RECORD OF PROCEEDINGS
             AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:      DOCKET NUMBER:  BC-2006-01757
            INDEX NUMBER: 100.00
      XXXXXXX    COUNSEL:  NONE

            HEARING DESIRED:  NO

MANDATORY COMPLETION DATE: 11 DECEMBER 2007

_________________________________________________________________

APPLICANT REQUESTS THAT:

The AF Form 356, Findings  and  Recommended  Disposition  of  USAF  Physical
Evaluation Board finding of  "Return  to  Duty",  be  corrected  to  reflect
"Permanent Retirement."

_________________________________________________________________

APPLICANT CONTENDS THAT:

At this point, he is unable to perform the job  (Air  force  Pilot)  he  was
trained for. He is convinced that he does, in fact, have Asthma and that  he
will never again be reinstated to flying  status.  While  he  has  a  strong
desire to fly for the Air Force, he believes that it is now  impossible.  He
merely  wishes  to  protect  his  own  health.  In   accordance   with   the
requirements of the applicable AFI, he requests his status be changed  to  a
medical retirement so as to best meet the needs  of  his  medical  condition
and the needs of the Air Force.

In support of his request, applicant submits a personal  letter,  copies  of
the AF Form 356, Findings  and  Recommended  Disposition  of  USAF  Physical
Evaluation Board, Aeromedical Consultation Service Report, doctors'  medical
reports, commander's support letter, and AFI 48-123.

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

_________________________________________________________________

STATEMENT OF FACTS:

The applicant was commissioned and entered active duty in  July  2001  after
graduating  from  the  Air  Force  Academy,  subsequently  completed   pilot
training and was assigned as a KC-135 air refueling pilot.

While deployed to Saudi Arabia and Turkey, between July and  November  2004,
the applicant developed recurrent symptoms  of  cough  and  chest  tightness
that improved with treatment with inhaled  bronchodilator  medication.  Upon
return to his home station, he was referred for  evaluation  by  a  civilian
pulmonary specialist who documented normal pulmonary function  tests  and  a
normal  exercise  bronchoprovocaltion   test.   Based   on   the   symptoms,
responsiveness to the inhaler and the exposure  to  dusts  and  fumes  while
deployed the specialist concluded the  applicant  had  occupational  induced
airway  hyper-reactivity  and  recommended  treatment  with  inhalers.   The
applicant was referred to the Aeromedical Consult Service (ACS),  Air  Force
School of Aerospace Medicine, Brooks AFB, TX for evaluation in  April  2005.
Although  his  reported  symptoms  were  suggestive  of   asthma,   repeated
documented  physical   examinations   finding   no   wheezing   and   normal
methacholine bronchoprovocation testing  did  not  support  a  diagnosis  of
asthma or reactive airways  disease.  Prior  allergy  testing  in  2002  was
negative for allergies. At the time of this evaluation,  he  was  reportedly
asymptomatic. Because his symptoms appeared to be unexplained and there  was
a history of stress induced nausea and vomiting (preceded by  cough)  during
flight training, he was referred for psychological evaluation to assess  for
psychogenic causes of his cough. Comprehensive psychological testing  showed
a pattern consistent with the expression of  physical  symptoms  when  under
severe  emotional  or  psychological  stress.  Because   of   the   negative
evaluation for evidence of reactive airways disease or asthma and result  of
psychological testing,  he  was  diagnosed  with  somatoform  disorder  with
recommendation for medical disqualification from flying duties based on  the
psychiatric diagnosis.

Following the ACS evaluation, the applicant was referred  for  psychological
follow up at his home base and was seen several times between May  2005  and
October 2005 for evaluation and  therapy.  The  psychologist  concluded  the
applicant did not have  a  somatoform  disorder  rendering  a  diagnosis  of
Adjustment Disorder with Anxiety. A 5 November 2005  flight  surgery  clinic
entry notes the applicant's symptoms were  triggered  by  cold  weather  and
that he was using inhalers infrequently. In  December  2005,  the  applicant
sough another pulmonary evaluation leading to a diagnosis  of  asthma  based
on  symptoms  and  a  methacholine  bronchoprovocation  test   that   showed
bronchoconstriction at methacholine dose which falls into  the  "borderline"
range of supporting a diagnosis  of  asthma.  Treatment  with  inhalers  was
recommended.

The applicant was referred  for  evaluation  in  the  disability  evaluation
system for his diagnoses of asthma and  Adjustment  Disorder  with  Anxiety.
Pulmonary  function  tests  performed  February  2006  were  normal  on  two
occasions. A mental health narrative summary dated February  2006  concluded
with  diagnosis  of  Adjustment  Disorder  with   Anxiety   that   was   not
disqualifying  for  continued  military  service.  An  Aeromedical   Consult
Service review of clinical information since the original ACS evaluation  in
April 2005 concluded  with  recommendation  for  continued  disqualification
from flying based on  diagnosis  of  asthma  and  Adjustment  Disorder  with
Anxiety. The commander's letter to the Physical Evaluation  Board  dated  15
March  2006  reported  excellent  duty  performance  as  a   staff/executive
officer, maintenance of flight proficiency in the  simulator  and  selection
ahead of peers to be an assistant  flight  commander.  The  commander  noted
that if the applicant could not be returned  to  flying  status  he  had  no
motivation to continue  an  Air  Force  career  in  any  other  capacity,  a
sentiment expressed by the applicant  in  his  letter  dated       15  March
2006.

