RECORD OF PROCEEDINGS
             AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

      IN THE MATTER OF:            DOCKET NUMBER:  BC-2007-00684
            INDEX CODE: 110.00
XXXXXXX                           COUNSEL:  NONE
                                   HEARING DESIRED:  NO

MANDATORY CASE COMPLETION DATE: 7 SEPTEMBER 2008

______________________________________________________________

APPLICANT REQUESTS THAT:

Her records  be  changed  to  reflect  a  permanent  disability  retirement
effective 27 September 2006.

______________________________________________________________

APPLICANT CONTENDS THAT:

She was overlooked by her last command and was not afforded the opportunity
to receive a medical disability retirement.  She  believes  her  unit,  the
161st Air Refueling Wing (161 ARW) was overwhelmed with  work  because  she
was  unable  to  obtain  an  appointment  to  discuss  medical   disability
retirements.  She was not aware she was entitled to  a  medical  retirement
until she spoke with a coworker.  In addition, she  has  medical  paperwork
showing a medical evaluation board (MEB) was  in  the  works;  however,  it
never occurred.  She believes she was highly encouraged to  retire  without
medical evaluations or retirement.

In support of her request, the applicant  submits  documentation  from  her
last unit, Department of Veterans Affairs (VA) disability documentation and
medical documentation from civilian and military doctors.

Her complete submission, with attachments, is at Exhibit A.

________________________________________________________________

STATEMENT OF FACTS:

Data extracted from the Personnel Data System indicates on  25 March  1986,
the applicant enlisted  in  the  Air  Force.   On  27 September  2006,  the
applicant voluntarily  separated  from  the  Air  National  Guard  and  was
relieved from her current assignment then assigned to the  retired  reserve
section and placed on the United States  Air  Force  Reserve  Retired  List
(RRL).  She served a total of 20 years, 4 months and 7 days of satisfactory
service.

_________________________________________________________________

AIR FORCE EVALUATION:

The BCMR Medical Consultant  recommends  denial.   The  Medical  Consultant
states there is nothing in the medical review from which  one  could  infer
military  service   causality   or   aggravation   for   osteoporosis   and
osteoarthritis  (general).   Irrespective   of   causality,   neither   the
applicant's sinusitis  nor  residuals  of  hysterectomy  were  recorded  as
interfering with duty, and  therefore  do  not  meet  the  requirements  of
Military Disability Evaluation System.  The applicant's hearing loss,  does
not meet the severity standards to be disqualifying for continued  military
service.  There is an  extensive  history  of  axial  skeleton  complaints,
including cervical,  thoracic  and  lumbar  spine.  There  is  specifically
nothing meeting the standards for military  disqualification  due  to  back
pain related to arthritis,  as  described  in  AFI  48-123.   The  civilian
medical documentation for recurrent/prolonged disability  related  to  back
pain is lacking; it appears that recommendations for limited activity  were
related to her concurrent knee  complaints,  rather  than  her  back.   The
military profile designation "L4" may be used to designate either  back  or
lower extremity concerns.  The initial L4  profile  in  November  2004  was
initiated due to her knee condition following  arthroscopic  knee  surgery.
There is likewise  insufficient  information  in  the  military  record  to
implicate back pain as the  cause  of  the  applicant's  duty  limitations.
There is nothing to definitively suggest disqualification for duty  due  to
back pain, and therefore no basis on which to conduct fitness determination
or disability processing.  She did not attest to knee problems on her entry
into the ANG in 2001.   In  October  2004  she  had  an  elective  surgical
procedure by a civilian provider correcting several internal knee  defects,
and she remained on a  restricted  duty  profile  until  the  date  of  her
separation two years following her  arthroscopic  knee  surgery.  The  knee
condition does appear to have precluded at least physical training (PT) for
a period of months preceding  surgery  and  for  two  years  following  the
surgery (as inferred from civilian medical notes, even  absent  a  military
profile for the full period), and she was  profiled  L4  from  November  6,
2004, until her transfer to the Retired Reserve in September 2006.

