RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS
IN THE MATTER OF: DOCKET NUMBER: BC-2012-04038
COUNSEL: NONE
HEARING DESIRED: NO
________________________________________________________________
APPLICANT REQUESTS THAT:
Obstructive Sleep Apnea (OSA) be added to his military record so
he would qualify for a medical retirement.
_______________________________________________________________
APPLICANT CONTENDS THAT:
He has medical expert evidence that proves OSA is a direct
correlation to atrial fibrillation, which when combined with the
10 percent rating he received for this condition would result in
a medical retirement. His discharge should have been based on
his OSA and atrial fibrillation, resulting in a disability
rating of 60 percent, which exceeds the 30 percent required for
a medical retirement.
The applicant's complete submission, with attachments, is at
Exhibit A.
_______________________________________________________________
STATEMENT OF FACTS:
On 23 Jan 2002, the applicant entered the Regular Air Force.
On 3 Sep 2009, the applicant was honorably discharged. His
narrative reason for separation is DISABILITY SEVERANCE PAY.
He served 7 years, 7 months and 11 days of active service.
The remaining relevant facts pertaining to this application are
contained in the letters prepared by the appropriate offices of
the Air Force at Exhibits C and D. Accordingly, there is no
need to recite these facts in this Record of Proceedings.
_______________________________________________________________
AIR FORCE EVALUATION:
AFPC/DPPD recommends denial. DPPD states that the preponderance
of evidence reflects that no error or injustice occurred during
the disability process. The member had a medical evaluation
board on 20 Nov 2008, for atrial fibrillation. On 19 Feb 2009,
the Informal Physical Evaluation Board (IPEB) reviewed the case
and recommended discharge with severance pay (DWSP) with a
disability rating of 10 percent. The member non-concurred on
5 Mar 2009 and requested a formal hearing with counsel. On
13 Apr 2009 the Formal Physical Evaluation Board (FPEB) reviewed
the case with medical records and also recommended DWSP for
atrial fibrillation requiring chronic Coumadin usage with a
10 percent disability rating. The FPEB did list his severe OSA
requiring a Continuous Positive Airway Pressure (CPAP) machine
as an unfitting condition, but not currently compensable or
ratable. On 13 Apr 2009, the applicant non-concurred and
requested his case be sent to the Secretary to the Air Force
Personnel Council (SAFPC) for review. On 21 May 2009, the SAFPC
directed the applicant be DWSP with a disability rating of
10 percent.
The complete DPPD evaluation is at Exhibit C.
The BCMR Medical Consultant recommends denial. The Medical
Consultant states that it could not be established that the
applicant was unable to reasonably perform his military duties
as a result of OSA. His commander's letter indicates he did not
demonstrate an impediment to performing either in-garrison or
CONUS duties due to his medical condition(s). Moreover, it
appears that only after initiation of the MEB for atrial
fibrillation, that OSA was introduced as an additional unfitting
and compensable medical condition.
Under paragraph E3.P3.3.3, Adequate Performance Until Referral,
"If the evidence establishes that the Service member adequately
performed his or her duties until the time the Service member
was referred for physical evaluation, the member may be
considered fit for duty even though medical evidence indicates
questionable physical ability to continue to perform duty."
Further, under paragraph E3.P3.3.4, Cause and Effect
Relationship, "Regardless of the presence of illness or injury,
inadequate performance of duty, by itself, shall not be
considered as evidence of unfitness due to physical disability
unless it is established that there is a cause and effect
relationship between the two factors. Based upon the supplied
Service medical evidence, the Medical Consultant found no cause
and effect relationship between the applicant's treated and
controlled OSA, and the termination of his military service.
Although the applicant has supplied an article and two letters
from medical experts which establish OSA as a possible risk
factor for Atrial Fibrillation, the reviewer finds this risk to
be associated with the untreated or non-compliant OSA patient.
Thus, the fact that the applicant requires a CPAP to prevent
periods of apnea and the resultant reduced oxygen levels, the
use of the device does not automatically infer unfitness for
continued service. Undeniably, the preponderance of evidence
suggests that it is the applicant's requirement for sustained
use of an anticoagulant, and the risk for hemorrhage under acute
trauma or thromboembolism if non-compliant, and not his OSA,
that posed the signature impediment to his retainability and
resulted in his release from military service.
The complete BCMR Medical Consultants evaluation is at Exhibit
D.
_______________________________________________________________
APPLICANT'S REVIEW OF AIR FORCE EVALUATION:
On 4 Feb 2013, copies of the Air Force and BCMR Medical
Consultants evaluations were forwarded to the applicant for
review and comment within 30 days. As of this date, this office
has received no response (Exhibit E).
_______________________________________________________________
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. 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; however, we agree with the opinions and
recommendations of AFPC/DPDD and the BCMR Medical Consultant and
adopt their rationale as the basis for our conclusion the
applicant has not been the victim of an error or injustice.
