ADDENDUM TO
RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS
DOCKET NUMBER: BC-1999-00390
COUNSEL: NONE
HEARING DESIRED: NO
IN THE MATTER OF:
________________________________________________________________
APPLICANT REQUESTS THAT:
The applicant submits DD Forms 149 (four), with attachments,
requesting the following:
1. His injuries be reflected as a result of a combat-related
event, instrumentality of war, hazardous service or simulated
combat service and he receive combat pay and other allowances
payable to the date of his retirement.
2. His compensable disability rating be increased to 80 or
100 percent based on unemployability.
3. The Physical Evaluation Board (PEB) be rendered invalid
because a Reserve officer was not a member.
________________________________________________________________
STATEMENT OF FACTS:
In Apr 94, an Informal Physical Evaluation Board (IPEB)
diagnosed the applicant with neck pain (minor) arm with weakness
and numbness, status post October 1992, C5 – C6 discectomy and
fusion, and Jun 93, C5 corpectomy and C4 - C6 fusion and
instrumentation. They recommended the applicant’s name be
placed on the Temporary Disability Retired List (TDRL) with a
compensable disability rating of 30 percent. The applicant
nonconcurred and requested his case be referred to the Formal
Physical Evaluation Board (FPEB). The FPEB recommended the
applicant name be placed on the TDRL, with a compensable
disability rating of 60 percent and a diagnosis of neck pain and
right (minor) arm pain with weakness and numbness, status post
Oct 92 C5-6 discectomy and fusion and Jun 93 C5 corpectomy and
C4-6 fusion and instrumentation.
The applicant’s name was placed on the TDRL, on 2 Aug 94, in the
grade of major, with a compensable disability rating of
60 percent, under the provisions of Title 10, United States Code
(USC), Section 1202.
Under the case, AFBCMR Docket No. BC-1994-00335, the applicant’s
record was corrected to reflect the following:
1. His AF Form 356, Findings and Recommended Disposition
of the Physical Evaluation Board (PEB), dated 27 May 94, was
changed as follows:
a. Item 9B reflect “Yes” rather than “NA.”
b. Item 9C reflect “Yes” rather than “NA.”
c. Item 9D reflect “NA” rather than “YES.”
d. Item 10B reflect “YES” rather than “NA.”
b. The Action of the Reviewing Authority Section now
3. AF Form 261, Line of Duty Report of Investigation,
4. On 1 Jul 94, he was recalled to active duty by
2. AF Form 348, Line of Duty Determination (LOD), dated
9 Jul 93, was changed to reflect “Aggravation of Spinal Injury”
rather than “Pain, Left Foot.”
dated 4 Aug 93, was changed as follows:
a. The basis for Findings Section now reflects a
medical diagnosis of “Aggravation of Spinal Injury” rather than
“Strain of left foot.”
reflects “Approved,” rather than “Disapproved.”
competent authority.
5. On 1 Aug 94, he was found unfit to perform the duties
of his office, rank, and grade or rating by reason of physical
disability incurred while entitled to receive basic pay; that
the diagnosis in his case was neck pain and right (minor) arm
pain with weakness and numbness, status post Oct 92 C5 - C6
discectomy and fusion and Jun 93 C5 corpectomy and C4 - C6
fusion and instrumentation, further surgery was pending,
occasional bladder incontinence, disability rating of 60 percent
VA code 5299-5293; that the disability was permanent; that the
disability was not due to intentional misconduct or willful
neglect; that the disability was not incurred during a period of
unauthorized absence; that the disability was incurred during a
period of national emergency; and that the disability was not
received in line of duty as a direct result or armed conflict.
6. He was permanently retired by reason of physical
disability, effective 2 Aug 94, under the provisions of Title
10, USC Section 1202, with entitlement to home of selection
travel and transportation allowances.
Under the case, AFBCMR Docket No. BC-1999-00390, the applicant
requested that his record be corrected to reflect that his
compensable disability rating of 60 percent be changed to
75 percent on the basis of unemployability. However, after
2
considering the available evidence, the Board found insufficient
evidence of error or injustice.
Under AFBCMR Docket No. BC-2007-00345 the Board corrected the
applicant’s record to extend his separation travel and
transportation allowances to 31 Jan 02, based on his medical
condition at the time of his disability retirement.
For an accounting of the facts and circumstances surrounding the
applicant’s disability retirement, and, the rationale of the
earlier decisions by the Board, see the Records of Proceedings
at Exhibit F.
