RECORD OF PROCEEDINGS 

AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS 

 

IN THE MATTER OF: DOCKET NUMBER: BC-2010-03405 

 COUNSEL: NONE 

 HEARING DESIRED: NO 

 

_________________________________________________________________ 

 

APPLICANT REQUESTS THAT: 

 

Her diagnosis of “Adrenal Insufficiency” be added to her AF Form 
356, Findings and Recommended Disposition of USAF Physical 
Evaluation Board, dated 22 Jul 10,” and included as part of her 
overall disability rating. 

 

_________________________________________________________________ 

 

APPLICANT CONTENDS THAT: 

 

The Medical Evaluation Board (MEB) did not have the necessary 
paperwork to make a decision about her adrenal insufficiency. 

 

Her military medical provider is willing to do whatever is needed 
to help correct her military record. She is currently seeing a 
civilian endocrinologist, whom she has been seeing on a regular 
basis for over a year. 

 

In support of her request, the applicant provides a personal 
statement, a letter from her civilian medical provider, and 
medical documents. 

 

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

 

_________________________________________________________________ 

 

STATEMENT OF FACTS: 

 

On 21 Nov 09, the applicant underwent a MEB for the following 
conditions: adrenal insufficiency, asthma, lumbago, obstructive 
sleep apnea (OSA), and post-traumatic stress disorder (PTSD). 

 

On 9 Feb 09, the Informal Physical Evaluation Board (IPEB) found 
the applicant unfit for PTSD (assigned a 50 percent rating), 
chronic low back pain (assigned a 40 percent rating), and adrenal 
insufficiency (assigned a 20 percent rating), and recommended 
placement on the Temporary Disability Retired List (TDRL) with a 
combined (not added) disability rating of 80 percent. The IPEB 
considered her OSA (controlled with a continuous positive airway 
pressure (CPAP) machine and asthma to be conditions that can be 
unfitting but were not currently compensable or ratable at the 
time. 

 


The applicant did not contest the findings and recommended 
disposition of the IPEB, and on 29 May 09 she was placed on the 
TDRL. 

 

On 22 Jul 10, the applicant received a TDRL re-evaluation of her 
conditions, the decision was made to remove her from the TDRL and 
permanently retire her with a combined (not added) disability 
rating of 70 percent, which included 50 percent for PTSD, 
40 percent for chronic low back pain. The IPEB noted that the 
adrenal insufficiency had resolved. It was noted in the medical 
narrative summary on 10 Mar 10: “Pt with h/o corticosteroid-
induced adrenal insufficiency. Currently followed by a civilian 
endocrinologist. Corticosteroid replacement was slowly decreased 
over several months and was ultimately discontinued in Nov 2009. 
Per patient’s report, a cosyntropin stimulation test resulted in 
normal adrenal cortisol response after discontinuation of 
prednisone [records are not available at this visit]. Given this 
information, pt’s adrenal insufficiency has likely resolved. 
Pt’s endocrinologist plans to continue following her for the next 
2-3 years to ensure adrenal insufficiency does not recur.” 

 

On 24 Aug 10, the applicant concurred with the IPEB’s 
recommendation. 

 

On 19 Sep 10, the applicant was removed from the TDRL, and was 
permanently retired with a 70 percent disability rating. 

 

Additional facts relevant to the applicant’s case are contained 
in the evaluations prepared by the Air Force office of primary 
responsibility and the BCMR Medical Consultant at Exhibits C & E. 

 

_______________________________________________________________ 

 

AIR FORCE EVALUATION: 

 

AFPC/DPSD recommends denial and states the preponderance of 
evidence reflects that no error or injustice occurred during the 
disability process or the rating applied at the time of the board 
and removal from the TDRL. 

 

While the applicant may continue to require follow-up from her 
physicians, the diagnosis alone was not sufficient for the IPEB 
to find the condition unfitting for continued service. 

 

It should also be noted that had the applicant felt her adrenal 
insufficiency should have been included as an unfitting condition 
and rated, she had the right to appeal at the Formal Physical 
Evaluation Board (FPEB) and could have appealed their findings to 
the Secretary of the Air Force Personnel Council. The applicant 
did not exercise either of these appeal rights. 