Review of the applicant's participation points summary indicates  continued
participation in Reserve drill and annual training throughout this  period.
Despite her continued participation, the duration of the  applicant's  duty
restriction was disqualifying for continued  military  service  and  should
have resulted in  referral  for  fitness  determination  no  later  than  6
November 2005.  There is  no  information  on  eventual  maximal  functions
capacity following orthopedic repair; those would have been material to MEB
deliberations for continued military duty, and to Physical Evaluation Board
(PEB) rating considerations if she had  been  found  disqualified.   It  is
inferred the applicant and her unit delayed the  appropriate  administrated
actions (LOD,  fitness  determination,  referral  to  MEB)  to  permit  the
applicant to accomplish duty sufficient to  complete  20  "good  years"  of
service on 20 May 2006 and qualify her for transfer to the Retired  Reserve
awaiting retirement at age 60.  While it  may  be  argued  the  applicants,
extended L4 profile argues against a presumption of  fitness,  evidence  of
the  record  indicates  limitations  in  fitness  testing   but   otherwise
substantial continued performance of military duties.  If the applicant had
been referred for Medical Evaluation Board (MEB) after one year on  the  L4
duty  limiting  profile  in  November  2005,  assuming  a  Line   of   Duty
Determination concluded her knee condition was in the  line  of  duty,  the
maximum rating warranted would have been less than 30%, and  not  qualified
her for  permanent  disability  retirement.   If  the  applicant  had  been
referred for a MEB in a timely fashion (that is, before reaching  20  "good
years" of service) and had been found disqualified at a rate less than 30%,
she would have forfeited  her  retirement  at  age  60  and  received  only
disability severance pay; there is no indication the applicant  is  seeking
severance, and further it is inferred that the risk  of  this  outcome  was
specifically avoided by delay in management of her duty restrictions. Based
on the preponderance of evidence  the  Medical  Consultant  concludes  that
actions and dispositions in this case are proper and  equitable  reflecting
the compliance with the Air Force directives that implement the law.

The complete Medical Consultant evaluation is at exhibit B.

________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

The  applicant  responded  stating  it  is   obvious   from   the   medical
documentation provided she has  multiple  disabilities  stemming  from  her
military service.  The VA rated her 60 percent for these disabilities.  She
believes her unit failed to process her  for  a  board  because  they  were
overwhelmed, understaffed and did not have the time  during  the  1999-2006
period.  She states the documentation shows she was going  to  be  boarded;
however, it never occurred.  This would  have  disqualified  her  from  the
military and afforded her a medical disability retirement.   The  applicant
states AFI 48-123, para 4.7 indicates her "4T" profile may not  be  imposed
for more than 12 months without an MEB or Physical Evaluation  Board  (PEB)
action when a service member is found to be disabled and are  not  able  to
meet the military mission due to their disability.  She believes  her  unit
is in violation of this regulation and believes she should  not  be  denied
her right to a medical  disability  determination  because  of  her  unit's
failure in the process.  In addition, AFI 48-123, para 4.8 states  "if  the
condition is permanent or expected to last more than a year as in her case,
then an MEB must be considered to  determine  qualification  for  continued
military  service.   The  applicant  provides  a  timeline   she   believes
demonstrates failures by her unit.  Furthermore, the applicant  states  she
spent the last two to three years in literal pain from her disabilities and
dragged herself to military drills and therefore was hardly "fit" for  duty
as cited in the findings by the Review Boards Office.  She could  not  pass
her physical training (PT) test and was not able to  participate  with  the
rest of her unit because of her disabilities.  She  believes  most  of  her
time was spent at the medical clinic  being  seen  by  doctors  and  asking
questions about her disability processing.  Furthermore, she  believes  she
was forced to retire by her chain of command and not afforded an  MEB,  she
was also not given  a  retirement  physical  180  days  from  her  date  of
separation (DOS).  Similarly, the AFI states all personnel 35 years old  or
older who are separating or retiring will complete screening for  Hepatitis
C, which was not done.  Finally,  the  AFI  states  when  individuals  have
medical conditions affecting their continued qualifications  for  retention
in the  Air  Force,  the  healthcare  providers  should  consult  with  the
supervisor or commander which was not done.

