP.

The Medical Consultant indicated  that  AFI  48-123  requires  medical
review on all active duty and Reserve members who suffer a  myocardial
infarction (formal MEB with Regular members, and review by  AFRES  SGP
in the Reserves).  Maintenance on  any  type  of  medication  for  the
treatment or prevention of angina (chest pain due to  coronary  artery
disease), congestive heart failure (weak heart muscle due to extensive
damage), or major rhythm disturbances is disqualifying.  The applicant
was on Procardia, Lopressor and Coumadin which are medicines  intended
to prevent recurrent angina, rhythm disturbances and heart attack.

AFI 48-123 outlines very strict criteria that identifies  members  who
may be considered for retention, usually with assignment  limitations.
In the Regular Air Force, some members, depending on clinical  status,
duties, and other factors, may be determined fit to  continue  service
in their  rank,  rate,  or  grade  often  with  assignment  limitation
preventing deployability and other restrictions.  The memorandum  from
the HQ AFRES/SG  clearly  indicated  that  retention  with  assignment
limitation was considered in their review and that they concluded that
special assignment limitations were not appropriate.  Of note was  the
poorer prognosis for recurrent heart attacks and the higher  risk  for
complications  that  anterior  wall  myocardial   infarction   implies
compared to  infarctions  in  other  locations  of  the  heart  (i.e.,
inferior wall), and the fact that the applicant demonstrated  evidence
of abnormal heart muscle wall  motion  and  continued  maintenance  on
medications, all likely factors influencing the decision.

According to the Medical Consultant, it is the policy of the Air Force
Reserve to  disqualify  reservists  with  any  history  of  myocardial
infarction due to atherosclerotic heart disease regardless of  current
functional ability pending review of the reservist’s case at  HQ  AFRC
to determine the reservist’s  fitness  for  continued  military  duty.
During this headquarters level determination process,  all  reservists
are put in a no pay or point gaining status.  This status  prevents  a
reservist  from  being  involuntarily  discharged  or  separated  from
military service while the evaluation processing is  being  conducted.
Unfortunately, this  same  status  prevents  a  reservist  from  being
promoted.

In the Medical Consultant’s view, action and disposition in this  case
were  proper  and  equitable  reflecting  compliance  with  Air  Force
directives that implement the law, and that no change in  the  records
is warranted.

A complete copy of the Medical Consultant’s evaluation is at Exhibit
G.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

A copy of the Air Force evaluation was forwarded to  applicant  on  22
Apr 03 for review and response.  As of this date, no response has been
received by this office (Exhibit H).

_________________________________________________________________

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  error  or  injustice.   We  took  notice  of   the
applicant's complete submission in judging the  merits  of  the  case.
However, we do not  find  it  sufficient  to  override  the  rationale
provided by the Air Force offices of  primary  responsibility  (OPRs).
The evidence of record indicates that the applicant suffered  a  heart
attack  and  was  medically  profiled  as  unfit  for  military  duty.
Subsequent to this, he was selected to fill a senior  master  sergeant
position contingent on  his  medical  clearance.   The  applicant  was
eventually determined by the Office of the Surgeon General of the  Air
Force Reserve to be medically disqualified for  continued  service  in
accordance with the applicable Air Force Instruction.   The  applicant
asserts that since he held the senior master sergeant  position  until
his  separation  from  the  Air  Force  Reserve  for  being  medically
disqualified, he should be promoted to that grade.  However, based  on
the evidence presented, the applicant was aware that his retention, as
well as his promotion, was contingent on a final determination by  the
Office of the Surgeon General.  Therefore, in the absence of  evidence
that the information used as a basis for his medical  disqualification
for continued service in the Air Force Reserve was erroneous, we agree
with the recommendations of the OPRs and adopt their rationale as  the
basis for our decision that the applicant has failed  to  sustain  his
burden of establishing that he has suffered  either  an  error  or  an
injustice.  Accordingly, we find  no  compelling  basis  to  recommend
granting the relief sought in this application.

_________________________________________________________________

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-
2002-00661 in Executive Session on 27 May 03, under the provisions  of
AFI 36-2603:

      Mrs. Barbara A. Westgate, Chair
      Mr. Roscoe Hinton, Jr., Member
      Ms. Carolyn B. Willis, Member

The following documentary evidence was considered:

    Exhibit A.  DD Form 149, dated 18 Feb 02, w/atchs.
    Exhibit B.  Applicant's Master Personnel Records.
    Exhibit C.  Letter, AFRC/DPM, dated 18 Apr 02.
    Exhibit D.  Letter, SAF/MRBR, dated 26 Apr 02.
    Exhibit E.  Letter, AFBCMR, dated 6 Feb 03.
    Exhibit F.  Letter, applicant, dated 11 Feb 03, w/atchs.
    Exhibit G.  Letter, Medical Consultant, dated 17 Apr 03.
    Exhibit H.  Letter, AFBCMR, dated 22 Apr 03.




                                   BARBARA A. WESTGATE
                                   Chair