The applicant submits a request for reconsideration contending
that he has been totally disabled, with multiple surgeries,
since 1991. According to The Department of Veterans Affairs
(DVA) and the Social Security Administration (SSA) he is
permanently and totally disabled with a compensable disability
rating of 100 percent for unemployability.
His injuries were caused by or aggravated by wartime service in
the Area of Responsibility (AOR) as a crewmember of a C-130
aircraft (weapons system), simulated combat training and wearing
other combat gear. He was injured and reaggravated previous
injuries while serving in the Persian Gulf War.
His disability rating, at retirement, should be changed to
100 percent due to unemployability, which can be granted by the
service.
In support of his appeal, the applicant provides a personal
statement and copies of extracts from his disability evaluation,
including documentation that he believes was not available at
the time of separation.
The applicant’s complete submission, with attachments, is at
Exhibit G.
________________________________________________________________
THE AIR FORCE EVALUATION:
The AFBCMR Medical Consultant recommends denial of the
applicant's request for designating his cervical spine injury as
Combat-related or the result of an Instrumentality of War, and
denial of assignment of a 100 percent total disability rating
retroactive to the date of his unfit finding.
The Medical Consultant has provided an extensive factual history
to facilitate the Board's decision of whether to grant
Instrumentality of War and/or to grant a 100 percent total
disability rating from the time of the applicant's initial unfit
finding (1994) or at the time of his removal from the TDRL
(1996). The applicant has presented a plausible argument
3
rating,
the
Medical
disability
supporting the establishment that he sustained a cervical spine
injury or worsening of a previous cervical spine injury in 1991
after tumbling from a military unique vehicle (or uniquely
configured or deployed for military use), which the Consultant
concedes was an Instrumentality of War.
The question confronting the Board is whether the applicant's
injury was the direct result of the Instrumentality of War. In
the case under review, the applicant reportedly turned his
vehicle off-road to allow the passage of a convoy, whereupon the
vehicle assumed a tilted position, following which he exited the
downward side door of the vehicle, fell, and injured himself.
One could argue that it was the applicant's error in judgment
not the Instrumentality of War that caused the fall;
particularly since the vehicle was no longer in motion at the
time. With reference to the applicant's contention for a
100 percent
Consultant
acknowledges the reference of record made to a questionable
reason why the Department of Veterans Affairs (DVA) has a higher
statistical award of total disability ratings when compared to
Military Departments. However, the allegation is not proof of
an error or injustice that invalidates the decision of the
military rating agency at the time of adjudication.
The Medical Consultant is aware of the policies governing total
disability ratings, as outlined in 38 C.F.R, also known as the
Veterans Administration Schedule for Rating Disabilities
(VASRD), and the variety of means of obtaining such a rating
decision. While the applicant implicitly alleges the Department
of Defense (DOD) rarely, if ever, considers awarding total
disability ratings, this option was indeed available to military
physical evaluation boards (PEBs), as pointed out by the
applicant in a submitted extract from the since rescinded DoD
Instruction (DODI) 1332.39, showing the award is made when a
medical condition "renders it impossible for the average person
suffering the same medical condition to engage in a
substantially gainful civilian occupation: In the case under
review, neither PEB considered the applicant's cervical spine
condition and unilateral upper extremity neurological deficit
rendered it "impossible" to engage in substantially gainful
employment, given his proven cognitive skills in leadership and
training, and the accommodations available to him under Title I
of the Americans With Disabilities Act of 1990. Likewise, there
are no objective evidence supplied to show the DVA assigned
separate disability ratings for other specific conditions, other
than the 60 percent rating, until 6 Oct 09.
Redirecting attention to the applicant's TDRL re-evaluation
reflecting increased incontinence, several times during each
day, the Consultant opines consideration should have been for
formally assessing this as either a separate unfit finding or
designating it as NOT unfitting with its own disability rating
code on the AF Form 356. However, both the Military Department
and the DVA appear to have subsumed the sequelae of the
4
applicant's cervical spine injury (at the maximum rating of
60 percent) under the unifying rating code for Intervertebral
Disc Syndrome; although we see the DVA has ultimately assigned a
separate disability ratings for bowel incontinence, urinary
incontinence, and for lumbar degenerative disc disease as recent
as 2009. The Consultant opines there is insufficient objective
evidence supplied to show these were individually unfitting
conditions at the time of placement and release from the TDRL;
as would have been best reflected through physical profile
documents, intervening medical progress notes, or their
inclusion on the applicant's AF Form 618, Medical Board Report
document as disqualifying medical conditions.
