RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF: 			DOCKET NUMBER: BC-2013-02042

 					COUNSEL:  NONE

					HEARING DESIRED:  NO 


APPLICANT REQUESTS THAT:

Her Entry Level Separation (ELS) be changed to a medical 
separation.  


APPLICANT CONTENDS THAT:

She sustained injuries while in Basic Military Training (BMT) and 
could not drill or perform her duties as required.

The extent of her injuries was not adequately investigated or 
diagnosed until after her ELS.  

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


STATEMENT OF FACTS:

On 14 Feb 11, the applicant entered the Air Force Reserve.

On 12 May 11, her commander notified her that he was recommending 
she be discharged from the Air Force under the provisions of AFI 
36-3208, Administrative Separation of Airmen, for erroneous 
enlistment.  The specific reason for the recommendation was a 
medical Narrative Summary (NARSUM) dated 10 May 11, stating the 
applicant did not meet minimum medical standards for enlistment 
due to recurring foot and knee pain which was contributed to flat 
feet.

On 12 May 11, the applicant acknowledged the discharge 
recommendation.  She waived her right to consult counsel and 
declined to submit statements in her own behalf.  She acknowledged 
that if she was discharged for the reason cited, she would not be 
entitled to any disability, retirement or severance pay.

In an undated letter, the discharge authority, approved the 
discharge recommendation.  

On 16 May 11, the applicant received an ELS with a narrative 
reason for separation of “Failed Medical/Physical Procurement 
Standards.”  The applicant served 3 months and 3 days on active 
duty.  

According to a Department of Veterans Affairs (DVA) rating 
decision dated 15 Feb 13, the applicant received a combined 
70 percent disability rating for left medial tibial plateau stress 
fracture, residual right medial tibial plateau stress fracture, 
back strain, degenerative joint disease of the left hip and 
degenerative joint disease of the right hip.

In a letter dated 19 Jun 13, the applicant requested that her case 
be administratively closed to allow for more time to gather 
information in response to the Air Force evaluations. 

In a letter dated 18 Mar 14, the applicant requested her case be 
re-opened.  


AIR FORCE EVALUATION:

AETC/SGPS recommends approval.  Based on the documentation on file 
in the applicant’s records, her separation was done IAW 
established policy and administrative procedures.  A review of the 
records provided and medical notes from Wilford Hall Medical 
Center (WHMC) reflects while in BMT she sustained injuries that 
prevented her from continuing in training and she was processed 
for an ELS.  She declined an AETC/SGPS waiver to continue in BMT.  
Although she may not have been bothered by her feet and leg pain 
prior to entry, the condition was present and was aggravated by 
BMT and its rigorous activities.  Once the condition is resolved 
and she is evaluated by her orthopedic doctor and released to full 
unrestricted activities, she is free to reapply for the military.  

The complete SGPS evaluation is at Exhibit C.

The BCMR Medical Consultant recommends changing the applicant’s 
character of service to honorable, and that she be placed on the 
Temporary Disability Retired List (TDRL) with a disability rating 
of 40 percent effective 16 May 11.  This should be followed by a 
TDRL re-evaluation at the soonest practical date by an orthopedic 
surgeon at the nearest military medical treatment facility.  This 
information, along with the applicant’s most current DVA rating 
decision should then be forwarded to the AFBCMR for a final 
disposition of the applicant’s military service.

The Medical Consultant notes that two separate Air Force policies, 
AFI 36-3208 and AFI 36-3212, Physical Evaluation for Retention, 
Retirement and Separation, may be at crossroads; one which 
justifies an ELS for the medical condition, pes planus (flat 
feet), which was likely to have Existed Prior to Service (EPTS) 
but contributed to her inability to complete training while 
serving a period of less than 180 days, and the other, the 
diagnosis of tibial plateau fractures which suggests that these 
related injuries were service-incurred or aggravated, warranting 
consideration for a medical separation; particularly noting the 
compensation ratings from the DVA.  However, re-directing 
attention to the DVA rating decision, the applicant’s supplied 
service documentation makes no reference to bilateral hip pain or 
back pain as a cause for career termination; thus if processed 
through the Disability Evaluation System (DES), these conditions 
would not have been included as unfitting in the disability rating 
computation.  

The BCMR Medical Consultant concludes that she qualified for a 
medical separation under the provisions of AFI 36-3212 but not for 
the competing ELS policy.  In searching for an appropriate remedy, 
the Medical Consultant opines that she should have received a 
Medical Evaluation Board (MEB) and referred to a Physical 
Evaluation Board (PEB), whereupon she would have likely been found 
unfit for further military service.  Due to the expected temporary 
nature of her impairment, she would have been placed on the TDRL 
effective 17 May 11, and received a timely evaluation by an 
orthopedic surgeon at the nearest military facility.  

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


APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

The advisory opinions make assumptions about her condition and 
contends that there were no medical tests available proving her 
injuries were incurred during BMT.  She immediately reported her 
injury to her superior but was instructed to continue training for 
two weeks then it was discovered that her knee was fractured.  
Subsequently, bone scans, MRIs and x-rays were performed.  These 
tests clearly show the injuries she received led to her discharge.  
This medical information is in the possession of the DVA and it 
could take 2-6 months before she receives it.  

In a letter dated 18 Mar 14, the applicant states that on 28 Feb 
11 she heard her knee “pop” while running.  She reported the 
injury to her Military Training Instructor (MTI) who instructed 
her to continue training but to go easier on it.  After a couple 
of days, she again reported to her MTI that her knee was extremely 
swollen and painful.  She was given an over the counter pain 
reliever and returned to continue training.  She was not given 
permission to seek medical treatment until two weeks after the 
initial injury.  By this time, her hips, right leg, both ankles 
and her heels had become painful from the stress of compensating 
for the instability of her knee.  