Therefore, in the absence of evidence to the contrary, we find
no basis to recommend granting 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 this application
in Executive Session on 30 May 2013, under the provisions of AFI
36-2603:
, Panel Chair
, Member
, Member
The following documentary evidence was considered in AFBCMR BC-
2012-04038:
Exhibit A. DD Form 149, dated 27 Aug 2012, w/atchs.
Exhibit B. Applicants Master Personnel Records.
Exhibit C. Letter, AFPC/DPPD, dated 4 Oct 2012.
Exhibit D. Letter, BCMR Medical Consultant, dated 3 Feb
2013.
Exhibit E. Letter, SAF/MRBC, dated 4 Feb 2013.
Panel Chair
AF | BCMR | CY2013 | BC-2012-04038
The remaining relevant facts pertaining to this application are contained in the letters prepared by the appropriate offices of the Air Force at Exhibits C and D. Accordingly, there is no need to recite these facts in this Record of Proceedings. The member had a medical evaluation board on 20 Nov 2008, for atrial fibrillation. The Medical Consultant states that it could not be established that the applicant was unable to reasonably perform his military duties as a result of OSA.
AF | BCMR | CY2003 | BC-2003-00371
_________________________________________________________________ AIR FORCE EVALUATION: The BCMR Medical Consultant recommends the application be denied. Following DPPD’s assessment, they conclude the applicant was treated fairly throughout the military Disability Evaluation System (DES) process, that he was properly rated under federal disability guidelines at the time of his evaluation, and that he was afforded the opportunity for further review as provided by federal law and policy. As...
AF | BCMR | CY2008 | BC-2007-03201
Both the Informal Physical Evaluation Board (IPEB) and Formal Physical Evaluation Board (FPEB) found the applicant unfit and recommended discharge with severance pay with a zero (0) percent disability rating. Additionally, the applicant’s inability to deploy and the requirement to utilize a CPAP machine were not measures for the severity of his medical condition under the Department of Defense (DoD) disability rating guidance for OSA at the time of the applicant’s discharge. Therefore,...
The AFBCMR Medical Consultant is of the opinion that no change in the records is warranted and the application should be denied (Exhibit C). Prior to that date, an evaluation of 30% was assigned for severe, frequent attacks. Accordingly, in view of the foregoing, I believe the applicant’s medical condition at the time of his retirement warrants a higher disability rating.
AF | BCMR | CY2012 | BC-2012-02228
The IPEB noted that she had declined further “ablation surgery.” On 9 March 2006, the applicant concurred with the findings and recommended disposition of the IPEB. The complete AFBCMR Medical Consultant evaluation is at Exhibit G. _________________________________________________________________ 5 APPLICANT’S REVIEW OF THE ADDITIONAL AIR FORCE EVALUATION: On 15 Feb 13, by letter, the applicant amended her request and now ask to be medically retired instead of being returned to duty. ...
AF | BCMR | CY2009 | BC-2008-01816
The FPEB recommended permanent disability retirement with a 10% disability rating. The BCMR Medical Consultant’s complete evaluation is at Exhibit F. _________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATIONS: In response to the AFPC/DPSD evaluation, counsel responds that the applicant’s rating has to be based on the rating criteria, in other words, the DVA rating chart, rather than pulling a percentage of out thin air and applying it to...
AF | PDBR | CY2009 | PD2009-00383
Despite normal tests, the CI continued to have symptoms and the Cardiologist opined his chest pain and palpitations were not cardiac conditions. The CI’s symptoms of chest pain and palpitations did not result from a cardiac condition. No VASRD code for non-cardiac chest pain and palpitations exists and the CI’s disability must be rated analogously.
AF | BCMR | CY2010 | BC-2010-00172
RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2010-00172 XXXXXXX COUNSEL: NONE HEARING DESIRED: NO ________________________________________________________________ APPLICANT REQUESTS THAT: Her disability discharge, with severance pay (DWSP) be changed to a medical retirement. The applicants case was forwarded to the Formal PEB (FPEB) and they concurred with IPEBs findings, with additional findings of myofascial pain syndrome...
AF | BCMR | CY2013 | BC 2013 01109
We note the BCMR Medical Consultant states that had the applicant indeed completed a MEB in 2004 and was found unfit by a PEB, his case would have been referred to SAFPC for a final disposition. In this respect, we note that the applicant in PD2009-00221 was initially referred to the PEB for asthma, mild persistent and found unfit for continued military service and separated with a 10 percent disability rating, whereas in the case before us, there is no evidence the he was unable to perform...
AF | PDBR | CY2010 | PD2010-00066
The CI was medically separated with a 10% disability rating. In the matter of the right arm and leg weakness conditions, migraine headache condition, vascular dementia and mood disorder condition, the Board unanimously agrees that it cannot recommend a finding of unfit for additional rating at separation. I have carefully reviewed the evidence of record and the recommendation of the Board.