In addition, the applicant states  she  did  not  note  these  disabilities
before entering the Air National Guard because she was not aware  of  them.
Furthermore, most of her appointments with military doctors were short  and
not thorough; consequently, she had to spend her money on civilian  doctors
in order to receive the proper diagnosis.

The complete response, with attachments, is at Exhibit D and 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.  Sufficient relevant evidence has  been  presented  to  demonstrate  the
existence of error or injustice.  After reviewing the complete  case  file,
the Board is of the opinion that the applicant has  established  reasonable
doubt as to whether or not the decision not  to  process  her  through  the
disability evaluation system was appropriate under the  circumstances.   In
this respect, a review of the evidence provided shows that during the  time
period  in  question,  a  condition  existed  that   may   have   warranted
consideration by the disability evaluation system  (DES).   Notwithstanding
or discrediting the Medical Consultant's opinion that had she gone  through
the DES at the time her unfitting condition more than likely would have  at
most warranted a rating of 20%,  the  board  believes  that  those  in  the
disability evaluation process would be in the best position to evaluate her
records and render a fitness and/or rating determination.   Accordingly  we
recommend her records be corrected to the extent 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:

      a.  A review of her medical records  be  conducted  by  the  attending
physician at the nearest medical treatment  facility  to  determine  if  her
medical condition, as of 27 September 2006, disqualified her  for  continued
military service and if referral to a  Medical  Evaluation  Board  (MEB)  is
appropriate.

      b.  If the review determines that MEB action is  appropriate;  she  be
issued  invitational  travel  orders  as  necessary  for  the   purpose   of
undergoing MEB and Physical Evaluation  Board  (PEB)  processing;  and,  the
results of the evaluation  be  forwarded  to  the  AFBCMR  at  the  earliest
practical date  so  that  all  necessary  and  appropriate  actions  may  be
completed.

________________________________________________________________

The following members of the Board considered AFBCMR Docket Number BC-2007-
00684 in Executive Session on 21 June 07, under the provisions of  AFI  36-
2603:

                 Mr. Michael K. Gallogly, Panel Chair
                 Mr. Elwood C. Lewis III, Member
                 Ms. Sharon B. Seymour, Member

All members voted to correct the records, as  recommended.   The  following
documentary evidence pertaining to AFBCMR Docket Number  BC-2007-00684  was
considered:

          Exhibit A.  DD Form 149, dated 25 Feb 07, w/atchs.
          Exhibit B.  Applicant's Master Personnel Records.
          Exhibit C.  Letter, Medical Consultant, dated 21 May 07.
          Exhibit D.  Letter, SAF/MRBR, dated 23 May 07.
          Exhibit E.  Letter, Applicant, dated 11 June 07.
          Exhibit F.  Letter, Applicant, dated 14 June 07.




                                   MICHAEL K. GALLOGLY
                                   Panel Chair

                         DEPARTMENT OF THE AIR FORCE
                                WASHINGTON DC



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Office Of The Assistant Secretary

BC-2007-00684




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
XXXXXXX, XXXXXXX, be corrected to show:

           a.  A review of her medical records be conducted by the
attending physician at the nearest medical treatment facility to determine
if her medical condition, as of 27 September 2006, disqualified her for
continued military service and if referral to a Medical Evaluation Board
(MEB) is appropriate.


           b.  If the review determines that MEB action is appropriate; she
be issued invitational travel orders as necessary for the purpose of
undergoing MEB and Physical Evaluation Board (PEB) processing; and, the
results of the evaluation be forwarded to the AFBCMR at the earliest
practical date so that all necessary and appropriate actions may be
completed.






  JOE G. LINEBERGER

  Director

  Air Force Review Boards Agency