RECORD OF PROCEEDINGS
             AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:      DOCKET NUMBER:  BC-2002-03102
            INDEX NUMBER:  145.00
            COUNSEL:  NONE

            HEARING DESIRED:  NO

_________________________________________________________________

APPLICANT REQUESTS THAT:

He be medically discharged for conditions resulting  from  a  motor  vehicle
accident while on inactive duty training.

_________________________________________________________________

APPLICANT CONTENDS THAT:

He was denied a medical evaluation that he believes would have  resulted  in
a medical discharge from the Reserves.

In support of his request, the applicant submits  a  copy  of       DD  Form
261, Report of Investigation Line of Duty and Misconduct Status, a  copy  of
--AMW  Form  141,  Ground  Mishap  Worksheet,  a  copy  of  AF  Form   1971,
Certification for Incapacitation Pay, excerpts  from  his  medical  records,
and a copy of a letter from his attorney.

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

_________________________________________________________________

STATEMENT OF FACTS:

The applicant served on active duty in the Air Force as  a  Fire  Protection
Specialist from 5 August 1981 to 14 May 1986 (four years,  nine  months  and
ten days).  He  enlisted  in  the  Air  Force  Reserves  January  1987,  and
reenlisted on 29 January 1993 for a  six-year  term  in  the  Reserves.   He
performed no active or inactive duty training  until  1993.   The  applicant
was involved in  a  motor  vehicle  accident  returning  home  from  a  unit
training assembly (inactive duty training) on 22 August 1995 at 2330  hours.
 His vehicle was struck on the right rear quarter panel by  another  vehicle
that ran a red light.  He was transported  by  ambulance  to  the  Emergency
Department at Travis AFB for evaluation.  The applicant was discharged  from
the Air Force Reserves on 28 April 1999 at the expiration  of  his  term  of
service.  On his discharge  orders  dated  17  May  1999,  his  reenlistment
status was coded as “5A”, Reserve reenlistment eligible.

_________________________________________________________________

AIR FORCE EVALUATIONS:

The BCMR Medical Consultant recommends denial.  Injuries directly  resulting
from  this  motor  vehicle  accident  would  be  considered  to  have   been
proximately caused by reserve duty  and,  if  unfitting  for  duty  and  the
reason for ending his Air Force  career,  eligible  for  evaluation  in  the
disability system for disability rating and compensation.

Evidence of the record shows that the applicant  was  involved  in  a  motor
vehicle accident sustaining mild head trauma as  evidenced  by  no  loss  of
consciousness and his normal examination in the  emergency  department.   He
experienced  a  persistent  headache  after  the  accident   that   improved
substantially  with  treatment.   He  also  developed  complaints  of   neck
discomfort  within  two  weeks  of  the  accident  that  became  a   chronic
discomfort.  His x-rays and  subsequent  MRI  of  the  cervical  spine  were
consistent with  long-standing  degenerative  disc  and  degenerative  joint
disease as well as a disclosing of a congenitally narrow spinal  canal  that
existed prior to the accident.  The x-ray  in  September  1995  disclosed  a
narrowed disc with associated osteophyte (bone spur)  formation,  a  process
that takes months to years to develop.  Evaluation  by  a  neurosurgeon  one
year after the accident concluded there was  no  cervical  spine  neurologic
injury or structural abnormality requiring therapy, but  that  he  did  have
some “myofascial trigger points” (tender  points  in  the  muscles)  due  to
chronic musculoskeletal strain of the  neck.   His  chronic  musculoskeletal
neck strain was clearly mild based on the absence of muscle  spasm  or  loss
of range of motion and lack  of  pain  with  range  of  motion.   Such  mild
chronic musculoskeletal strain could have resulted from  the  motor  vehicle
accident or been the result of his underlying  degenerative  spine  disease.
The applicant was noted to have symptoms of depression  in  March  1996  and
was started on an antidepressant medication (Paxil).  Within two  weeks  his
symptoms  were  improved,  notably  sleep   disturbance.    Evaluations   by
neurosurgery (August 1996) and psychiatry (March 1997) determined  that  the
applicant was fit for continued military  service.   There  are  no  further
service medical record entries.  The applicant performed  no  inactive  duty
or active duty training after February 1997, and  was  discharged  from  the
Reserves  effective  April  1999  with  a  reenlistment  status  code   that
indicated he was eligible for  reserve  reenlistment.   Thus,  there  is  no
evidence that the reason his Air Force career  was  cut  short  was  due  to
medical reasons including any directly related to injuries from the  service
connected motor vehicle accident.