She was placed on convalescent leave for 30 days.  Her 
understanding of the ELS was that she was leaving BMT prior to 
completion in order to heal at home rather than at Lackland AFB.  
She was advised that the report and recommendation would be 
completed to allow her to return to the Air Force as an officer 
once her schooling was completed.   She was not aware until 
submitting her application to the Board that her medical report 
attributed her injury to an EPTS condition of flat feet.  

It would have been physically impossible for her to have completed 
BMT.  The mismanagement of her injuries and not receiving the 
proper medical care left her with continuous muscle spasms in her 
lower back, misalignment of her lower spine/hips with accompanying 
deep muscle pain and numbness in her lower legs due to nerve 
damage.  In addition, since there is no indication of pes planus, 
her injuries were not attributed to an EPTS condition but a 
pathological result of her initial injury and bilateral damage 
sustained due to delayed medical care.  Therefore, she requests 
that her discharge be corrected to reflect that she separated due 
to medical injuries sustained at BMT and her separation be 
classified as a medical discharge.   

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


ADDITIONAL AIR FORCE EVALUATION:

AFPC/DPSOR recommends denial.  Her condition rendered her 
unsuitable for continued military service and her character of 
service should not be changed.  Her separation was done IAW 
established policy and administrative procedures. The 
documentation on file in her master personnel records supports the 
basis for the discharge and the ELS characterization.  The 
discharge was consistent with the procedural and substantive 
requirements of the discharge instruction and was within the 
discretion of the discharge authority.  An airman is given an 
ELS/uncharacterized service characterization when separation is 
initiated in the first 180 days of continuous active service.  The 
DOD determined if a member served less than 180 days continuous 
active service, it would be unfair to the member and the service 
to characterize their limited service.  Therefore, her narrative 
reason for separation is correct and IAW DOD and Air Force 
instructions.  The applicant did not submit any evidence or 
identify any errors or injustice that occurred in the discharge 
processing.  She provided no facts warranting a change to her 
discharge.  

The complete DPSOR evaluation is at Exhibit G.   


APPLICANT'S REVIEW OF ADDITIONAL AIR FORCE EVALUATION:

A copy of the Air Force evaluation was provided to the applicant 
on 17 Feb 15 for review and comment (Exhibit K).  As of this date, 
this office has not received a response.



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 to warrant 
changing her ELS to a medical separation.  We took notice of the 
applicant's complete submission in judging the merits of the case; 
however, based on the available evidence, we are not persuaded 
that relief is warranted at this time.  Therefore we find no basis 
to act on this portion of the applicant’s request.

4.  Notwithstanding the above, sufficient relevant evidence has 
been presented to demonstrate the existence of an error injustice 
to warrant partial relief.  We note that DPSOR states that an 
airman is given an uncharacterized service characterization when 
separation is initiated in the first 180 days of continuous active 
service.  However, we agree with the opinion and recommendation of 
the Medical Consultant and adopt the rationale expressed as the 
basis for our decision that the applicant has been the victim of 
either an error or an injustice.  Accordingly, we recommend the 
applicant's records be corrected as indicated below.


THE BOARD RECOMMENDS THAT:

The pertinent military records of the Department of the Air Force 
relating to the APPLICANT be corrected to show that: 

      a. On 16 May 11 she was found unfit to perform the duties of 
her office, rank, grade, or rating by reason of physical 
disability, incurred while she was entitled to receive basic pay; 
the unfitting diagnosis in her case was bilateral tibial plateau 
fractures; the combined compensable percentage was 40 percent 
under VASRD code 5262 and VASRD code 5271; the degree of 
impairment is temporary; the disability was not due to intentional 
misconduct or willful neglect; the disability was not incurred 
during a period of unauthorized absence; and that the disability 
was in line of duty but not a direct result of armed conflict or 
caused by an instrumentality of war. 

      b. She was not separated on 16 May 11; rather she was 
released from active duty on that date and on 17 May 11 was placed 
on the TDRL.  Since this record correction is retroactive to 
2011 she is now due for a TDRL re-evaluation under 10 U.S.C. 
1210 and AFI 36-3212.  Such re-evaluation must occur as soon as 
practicable and may be performed by a civilian, military, or 
Department of Veterans Affairs orthopedic surgeon.  The purpose of 
the re-evaluation is to identify any residual functional 
impairments or impediments returning to duty.  This information, 
along with the applicant's most current VA rating decisions should 
then be forwarded to the AFBCMR for final adjudication in the 
case.  


The following members of the Board considered AFBCMR Docket Number 
BC-2013-02042 in Executive Session on 17 Mar and 30 Mar 15 under 
the provisions of AFI 36-2603:

	 , Panel Chair
	 , Member
	 , Member

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

	Exhibit A.  DD Form 149, dated 25 Apr 13, w/atchs.
	Exhibit B.  Applicant's Master Personnel Records.
	Exhibit C.  Memorandum, AETC/SGPS, dated 13 May 13.
        Exhibit D.  Memorandum, BCMR Medical Consultant, dated 
23 May 13.
        Exhibit E.  Letter, SAF/MRBC, dated 24 May 13.
        Exhibit F.  Letter, Applicant, dated 19 Jun 13, w/atch.   
        Exhibit G.  Memorandum, AFPC/DPSOR, dated 21 Jun 13.  
        Exhibit H.  Letter, SAF/MRBC, dated 23 Jun 13.
        Exhibit I.  Letter, Applicant, dated 18 Mar 14.
        Exhibit J.  Letter, Applicant, dated 8 May 14.  
        Exhibit K.  Letter, SAF/MRBC, dated 17 Feb 15.