 

The Department of Defense (DoD) and the Department of Veterans 
Affairs (DVA) disability evaluation systems operate under 
separate laws. Under Title 10, United States Code (USC), 


Physical Evaluation Boards must determine if a member’s condition 
renders them unfit for continued military service relating to 
their office, grade, rank or rating. The fact that a person may 
have a medical condition does not mean that the condition is 
unfitting for continued military service. To be unfitting, the 
condition must be such that it alone precludes the member from 
fulfilling their military duties. If the Board renders a finding 
of unfit, the law provides appropriate compensation due to the 
premature termination of their career. Further, the USAF 
disability boards must rate disabilities based on the member’s 
condition at the time of evaluation; in essence a “snap shot” of 
their condition at that time. It is the charge of the DVA to 
pick up where the AF must, by law, leave off. Under Title 38, 
USC, the DVA may rate any service-connected condition based upon 
future employability or reevaluate based on changes in the 
severity of a condition. This often results in different ratings 
by the two agencies. 

 

The complete DPSD evaluation is at Exhibit C. 

 

_________________________________________________________________ 

 

APPLICANT'S REVIEW OF AIR FORCE EVALUATION: 

 

On 8 Apr 11, a copy of the Air Force evaluation was forwarded to 
the applicant for review and comment within 30 days. To date, a 
response has not been received (Exhibit D). 

 

_________________________________________________________________ 

 

ADDITIONAL AIR FORCE EVALUATION: 

 

The BCMR Medical Consultant recommends denial. The applicant has 
not met her burden of proof of an error or injustice that 
warrants the desired change of the record. 

 

The IPEB opined based upon the evidence supplied, that the 
applicant’s adrenal insufficiency was no longer unfitting. The 
applicant’s current endocrinologist states she will likely 
require continued periodic follow-up of her condition and even 
may require treatment at a future date. However, the fact the 
applicant will require long-term-follow-up and observation of the 
condition and may require treatment at an indeterminate future 
date is not determinative of unfitness to serve. Although 
conditions justifying initial TDRL placement have generally not 
yet been stabilized, the Consultant opines at the time of the 
applicant’s TDRL assessment the adrenal insufficiency had been 
reasonably brought under control (no longer required steroid 
replacement therapy since Nov 09) to the extent that removing 
this as an unfitting condition was appropriate. 

 

The applicant will retain her eligibility to receive disability 
compensation by the DVA, for this and her other service connected 


medical conditions which were not found unfitting; bearing in 
mind that even the DVA may assign a zero percent rating (no 
compensation) for a service connected medical condition that no 
longer presents a functional impairment or does not meet minimum 
disability rating criteria. 

 

The complete BCMR Medical Consultant’s evaluation is at Exhibit 
E. 

 

_________________________________________________________________ 

 

APPLICANT'S REVIEW OF ADDITIONAL AIR FORCE EVALUATION: 

 

On 29 Jul 11, a copy of the BCMR Medical Consultant evaluation 
was forwarded to the applicant for review and comment within 
30 days. To date, a response has not been received. (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 change in her 
military record. As indicated by the BCMR Medical Consultant, 
the fact the applicant will require long-term-follow-up and 
observation of the condition and may require treatment at an 
indeterminate future date is not determinative of unfitness to 
serve. In this respect, we note that although at the time of her 
initial TDRL placement her adrenal insufficiency was found to be 
unfitting; at the time of her TDRL reassessment it was reasonably 
brought under control, and determined not to be unfitting at the 
time. 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 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-2010-03405 in Executive Session on 13 Sep 11, under the 
provisions of AFI 36-2603: 

 

 , Panel Chair 

 , Member 

 , Member 

 

The following documentary evidence pertaining to Docket Number 
BC-2010-03405 was considered: 

 

 Exhibit A. DD Form 149, dated 15 Sep 10, w/atchs. 

 Exhibit B. Applicant's Master Personnel Records. 

 Exhibit C. Letter, AFPC/DPSD, dated 21 Mar 11. 

 Exhibit D. Letter, SAF/MRBR, dated 8 Apr 11. 

 Exhibit E. Letter, BCMR Medical Consultant, dated 22 Jul 11. 

 Exhibit F. Letter, SAF/MRBR, dated 29 Jul 11. 

 

 

 

 

 

 Panel Chair