In conclusion, the Medical Consultant opines the applicant has
not met the burden of proof that his cervical spine injury,
believed to have first occurred in 1989 [errantly diagnosed as a
shoulder injury) and which was aggravated in 1991, was the
direct result of an Instrumentality of War. With respect to the
determination of the requested total disability rating, the
Consultant opines that the DVA decision, that of the Social
Security Administration, and that made by the PEBs are not
binding upon each other. The Board nevertheless has the
authority to grant the applicant a 100 percent total disability
rating and/or find his cervical spine injury either Combat-
related or the result of an Instrumentality of War independent
of the advisory opinion provided.
The complete AFBCMR Medical Consultant evaluation is at
Exhibit H.
________________________________________________________________
APPLICANT'S REVIEW OF THE AIR FORCE EVALUATION:
EXAMINER’S NOTE: The BCMR Medical Consultant evaluation, dated
24 Mar 11 was mailed to the applicant on 5 Oct 11. However, the
applicant provided additional documents for review prior to this
mailing. The applicant responded to the 24 Mar 11 evaluation by
the BCMR Medical Consultant and his response with the previously
submitted documentation was provided to the BCMR Medical
Consultant for review.
In the additional documentation, the applicant maintains that
servicemembers are entitled to protection in their retirement by
an award of unemployability; therefore, he is entitled to a
70 percent level of compensation.
He notes that Air Force officials (BCMR Medical Consultant has
briefed the President, Veterans Affairs Disability Benefits
Commission (VADBC) on the subject of unemployability, explaining
the differences in numbers of awards by the Air Force and the
DVA. He notes in his briefing that the BCMR Medical Consultant
explained the variances of awards by the two organizations were
5
a matter of “different physician training.” However, he did not
state the Air Force does not actually make such awards. In this
respect, the applicant notes, in researching this through
Freedom of Information Act (FOIA) requests, he has found out
that the BCMR Medical Consultant did not tell the VADBC that the
Air Force actually does not make any findings of unemployability
for servicemembers at all. A statistically insignificant number
of around just 12 members in over a decade has received this
protection, yet he has provided adequate proof that he qualifies
for this protection.
In addition, through his FOIA request, he was not provided any
record of the Board’s consideration of unemployability for total
disability, nor any written information or guidance. However,
he did find two briefings of the last two AFBCMR Training
Conferences, where the word “unemployability” does not even
appear and if the response to the FOIA is accurate these two
briefings appear to be the only guidance to the Board, so, he is
unaware as to how servicemembers can be protected by the
provisions of this law, if the subject of unemployability is not
even mentioned.
While he understands the difference between the two laws
governing the Military Disability Evaluation Systems (MDES) and
the DVA, how can both agencies differ so widely in their
evaluation of the same “snapshot in time,” at the time of
retirement? (Exhibit I)
In addition, the applicant submitted supporting documentation to
corroborate his contentions that his LOD injuries were worsened
by the care he received from the VA and the inadequacies of the
first surgery at Bethesda. He maintains that these findings
should have been reflected in his Air Force medical evaluation
for permanent and total disability and should have been
separately rated at the PEB.
Additionally, the applicant submitted further documentation to
corroborate his contentions for combat-related injuries and
illness associated with Agent Orange; and amended his request to
include acute peripheral neuropathy due to an instrumentality of
war.
He respectfully disagrees with several recommendations of the
Advisory Opinion and notes that it makes no objection to the
backdating of the requested relief, which he maintains should be
backdated to the date of his original retirement because he was
clearly totally and permanently disabled at that time and the
Air Force failed to allow the PEB and AFBMCR to be even
superficially informed regarding the unemployability rating and
his eligibility for it.
Additionally, he notes that the evaluation:
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-Fails to address several of the issues for which relief
was sought, specifically, Agent Orange exposure and its related
illnesses, plus other injuries and illnesses.
-Ignores justifications detailed in his appeal.
-Is in factual error regarding numerous conclusions.
-Concludes that his appeal has enough justification to
permit the Board to give him the benefit of the doubt.
Further, he notes, that because of his duties during deployments
and the Gulf War, he maintains that his cervical spine injury
was aggravated and post-surgical and DVA medical care worsened
his injuries and illnesses. The aircraft and previous fall from
a military vehicle are evidence that his disabilities should be
combat-related, because they are instrumentalities of war. He
maintains that the Air Force’s record with consideration of
unemployability is inconsistent with law and policy and he
should be granted a compensable disability rating of 100 percent
based on unemployability.