Evidence in the record indicates that the applicant missed 3 weeks  of  work
following the accident, and subsequently changed jobs from a firefighter  to
aircraft inspector.  He continued to be employed  despite  his  symptoms  of
depression as of the time of the Kaiser psychiatry evaluation in 1999.   The
applicant claims his depression is  the  direct  result  of  his  mild  head
trauma  from  the   motor   vehicle   accident   and   requests   disability
compensation.  He was treated for symptoms  of  depression  beginning  March
1996, approximately six months after the  accident.   However,  evidence  in
the medical records show that he reported  symptoms  of  depression  in  May
1993.  At the time of his Kaiser psychiatry evaluation in February  1999  he
reported that with treatment with Paxil  following  the  August  1995  motor
vehicle accident, he “felt great” with decreased headaches  and  good  sense
of well being but experienced recurrent symptoms of depression in  the  year
period  1998-1999  (apparently  off  Paxil),  some  three  years  after  the
accident.  His  Kaiser  medical  plan  psychiatrist  identified  maladaptive
personality traits, possibly sufficient to  diagnose  personality  disorder,
that were significantly contributory to his symptoms  of  depression.   Such
maladaptive personality traits are life-long patterns (that  usually  become
manifest in late adolescence and early adulthood)  of  thinking,  perceiving
and  coping  in  the  individual's  personality  structure,  which  are  not
medically disqualifying or unfitting but  interfere  with  the  individual’s
social  and  occupational  functioning  and  predispose  the  individual  to
depression.  These traits may render the individual unsuitable  for  further
military  service  and  may  be  cause  for  administrative  action  by  the
individual's unit commander.  Although  the  severity  of  his  symptoms  as
documented  in  the  Kaiser  psychiatry  evaluation  appear  to  have   been
sufficient  to  have  made  him  disqualified  for  continued  service,  the
preponderance of the evidence based on medical principles  cannot  establish
a direct causal link to the mild head trauma.  It is true  that  individuals
with moderate to severe brain trauma may  suffer  depression  and  cognitive
deficits  in  the  weeks  to  months  after  trauma.   However  it  is  very
controversial  in   mild   head   trauma,   especially   without   loss   of
consciousness,  whether  persistent  post  concussive  symptoms  are  injury
specific in individuals after mild traumatic head injury since frequency  of
such symptoms  in  individuals  with  a  history  of  mild  head  injury  is
comparable to uninjured groups.

The BCMR Medical Consultant concludes that the  applicant’s  depression  was
not the direct result of mild  head  trauma  during  his  service  connected
motor vehicle accident.  He  manifested  symptoms  of  depression  over  two
years  before  the  accident,  possesses  maladaptive   personality   traits
predisposing to depressive symptoms  and  did  not  present  for  depressive
symptoms until six months after the  accident.   Treatment  with  Paxil  was
effective, he maintained employment, and reported in February 1999  that  he
felt great while on the Paxil.  The psychological stress  of  the  MVA,  the
associated  litigation,  and  occupational  stressors  referred  to  by  the
applicant in the Kaiser  evaluation  may  have  transiently  aggravated  his
preexisting depressive symptoms, but the MVA did not  cause  his  underlying
psychiatric condition.  His other post injury symptoms of headache and  neck
pain were not unfitting  for  continued  duty.   The  preponderance  of  the
evidence does not support the applicant’s claim.

Action and disposition in this case  are  proper  and  equitable  reflecting
compliance with Air Force directives that implement the law.

The BCMR Medical Consultant’s evaluation is at Exhibit C.