On  20  March  2006,  the  applicant  was  referred  to  the  USAF  Physical
Evaluation Board (IPEB), for diagnoses of  asthma  and  adjustment  disorder
with anxiety. The IPEB reviewed his  case  and  found  the  member  fit  and
recommended,  "Return  to  Duty."  The  IPEB  noted  the  narrative  summary
indicated symptoms of asthma without objective findings. By  law,  a  member
may appeal a recommended disposition if he/she is found unfit and  is  being
involuntarily separated or retired for disability.  This  is  not  true  for
members found fit. However, if the  hospital  commander  believes  there  is
additional  compelling  medical  documentation  calling  into  question  the
appropriateness of the return to duty decision, he/she could have  requested
a "special review of the IPEB recommendation.

On 11 May 2006, the applicant applied for  miscellaneous  separation.  On  5
July 2006, the Secretary of the Air Force  Personnel  Council  approved  the
applicant's request for miscellaneous separation  effective  1  August  2006
and waived recoupment of the unearned portion of his AF Academy education.

_________________________________________________________________

AIR FORCE EVALUATION:

AFPC/DPPD  recommends  denial  and  states  the  preponderance  of  evidence
reflects that no error or injustice occurred during the disability  process.


AFPC/DPPD's complete evaluation is at Exhibit C.

The BCMR Medical Consultant recommends denial. The  applicant  was  returned
to duty after evaluation  in  the  disability  evaluation  system  for  mild
asthma or  reactive  airways  disease  and  adjustment  disorder  that  were
determined to be not unfitting for continued military  service  even  though
they were disqualifying for military flying  duties.  Because  he  could  no
longer fly, the applicant  wished  to  voluntarily  separate  from  the  Air
Force. He submitted simultaneous requests for miscellaneous  separation  and
corrections  of  records  show  disability  retirement.  His   request   for
miscellaneous separation was approved with an effective  date  of  1  August
2006.

Once an individual has been declared  unfit,  the  Service  Secretaries  are
required by law to rate the condition based upon the  degree  of  disability
at the time of permanent disposition and not on future events. No change  in
disability ratings can occur after permanent disposition,  even  though  the
condition may become better or worse.

The preponderance of the evidence of the record  supports  the  decision  of
the Physical Evaluation Board. Action  and  disposition  in  this  case  are
proper and equitable reflecting compliance with Air  Force  directives  that
implement the law.

BCMR Medical Consultant's complete evaluation is at Exhibit D.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Applicant reviewed the Air Force evaluations and stated he sought  a  second
opinion by pulmonologist in December 2005  and  was  diagnosed  with  asthma
after  having  below  normal  pulmonary   function   tests.   A   "positive"
bronchoprovocation test which was described by ACS as  "borderline  normal."
Of course this second opinion was not shared  by  the  flight  surgeons  who
worked his case and by the physicians at ACS due to the legal  ramifications
surrounding his case  given  that  those  physicians  felt  his  respiratory
problems were simply a psychological problem. Thus  a  second  diagnosis  of
asthma from a separate pulmonologist nearly one year  later  only  confirmed
that he had a physical condition and not  a  psychological  condition  which
raised questions of malpractice in his medical processing. Therefore, he  is
asking the AFBCMR to change his records to a medical  discharge  which  will
allow him to continue medical coverage for a condition which  was  obviously
caused by his service in the military.

Applicant’s complete response 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 timely filed.

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 and do not  find  that
it supports a determination that the applicant should  have  been  medically
discharged.  The Board notes that for an individual to be  considered  unfit
for military service there must be a medical condition  so  severe  that  it
prevents performance of any work commensurate with rank and experience.   In
this respect, the Board notes that his condition did not  render  him  unfit
for continued service prior to him applying for a  miscellaneous  discharge,
however, found  him  medically  disqualified  for  military  flying  duties.
Therefore, we agree with the opinion and recommendation of the BCMR  Medical
Consultant and the Air Force office  of  primary  responsibility  and  adopt
their rationale as the basis for our conclusion that the


applicant has not been the victim of an error or injustice.  In the  absence
of evidence to the contrary, we  find  no  basis  to  recommend  the  relief
sought in this application.

_________________________________________________________________

THE BOARD DETERMINES THAT:

The applicant be notified that the evidence presented  did  not  demonstrate
the existence of a 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  Docket  Number  BC-2006-01757
in Executive Session on 15 November 2006, under the provisions  of  AFI  36-
2603:

                 Ms. B. J. White-Olson, Panel Chair
                 Mr. Patrick C. Daugherty, Member
                 Mr. Wallace F. Beard Jr., Member

The following documentary evidence was considered in connection with  AFBCMR
Docket Number BC-2006-01757:

      Exhibit A. DD Form 149, dated 30 May 06, w/atch.
      Exhibit B. Applicant's Master Personnel Records.
      Exhibit C. Letter, AFPC/DPPD, dated 7 Jul 06.
      Exhibit D. BCMR Medical Consultant, dated 27 Jul 06
      Exhibit E. Letter, SAF/MRBR, dated 28 Jul 06.
      Exhibit F. Applicant’s Response, dated 15 Aug 06



      B. J. WHITE-OLSON
                                             Panel Chair