The applicant’s complete responses, with attachments, are at
Exhibit K.
________________________________________________________________
ADDITIONAL AIR FORCE EVALUATION:
The BCMR Medical Consultant recommends granting the applicant
relief by amending the record to reflect that he was placed on
the Temporary Disability Retired List (TDRL), effective
2 Aug 94, with a 60 percent disability rating and remained so
until he was removed from the TDRL and permanently retired with
the assignment of a total [100 percent] disability rating under
the individual unemployability provision of 38 C.F.R. and the
provision of the since rescinded DoDI 1332.39, paragraph 6.5,
Total Disability Rating, effective 28 Mar 96. He notes that
this supplemental advisory analysis is in response to the
applicant's rebuttal letter to the Board. The applicant
maintains that he should have received a 100 percent disability
rating due to unemployability backdated to his date of
retirement and that his medical condition(s) be determined to
have been the direct result of an Instrumentality of War.
Setting the stage of the applicant's petition is evidence
supplied to him via FOIA which demonstrated that the Air Force,
in a disproportionate manner, has granted far fewer total
disability rating awards for unemployability, as compared with
the DVA.
The BCMR Medical Consultant notes that fundamentally, the
applicant's petition for a total disability rating appears to be
largely based upon the "unemployability" decisions previously
rendered by other federal agencies, the DVA and the Social
Security Administration (SSA); and the implicit allegation that
the Military Department failed to do so because it "[does] not
like issuing unemployability ratings," or words to that effect.
7
The Medical Consultant concedes the opinions from other sources
supporting the applicant's petition are compelling that he may
have been reasonably unemployable during the timeframe from 1994
to 1996 (the latter date when he was removed from the TDRL).
However, the Medical Consultant would prefer to reach a
consensus via an independent review of the applicant's actual
service medical documentation, e.g., MEB narrative summary,
applicable progress notes leading to the MEB and the assigned
military profile restrictions, notwithstanding the reputable
sources of the opinions provided [National Naval Medical Center,
a VA Medical Center, Johns Hopkins and Massachusetts General
Hospital] and his military TDRL reevaluation. For this reason,
the Consultant opines that the collective probative value of the
VA determinations coupled with the clinical assessment at the
time of TDRL re-evaluation should be taken into consideration
for granting the unemployability rating under the aforementioned
provision of DoDI 1332.39 and existing provisions under Title 38
Code of Federal Regulations (C.F.R.), at the time of release
from the TDRL.
We now know that, as a result of NDAA 2008 and the current
Integrated Disability Evaluation System, the Military Department
relinquishes all rating determinations to the DVA, is required
to follow only VA or mutually agreed upon guidelines in rating
determinations, but still only applies the disability rating
decision to those conditions found unfitting for further
military service. This remedy has removed the opportunity for
future disparities between VA and Military Departmental rating
decisions when evaluating the same patient, with the same
reported disabilities, although operating under the same VASRD;
but bearing in mind that the DVA assigns disability ratings to
all conditions found service connected, without regard to their
impact upon a member's retainability, fitness to serve, or PEB
determinations. Based upon a preponderance of evidence, to
include the applicant's reported worsening incontinence and the
emergence of an intervening secondary affective disorder [and
the failure of medical officials to obtain a recommended
psychiatric evaluation], which likely contributed to his level
of overall functional impairment, the Consultant finds it fair
to change the rating at the time of the applicant's release from
the TDRL and to apply the total disability rating due to
unemployability.
The Medical Consultant opines the Service evidence does not
adequately support a total disability rating at initial TDRL
placement; particularly in the context of the applicant's
demonstrated performance history during Service and prior to
initial TDRL placement. Addressing the applicant's concern for
failing to address other medical conditions reportedly present
in his service treatment record, unlike the DVA, the MDES,
operating under Title 10, U.S.C., is established to maintain a
fit and vital fighting force and can by law, only offer
compensation for those service incurred diseases or injuries
which specifically rendered a member unfit for continued active
8
service or were the cause for career termination; and then only
for the degree of impairment present at the time of separation
and not based on future changes or worsening; unless such
changes occurred in the condition(s) previously found unfitting,
while in TDRL status. Although the applicant contends other
medical conditions were not considered in his disability rating
computation, which were reportedly documented in his service
treatment record, there is insufficient evidence to demonstrate
that any of these reported additional clinical symptoms
interfered with his ability to perform assigned military service
of a sufficient sustained level of restriction, e.g., "P4T" or
"L4T" profile and duration [as would have been reflected on AF
Form 422, Physical Profile Serial Reports] to warrant
independent bases for separate unfit findings for termination of
his military service.
