RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS


IN THE MATTER OF:	DOCKET NUMBER:  BC-2012-05787

		COUNSEL:  NONE

		HEARING DESIRED:  YES


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APPLICANT REQUESTS THAT:

Her reentry (RE) code of 2Q (medically retired or discharged) with the narrative reason for separation of “Disability Existed Prior to Service – Physical Evaluation Board (PEB)” be revised to allow her commission in the United States Air Force.  

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APPLICANT CONTENDS THAT:

She does not have ankylosing spondylitis (AS) as supported by three independent board certified rheumatologists.  She accepted the Formal Physical Evaluation Board’s (FPEB) recommendation for discharge under duress; however, she is fit for duty.  

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

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STATEMENT OF FACTS:

The applicant served as a Cadet in the United States Air Force Reserve during the matter under review.  

On 28 Aug 12, a FPEB evaluated the applicant’s medical diagnosis of ankylosing spondylitis to determine whether or not she was physically fit for continued retention in the Air Force.  The FBEB found that the applicant’s medical condition, consistent with early onset AS, that existed prior to service (EPTS), was incompatible with the rigors of military service and has not been permanently aggravated through military service.  Therefore, the FPEB found the applicant’s medical condition of AS unfitting for continued service and recommended that she be discharged due to her EPTS condition.  

On 30 Aug 12, the applicant was notified of the decision of the FPEB and of her right to appeal the decision to the Secretary of the Air Force. 

On 31 Aug 12, the applicant acknowledged receipt of the action, indicating that while she did not agree with the Board’s reasoning, she accepted the discharge, essentially waiving her right to appeal the decision to the Secretary of the Air Force.  

On 28 Sep 12, the applicant was furnished an honorable discharge, with a narrative reason for separation of “Disability Existed Prior to Service – PEB,” and an RE code of 2Q.  She was credited with four years, three months, and three days of total inactive service as her service as a USAFA Cadet is not creditable for any purpose in commissioned officer status.  

The remaining relevant facts pertaining to this application are described in the letter prepared by the Air Force office of primary responsibility, which is attached at Exhibit C.  

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AIR FORCE EVALUATION:

AFPC/DPFD recommends denial, indicating there is no evidence of an error or injustice which occurred during the disability process.  An Informal Physical Evaluation Board (IPEB) reviewed the applicant’s diagnosis of AS, which existed prior to service, and recommend her discharge.  The board noted the applicant had recurrent eye pain since age 15, suffered from lower back pain, and was currently being treated for AS.  The applicant non-concurred with IPEB’s recommendation and requested a formal hearing.  The FPEB reviewed the applicant’s case and also recommended discharge due to her EPTS medical condition.  The FPEB acknowledged the applicant commander’s assessment of her duty performance and that she met all requirements necessary for graduation.  However, medical records revealed the applicant has had a history of recurrent iritis dating back to age of 15.  Medical records also indicated the applicant has suffered from early morning lower back pain that lessened by mid-morning.  However, the applicant indicates it is hip pain that only lasts a few minutes.  The applicant was initially diagnosed with AS in October 2011 and was treated with medication.  She disputes the treatment she received for AS; however; there is no supporting documentation to confirm her statement.  She secured statements from civilian rheumatologists in regards to her diagnosis.  It was opined by one doctor that current examination failed to disclose evidence of any bony changes of AS of the spine; another opined it is likely the applicant will be able to handle the physical demands of the military; another opined that a recent sacro-iliac joint MRI (July 2012) showed evidence of mild right sided sacroiliitis with no mention of left sided involvement.  Lastly, the doctor who diagnosed her with AS, indicated that it would be reasonable to watch her expectantly over time to see if she develops x-ray changes and to give her a diagnosis of possible AS.  The Board further noted an article which supports the applicant’s diagnosis of AS.  Specifically, the applicant was initially presented with iritis at age 15 years old, with recurrences of her Iritis at age 20 years of age and 21 years of age per her own statement, which is in alignment with the facts annotated in the article.  The Board also acknowledged AS symptoms of pain at rest, with relief of symptoms with exercise, while not pathognomonic of AS, are consistent with AS.  As such, the applicant gets very high scores on her fitness testing.  In addition, the Board noted the intermittent nature of the applicant’s back pain, with intermittent resolution, based on review of documentation and testimony.  The goal of intervention is the prevention of the progression of the seronegative arthropathy.  NSAIDs and disease modifying anti-rheumatic drugs (DMARDSs) are used to prevent the progression of AS.  Due to the immune-modulating nature of DMARDs, service members treated with them are generally considered ineligible to deploy to the AOR.  Although the applicant indicated she is able to perform all physical activities associated with training, her medical condition, consistent with early onset AS, which existed prior to service, is incompatible with the rigors of military service and has not been permanently aggravated through military service.  The FPEB found the applicant’s medical condition of AS unfitting and recommended a discharge under provisions other than Title 10 USC, Chapter 61, Retirement or Separation for Physical Disability.  

