RECORD OF PROCEEDINGS
             AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS


IN THE MATTER OF:      DOCKET NUMBER:  BC-2004-02942
            INDEX CODE: 124.01, 108.00
            COUNSEL:  None

            HEARING DESIRED:  No

MANDATORY CASE COMPLETION DATE:  22 Mar 06

_________________________________________________________________

APPLICANT REQUESTS THAT:

His 2001 discharge for disability be changed to a medical retirement.

_________________________________________________________________

APPLICANT CONTENDS THAT:

His disability discharge was inequitable because it was not  based  on
his total medical history.  No one took the proper action to find  out
why he was having headaches and dizziness  all  the  time.   The  only
action taken was to give him Motrin and  send  him  home.   After  the
problems persisted throughout the years, he finally found out he has a
tumor on the left side of his brain.  He has  been  out  of  work  for
months and cannot drive due to the seizures caused by the  tumor.   He
was discharged for asthma, but should have been medically retired.

The applicant submits copies of service  medical  record  entries  for
headaches and dizziness as  well  as  post-service  medical  documents
showing a diagnosis of a brain tumor.

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

_________________________________________________________________

STATEMENT OF FACTS:

The  following  information  was  extracted   from   the   applicant’s
submission (Exhibit A), his military  records  (Exhibit  B),  and  the
AFBCMR Medical Consultant’s evaluation (Exhibit C).

The applicant enlisted in the Regular Air Force on 3 Apr 96 and served
as a fire protection journeyman, first stationed at Shaw AFB, SC,  and
then at Aviano AB, Italy.  The overall ratings of his four performance
reports were 3, 4, 4, and 4 (new system).

A 10  Mar  97  dental  record  documented  a  complaint  of  “migraine
headaches & ear ache on left side” while he was being treated  for  an
infected left-side rear tooth.  A follow-up dental entry, dated 12 Mar
97, indicated the tooth infection was resolving with no  complaint  of
headache reported.  On 8 Nov 97, the applicant sought  emergency  room
care for headache and left eye pain after he hit his left eye the week
before (no further details).  Neurological examination was recorded as
normal.  A 12 Nov 97 clinical record for a scheduled  appointment  the
next day, 13 Nov 97, is blank, apparently indicating the applicant was
not seen that day.

A 5 Jun 98 entry recorded a one-year history of right-sided  headaches
characterized by an initial two-month period of headaches, followed by
resolution,  and  then  recurrent  headaches   for   about   a   week.
Neurological examination  was  normal.   The  physician  considered  a
diagnosis of cluster headaches and  requested  the  applicant  keep  a
headache diary with follow-up in one month.  A 9 Jul 98  primary  care
clinic appointment for follow-up headaches stated, “headaches resolved
after stopping fasting and diet limitations of decreased  calorie  for
working out . . .  When  he  increased  diet  and  lessened  strenuous
workout, no HAs occurred.”  The physician  noted  the  headaches  were
marked  by  improvement   and   considered   diagnosis   of   possible
musculoskeletal contraction  headache  versus  dehydration  effect  of
dietary restriction and exercise.  The applicant sought care on 26 Sep
98 for dizziness and nausea with otherwise unremarkable physical  exam
felt to be viral in etiology.

A partial 28 Jan 99 clinic entry  documented  a  follow-up  visit  for
upper respiratory tract symptoms with headache, fever, dizziness,  and
a low-grade fever.  A 27 Mar 99 clinic record reported  complaints  of
dizziness, headache,  and  sore  throat,  with  low  grade  fever  and
dehydration.  The applicant was diagnosed with  an  upper  respiratory
viral infection with possible vertigo.

A partial 10 Feb 00 clinic  note  documented  care  for  sore  throat,
fever, fatigue,  light  headedness,  and  congestion  associated  with
dehydration.  [Following this entry until  the  applicant’s  discharge
for asthma on 8 Jan 01, there were no other  service  medical  entries
for headache.]

At the time of a 6 Apr 00 periodic medical examination, the  applicant
indicated he did not have frequent or severe headaches, dizziness,  or
fainting spells.