AFPC/DPPD recommends  denial.   The  applicant  failed  to  provide  medical
documentation to corroborate he was unfit  at  the  time  of  his  voluntary
discharge from the Reserves, which would justify a medical  discharge  under
military disability laws and policy.

Two items of interests were noted  during  the  review  of  the  applicant’s
military personnel  records.   Although  his  files  show  he  extended  his
enlistment for the purpose of undergoing an MEB, records failed to show  one
was initiated or completed.  The DD Form 261, Report of Investigation,  Line
of Duty and Misconduct Status, dated 7 May 97, which relates  to  the  motor
vehicle accident is  incomplete.   AFPC/JA  confirmed  the  report  was  not
appropriately  processed  and   is   currently   incomplete   according   to
prescribing directive.  Chapter 61, Title  10,  United  States  Code  (USC),
requires  a  line  of  duty  determination  for  each  unfitting  defect  or
condition.   Specifically,  for   compensability   purposes   the   physical
evaluation  board  must  know  whether  or  not  the  member  incurred   the
disability as the result of his or her intentional misconduct  or  during  a
period of unauthorized absence.

Although the incident appears to be due to no misconduct on the  applicant’s
part during the incident, that does not excuse  the  incomplete  report  for
legal purposes, which protects both  the  individual  as  well  as  the  Air
Force.  Based on  the  limited  preponderance  of  evidence,  the  consensus
within this office is that the service  member  was  reasonably  capable  of
performing  his  Reserve  military  duties  right  up  until  his  Honorable
discharge.  This is assumed since he was eligible for reenlistment  and  his
career was not curtailed for physical disability.

The AFBCMR case file revealed no errors or irregularities  at  the  time  of
his voluntary discharge that would justify a change to his military  records
to reflect he was awarded a disability discharge  under  the  provisions  of
AFI 36-322.  The medical aspects of the case  are  thoroughly  explained  by
the  BCMR  Medical  Consultant  and  DPPD  wholeheartedly  agree  with   his
advisory.

The DPPD evaluation is at Exhibit D.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATIONS:

He states that he is amazed that the BCMR Medical Consultant  has  diagnosed
him from hundreds of miles away.  His friends and family can attest  to  his
pain, headaches, shocks and depression that he has had to endure  since  the
accident.  He claims that he is addicted to paxil, continues to suffer  with
headaches, and has
very limited movement and other problems  with  his  neck.   The  Air  Force
prescribed him paxil for depression, for which he is dependent.

His complete submission 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 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.  After a thorough review  of  the  evidence
of record  and  applicant’s  submission,  we  are  not  persuaded  that  the
applicant should be given a medical discharge.  While we note  the  concerns
of the Air Force in regards  to  not  initiating  or  completing  a  medical
evaluation board (MEB) and the incomplete line  of  duty  investigation,  we
find insufficient evidence to conclude the applicant was unfit at  the  time
of separation.  In this respect we note  the  Medical  Consultant's  opinion
that the applicant's post injury symptoms of headaches and  neck  pain  were
not unfitting  for  continued  duty.  Based  on  the  preponderance  of  the
evidence, we believe the applicant has failed to sustain his burden that  he
has suffered either an  error  or  an  injustice.   Therefore,  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 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 1 July 2003, under the provisions of AFI 36-2603:

            Ms. Brenda L. Romine, Panel Chair
            Ms. Marilyn Thomas, Member
            Mr. Grover L. Dunn, Member


The following documentary evidence was considered for AFBCMR  Docket  Number
BC-2002-03102:

      Exhibit A.  DD Form 149, dated 23 Sep 02, w/atchs.
      Exhibit B.  Applicant's Master Personnel Records.
      Exhibit C.  Letter, BCMR Medical Consultant, dated 13 Feb 03.
      Exhibit D.  Letter, AFPC/DPPD, dated 17 Apr 03.
      Exhibit E.  Letter, SAF/MRBR, dated 25 Apr 03.
      Exhibit F.  Letter, Applicant, dated 18 May 03, w/atchs.




               BRENDA L. ROMINE
               Panel Chair