A complete copy of the AFPC/DPFD evaluation is at Exhibit C.  

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

The applicant reiterates her argument that she does not have AS and the PEB findings are flawed, questionable, and invalid.  There are inconsistencies and contradictory facts in the medical reports of the doctors regarding her diagnosis.  The FPEB’s finding of AS flies in the face of three board-certified rheumatologists, which do not support her diagnosis of AS.  Nevertheless, despite the unsubstantiated physical disability of AS, her fitness scores, medical records, and witness statement attest to her fitness for duty.  

A complete copy of the applicant’s response is at Exhibit E.

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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 an error or injustice.  The applicant contends she does not have AS and three board-certified rheumatologists substantiates her contention; however, a diagnosis of AS was the basis of her discharge.  After a thorough review of the evidence of record and the applicant’s complete submission, including her rebuttal response, we do not find her arguments or the documentation provided sufficient to undermine the basis of the contested action.  While it is clear the applicant disputed the diagnosis for which she was ultimately discharged and provided letters from three physicians supporting this point, we do not find the applicant’s arguments and these statements sufficient for us to recommend the decision of the FPEB be overturned, particularly when the evidence of record indicates FPEB was privy to this information prior to making their determination.  In our view, the applicant has provided no new supporting evidence or documentation to consider and, as such, is essentially arguing that we should substitute our judgment for that of the FPEB, with no new evidence to consider.  However, the presumption of regularity in the conduct of government affairs dictates that, in the absence of any evidence to the contrary, we must presume that the FBEB’s decision, based on the evidence before them, was reasonable and carried out in accordance with prescribing directives.  In our view, the applicant was afforded full due process, which included the right to appeal the decision to the Secretary of the Air Force, where she could have received the critical review of the decision that she seeks from this Board.  Therefore, in the absence of evidence to the contrary, we find no basis to recommend granting the relief sought in this application.

4.  The applicant’s case is adequately documented and it has not been shown that a personal appearance with or without counsel will materially add to our understanding of the issues involved.  Therefore, the request for a hearing is not favorably considered. 

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THE BOARD DETERMINES THAT:

The applicant be notified the evidence presented did not demonstrate the existence of material error or injustice; the application was denied without a personal appearance; and the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application.

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The following members of the Board considered AFBCMR Docket Number BC-2012-05787 in Executive Session on 19 Dec 13, under the provisions of AFI 36-2603:

	, Chair
	, Member
	, Member

The following documentary evidence was considered:

     Exhibit A.  DD Form 149, dated 24 Feb 13, w/atchs.
     Exhibit B.  Applicant's Master Personnel Records.
     Exhibit C.  Letter, AFPC/DPFD, dated 27 Mar 13.
     Exhibit D.  Letter, SAF/MRBR, dated 6 Apr 13.
     Exhibit E.  Letter, Applicant, dated 28 Apr 13, w/atchs.




                                   
                                   Chair

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