An 18 Sep 00 Narrative Summary for a Medical  Evaluation  Board  (MEB)
reported the applicant complained of shortness  of  breath  (SOB)  and
coughing related to allergies and exertion, being worse at  night  and
in the  morning.   He  first  experienced  asthma-type  symptoms  with
bronchitis in Feb 00, and was treated with decongestants as well as an
inhaler with some relief.  He was determined not  worldwide  qualified
for asthma, moderate, persistent.  The MEB referred the  case  to  the
Physical Evaluation Board (PEB) on  26 Sep  00.   On  29 Sep  00,  the
applicant indicated in his  Impact  Statement  that  he  believed  his
asthma would hinder his job performance  as  a  firefighter.   He  was
willing to remain in the Air  Force  if  utilized  in  another  career
field.   On  13 Oct  00,  the  Informal  PEB  (IPEB)  recommended  the
applicant be discharged with severance pay  for  moderate,  persistent
asthma rated at 10%.  The applicant agreed with the findings on 30 Oct
00.

On 1 Nov 00, the Secretarial Designee  determined  the  applicant  was
physically unfit for continued military  service  and  was  discharged
with severance pay at  10%.   [Note:   The  instrument  indicates  the
applicant’s name should  be  removed  from  the  Temporary  Disability
Retirement List (TDRL) and discharged with  severance  pay.   However,
the applicant had not been on the TDRL.]

A review of the applicant’s medical records  determined  physical  and
occupational  health  exams  were  required  and  an  appointment  was
scheduled for the applicant on 28 Nov 00.

On 8 Jan 01, the applicant was honorably discharged in  the  grade  of
senior airman for medical disability with severance pay at  10%  after
four years, nine months, and six days of active service.

A 5 May 04 magnetic resonance imaging (MRI)  report,  obtained  for  a
clinical indication of vertigo,  reported  the  presence  of  a  brain
lesion  that  potentially  could  have  been  caused   by   infection,
inflammation,  bleeding  and  tumor.   After  the   examination,   the
applicant apparently experienced  a  seizure  and  was  taken  to  the
emergency room for evaluation.  A  24 May  04  correspondence  from  a
neurologist indicated a diagnostic impression of a possible  low-grade
glioma with a six-year history of vertigo/dizziness.   He  recommended
further specialized imaging.

On a 2 Jun 04  follow-up,  the  neurologist  recorded  that  MRI  with
spectroscopy was consistent with a low-grade  glioma,  commenting  the
applicant was “only marginally symptomatic at this point with his main
problem being vertigo and it is very difficult to say that this lesion
is responsible for vertigo but certainly I think a trial  of  Decadron
would be warranted and if it resolves then I would think  that  he  is
symptomatic.”  He planned to follow the  applicant  with  serial  MRIs
since biopsy was felt to carry a great risk at that  time.   On  7 Jul
04, the applicant was hospitalized for  involuntary  movement  of  the
right arm felt to be a seizure related to the tumor.  The  neurologist
noted, “This is in the distribution of his lesion which is in the left
basal ganglion.  The possibility of seizure was raised.   The  patient
states that he has little  in  the  way  of  headache.”   A  follow-up
neurology record reported treatment with  an  anti-seizure  medication
and that the tumor would keep the applicant from holding down  a  job,
either because of intermittent seizure activity or the  vertigo  which
the tumor tended to cause intermittently.
_________________________________________________________________

AIR FORCE EVALUATION:

The AFBCMR Medical Consultant notes the  applicant’s  service  medical
records do not show complaints of headache or dizziness after Feb  00,
nearly a  year  before  his  separation,  and  he  denied  significant
problems with these symptoms during an Apr 00  exam.   The  Consultant
advises that gliomas are the most common group of tumors of the brain.
 The term “low-grade glioma” refers to tumors that are  slow  growing.
The growth of these tumors is not constant, and they can remain stable
for several years followed by the onset of  more  rapid  growth.   The
diagnosis can be difficult on initial presentation because of  subtle,
mild, or intermittent symptoms.   However,  even  in  retrospect,  the
applicant’s intermittent symptoms while on active duty could  be,  but
are not clearly the result of, a very small, slowly growing tumor  and
were often associated with  other  acute  illnesses.   Review  of  the
available service medical records also does not show that  imaging  of
the brain was indicated at the time.   Furthermore,  civilian  records
indicate that post-service computed axial  imaging  studies  had  been
negative.   The  Consultant  discusses  the  differences  between  the
Military Disability Evaluation System  (DES)  and  the  Department  of
Veterans Affairs (DVA) medical systems.  The applicant’s  symptoms  of
headache and dizziness while in service did  not  interfere  with  the
performance of military duties and did not warrant evaluation  in  the
DES.  The applicant’s low-grade glioma  diagnosed  three  years  after
separation does not qualify for change of records to  show  disability
retirement.  Although plausible, it is speculative that the  applicant
manifested symptoms while in service, and review  of  service  records
does  not  show  that  advanced  imaging   was   indicated   for   the
intermittent,  non-progressive  symptoms,  with  normal   neurological
examinations.  Denial is recommended because action and disposition in
this case were proper, equitable, and in  compliance  with  Air  Force
directives.

A complete copy of the evaluation is at Exhibit C.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

A complete copy of the Air  Force  evaluation  was  forwarded  to  the
applicant on 24 Aug 05 for review and comment 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 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  to  warrant   changing   the
applicant’s  disability  discharge  to  a  medical  retirement.    The
applicant’s submission was carefully considered and  the  post-service
medical evaluations he provided were duly noted.  However, we  do  not
find these materials sufficiently persuasive to override the  evidence
in his available military medical records and the  rationale  provided
by the AFBCMR Medical Consultant.  Title 10, USC,  Chapter  61,  which
governs the Air  Force  system,  first  requires  a  determination  of
unfitness, and that the degree of unfitness be based upon the member’s
condition at the time of  permanent  disposition---not  upon  possible
future events.  Further, while a  military  member’s  various  medical
problems may be considered, only  those  that  render  him  unfit  for
military service will be rated.  For an individual  to  be  considered
unfit for military service, a medical condition must be so severe that
it prevents  performance  of  any  work  commensurate  with  rank  and
experience.  In this case, the applicant was medically discharged  for
asthma, which had rendered him unfit to perform his  duties.   At  the
time of his disability processing, he was not unfit from dizziness  or
headache; in fact, he had not displayed these symptoms  for  almost  a
year before his discharge.  Further, as noted by the Consultant, these
symptoms during his military  service  were  mild,  intermittent,  and
associated with other acute illnesses (dental  infection,  dehydration
with strenuous exercise, eye injury, respiratory infection),  and  his
neurological exams were normal.  Indeed, according to the  applicant’s
civilian provider, he was still “only marginally symptomatic”  in  Jun
04, almost three years after his separation.  We sympathize  with  the
applicant’s present medical condition, but he has not  established  to
our satisfaction that the Air Force’s medical treatment and disability
determination were inappropriate, unreasonable, or  noncompliant  with
Air Force directives.  We therefore adopt the rationale  expressed  by
the AFBCMR Medical Consultant as the basis for our decision  that  the
applicant has not sustained his burden of having  suffered  either  an
error or an injustice.  In view of the  above  and  absent  persuasive
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 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 12 October 2005, under the provisions of AFI  36-
2603:

                 Ms. Marilyn M. Thomas, Vice Chair
                 Ms. Jean A. Reynolds, Member
                 Ms. Patricia R. Collins, Member

The following documentary evidence relating to AFBCMR Docket Number BC-
2004-02942 was considered:

  Exhibit A.  DD Form 149, dated 13 Sep 04, w/atchs.
  Exhibit B.  Applicant's Master Personnel Records.
  Exhibit C.  Letter, AFBCMR Medical Consultant, dated 23 Aug 05.
  Exhibit D.  Letter, SAF/MRBR, dated 24 Aug 05.




                                   MARILYN M. THOMAS
                                   Vice Chair