RECORD OF PROCEEDINGS
             AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:      DOCKET NUMBER:  BC-2008-00407
            INDEX CODE:  112.00
            COUNSEL:  NONE
            HEARING DESIRED:  NOT INDICATED

_________________________________________________________________

APPLICANT REQUESTS THAT:

His reentry code of  2Q  (Personnel  medically  retired  or  discharged)  be
changed.

_________________________________________________________________

APPLICANT CONTENDS THAT:

His reentry code is  preventing  his  reentrance  into  the  military.   His
medical  condition  at  the  time  of  his  discharge  has  been  completely
resolved.

In support of his request, the applicant provided a  copy  of  his  DD  Form
214, Certificate  of  Release  or  Discharge  from  Active  duty,  documents
extracted from his service and civilian  medical  records  and  a  statement
from his physician.

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

_________________________________________________________________

STATEMENT OF FACTS:

A medical report narrative summary  indicates  the  applicant  presented  to
military medical officials with  a  history  of  increasing  bilateral  knee
pain, since entering Basic  Military  Training.   He  reported  experiencing
episodes of pain since childhood, but that  those  resolved  after  quitting
sports activities.  He underwent a bone scan, plain x-rays, and  a  magnetic
resonance imaging (MRI) scan of both knees;  the  latter  test  revealing  a
localized degenerative  defect  involving  the  articular  surface  of  each
distal femur, called osteochrondritis dessicans (OCD).  His examination  and
MRI scan confirmed evidence  of  an  unrelated  anterior  cruciate  ligament
(ACL) deficiency,  believed  to  be  the  cause  of  his  reported  give-way
sensation involving the right knee.  He declined surgical treatment  of  his
deficient ACL.  After discussing other treatment options with an  orthopedic
surgeon, he elected to undergo a bilateral surgical procedure to excise  the
localized articular defects and  to  replace  each  with  an  allograft,  by
essentially introducing a bone plug to reestablish continuity of  the  joint
surface.  Following surgery, he was then placed on a  post-operative  course
of treatment, to include a period  of  physical  therapy,  nonweight-bearing
crutch walking, and a nonsteroidal anti-inflammatory for pain.  Five  months
following surgical treatment, he reported a  return  of  pain  to  its  pre-
operative severity level; with particular difficulty climbing  stairs,  with
no pain when at rest.

A Medical Evaluation Board (MEB) convened on 27 June 2003 and  referred  his
case to an Informal Physical Evaluation Board (IPEB)  with  a  diagnosis  of
ACL deficiency, right knee.  On 30 July 2003, the IPEB found him  unfit  for
further military service and recommended discharge.   The  IPEB  stated  his
medical  condition  existed  prior  to  service  (EPTS)  and  has  not  been
permanently  aggravated  through  military  service.   The  IPEB  noted  the
applicant’s childhood history  of  symptoms  with  sports  activities.   The
applicant agreed with the findings and recommended disposition of the  IPEB.
 On 4 August 2003, the Office of the Secretary of  the  Air  Force  directed
discharge effective 2 September 2003.  He  served  1  year,  2  months,  and
29 days on active duty.

_________________________________________________________________

AIR FORCE EVALUATION:

AFPC/DPSD recommends denial.  DPSD states the applicant is stating that  his
medical condition has resolved completely and he has  generous  support  for
medical clearance to reenlist in the service  or  join  the  Reserves.   The
correct RE code for a person who is approved for  a  medical  retirement  or
separation is 2Q.  The preponderance of evidence reflects that no  error  or
injustice  occurred  during  the  disability  process  or  at  the  time  of
separation.

The complete DPSD evaluation is at Exhibit C.

AFPC/DPSOA recommends denial.  DPSOA states there is no error  or  injustice
in this case.

The complete DPSOA evaluation is at Exhibit D.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

The applicant reviewed the evaluations and states he is  not  alleging  that
there was some injustice or error in his MEB findings.  The findings of  the
MEB were correct at that time to the best of his knowledge.   He  did  agree
and decided not to appeal the findings/decision  at  that  time.   When  his
case was decided upon by the MEB, his knees had  not  fully  recovered  from
the bilateral knee surgery (osteoarthritic transfer) and he was not sure  if
he was going to return to normal or  not  considering  it  had  been  a  few
months post-op.  He had allografts placed  bilaterally.   They  took  a  few
months of non-weight bearing for them  to  fuse  completely.   It  did  take
quite some time and physical therapy to get him  back  to  normal  after  so
long of inactivity.  That is why at the time, he was  not  sure  if  he  was
going to be able to  stay  with  the  military  and  he  agreed  with  their
findings.

He has a strong desire to reenlist.  He runs three to five miles a  day  and
performs strenuous activities frequently.  The  reviewing  individual  seems
to think the orthopedic physician and the MRI result conflict.  The MRI  may
look a bit negative but it is fairly normal  to  have  those  changes  after
that kind of surgery and basically his knees are a bit arthritic, which  has
not posed a problem for him.   He  has  full  range  of  motion,  no  edema,
slipping, or pain.  He has visited many  physicians  as  well  as  undergone
numerous tests specifically to present  to  the  Air  Force  that  he  is  a
healthy individual capable and desiring reentry.  He has dedicated a lot  of
money and time to this and has taken more than the necessary steps  that  he
was told by the recruiters to do.