In conclusion, the Medical Consultant opines the applicant has
raised reasonable doubt in his favor, that he should have been
considered for the total disability rating for individual
unemployability at the time of removal from the TDRL and that
his cervical spine injury, that occurred after falling out of a
military vehicle and which required two surgeries, was the
direct result of an Instrumentality of War. Should the Board
agree with this analysis, the reader is advised that this does
not establish a precedent, but would be based solely on the
unique characteristics of the applicant's disabilities and
evidence provided reflecting both significant mental and
residual physical impairments that adversely affected his
employability.
The complete BCMR Medical Consultant evaluation is at Exhibit L.
________________________________________________________________
ADDITIONAL APPLICANT'S REVIEW OF THE AIR FORCE EVALUATION:
The applicant concurs with and accepts the recommendations and
offers
opinion’s
characterization of his service prior to being placed on the
TDRL. He notes that, in fact, documents submitted to the Board
establish that he was for nearly two years on Incapacitation Pay
status, itself a disability situation for which he had to be
unemployable to qualify. Further, he wish to offer another
minor observation that the opinion discusses justification for
providing an Instrumentality of War finding and seems to
recommend that such a finding “could reasonably be considered.”
However, no later discussion of this is made in the
Recommendation section of page 5, so he concurs and accepts this
opinion if that is actually its recommendation. Additionally,
he notes, that some of the points raised in his appeal (such as
not having a Reserve Component officer as a PEB board member)
have not been touched upon but it now seems that all the total
relief he could hope for has been recommended in the opinion.
observation
regarding
a
minor
the
9
The applicant’s complete response is at Exhibit N.
________________________________________________________________
THE BOARD CONCLUDES THAT:
Sufficient relevant evidence has been presented to demonstrate
the existence of error or injustice warranting corrective
action. After careful consideration of the applicant’s complete
submission, including his responses to the BCMR Medical
Consultant’s evaluations and based on the preponderance of
evidence, we recommend partial relief. In this respect, we note
the BCMR Medical Consultant has conducted an exhaustive review
of the available evidence and we are in agreement with his
opinion and recommendation that the additional documentation
provides a reasonable basis to conclude that the applicant
should be entitled to a compensable disability rating of 100
percent for individual unemployability subsequent to his release
from the TDRL.
However, in considering the applicant’s request that his
conditions be reflected as a result of a combat-related event,
instrumentality of war, hazardous service or simulated combat
service; that his PEB be rendered invalid based on the make-up
of the board’s membership, we found no evidence that the PEB was
conducted inappropriately or was not administered in accordance
with the governing Air Force instructions and policy.
Additionally, in our view, while we note the comments of the
BCMR Medical Consultant, we are not convinced that the
applicant’s injuries were a direct result of a combat-related
event or an instrumentality of war. Accordingly, we recommend
the applicant’s record be corrected only 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:
1. On 2 August 1994, he was not permanently retired by
reason of disability under the provisions of Title 10 USC
Section 1202, but his name was placed on the Temporary
Disability Retired List (TDRL), with a compensable disability
rating of 60 percent.
2. On 28 March 1996, his name was removed from the TDRL and
he was permanently retired by reason of physical disability with
a compensable disability rating of 100 percent.
________________________________________________________________
10
The following members of the Board considered AFBCMR Docket
Number BC-1999-00390 in Executive Session on 21 February 2012,
under the provisions of AFI 36-2603:
All members voted to correct the records, as recommended. The
following documentary evidence was considered:
Exhibit F. Record of Proceedings,
dated 30 Aug 00, w/exhibits.
Exhibit G. DD Forms 149, dated 22 Oct 10, w/atchs.
Exhibit H. Letter, AFBCMR Medical Consultant,
dated 24 Mar 11.
Exhibit I. Letters, Applicant, dated
27 Apr and 18 May 11, w/atchs.
Exhibit J. Letter, AFBCMR, dated 5 Oct 11.
Exhibit K. Letter, Applicant, dated 23 Oct 11, w/atchs.
Exhibit L. Letter, AFBCMR Medical Consultant,
dated 6 Jan 12.
Exhibit M. Letter, AFBCMR, dated 10 Jan 12.
Exhibit N. Letter, Applicant, dated 31 Jan 12.
Panel Chair
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