The applicant’s complete response, with attachments, is at Exhibit F.

_________________________________________________________________

ADDITIONAL AIR FORCE EVALUATION:

The AFBCMR Medical Consultant recommends  denial.   The  Medical  Consultant
states the applicant has been fortunate to  have  received  the  benefit  of
surgical treatment of his OCD.  He has reportedly been asymptomatic and  now
reportedly has been able to compete in  a  5  kilometer  race  with  a  time
approximating 22 minutes.  The applicant is highly motivated  to  return  to
active military service and to pursue the  nursing  career  field,  possibly
becoming a certified registered nurse anesthetist.  The  Medical  Consultant
cannot determine the applicant’s long-term prognosis (particularly if  truly
running on a daily basis), but based upon the  expected  natural  course  of
his degenerative joint disease, it is more likely than not that the  process
will continue to progress at the risk of a recurrence of  difficulties  with
pain.  Thus, in making its determination,  the  Board  should  consider  the
likely return on investment for returning the applicant to  duty  to  pursue
new or resume his previous career field  (having  already  been  transferred
from Air Traffic Control to a medical career field).  Further,  although  an
abnormal x-ray or an illness does not constitute unfitness for duty, in  the
case under review the radiographic evidence of degenerative arthritis is  an
ominous sign for a  return  of  problems  in  the  not  so  distant  future.
Additionally, although perceived to be less physically strenuous, a  medical
career field will not spare the applicant’s vulnerability for  enduring  the
same extreme physical stressors and requirements confronting all members  of
today’s Air and Space Expeditionary Force.

The Medical Consultant finds the  applicant’s  recovery  remarkable  and  is
pleased to see he has demonstrated the ability to perform in  activities  in
which he was unable to perform prior to and  during  his  military  service.
Additionally, the Medical  Consultant  acknowledges  the  nursing  shortages
confronting the military and the nation.  However, the interests of the  Air
Force are better served by not subjecting the applicant to  conditions  that
will place him at great risk for an exacerbation or chronic knee  pain  that
will likely restrict his utilization as a total force asset; and which  will
follow him long after serving our nation.

The Medical Consultant’s complete evaluation is at Exhibit G.

_________________________________________________________________

APPLICANT'S REVIEW OF ADDITIONAL EVALUATION:

A  copy  of  the  Medical  Consultant's  evaluation  was  forwarded  to  the
applicant for review and comment within 30 days (Exhibit  H).   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.  Sufficient relevant evidence  has  been  presented  to  demonstrate  the
existence of an injustice warranting some relief.  We  understand  that  the
reentry code assigned to the applicant at the  time  of  his  discharge  was
technically correct and  in  compliance  with  the  applicable  instruction.
Further, we are not unmindful of the position of the Air  Force  offices  of
primary responsibility and BCMR Medical Consultant.  However,  according  to
the evidence presented by the applicant it appears that the condition  which
prevented him for continuing his military career may have  resolved  and  we
believe reasonable doubt has been established as to whether or  not  he  may
be  able  to  provide  effective  and  meaningful  service  to  our  nation.
Accordingly, it is our opinion that the  benefit  of  any  doubt  should  be
resolved in his favor and we recommend that his records be  corrected  in  a
manner which would allow him to apply for a waiver to reenlist.  Whether  or
not he is successful in his endeavor will  depend  upon  the  needs  of  the
service and our recommendation in no way guarantees that he will be  allowed
to return to the Air Force or any branch of  military  service.   Therefore,
we recommend his RE code be changed as indicated below.

_________________________________________________________________

THE BOARD DETERMINES THAT:

The pertinent military records of the Department of the Air  Force  relating
to APPLICANT be corrected to show that at the time of  his  discharge  on  2
September 2003, his reentry code was 3K.

_________________________________________________________________

The following members of the Board considered AFBCMR Docket Number  BC-2008-
00407 in Executive Session on 9 October 2008, under the  provisions  of  AFI
36-2603:

                 Mr. James W. Russell III, Panel Chair
                 Mrs. Lea Gallogly, Member
                 Mr. Gregory A. Parker, Member

All members voted to correct the  records  as  recommended.   The  following
documentary evidence was considered:

   Exhibit A.  DD Form 149, dated 20 January 2008, w/atchs.
   Exhibit B.  Applicant's Master Personnel Records.
   Exhibit C.  Letter, AFPC/DPSD, dated 8 February 2008.
   Exhibit D.  Letter, AFPC/DPSOA, dated 27 February 2008.
   Exhibit E.  Letter, SAF/MRBR, dated 4 April 2008.
   Exhibit F.  Letter, Applicant, not dated, w/atchs.
   Exhibit G.  Letter, AFBCMR Medical Consultant, dated 27 May 2008.
   Exhibit H.  Letter, SAF/MRBR, dated 10 June 2008.




                       JAMES W. RUSSELL III
                       Panel Chair





AFBCMR BC-2008-00407




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 XXX, be corrected to show that at the time of his discharge on
2 September 2003, his reentry code was 3K.





      JOE G. LINEBERGER
      Director
      Air Force Review Boards Agency