RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS


IN THE MATTER OF:	DOCKET NUMBER:  BC-2013-02125
		COUNSEL:  NONE
		HEARING DESIRED:  NO 


APPLICANT REQUESTS THAT:

He be placed on medical continuation (MEDCON) orders covering the period 18 Apr 11 through the present.  



APPLICANT CONTENDS THAT:

He should not have been released from active duty orders until a Medical Evaluation Board (MEB) was complete.  He suffered Post-Traumatic Stress Disorder (PTSD) and a shoulder injury he sustained while lifting weights in a deployed location, both of which were determined to be in the line-of-duty (LOD).  However, he was released from active duty before an MEB was accomplished.  

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



STATEMENT OF FACTS:

The applicant serves in the grade of Technical Sergeant (TSgt) in the Air Force Reserve.  

While serving on active duty at a deployed location during the period 28 Nov 10 through 2 Feb 11, the applicant injured his shoulder lifting weights in the gym. 

On 24 Feb 11, the applicant was released from active duty due to demobilization.  

According to the documentation submitted by the applicant:

	a.  On 18 Apr 11, the applicant’s civilian mental health provider signed a memo stating he was treating the applicant for major depression, anxiety, and PTSD, and requesting an immediate leave of absence for the applicant.  

	b.  On 23 Apr 12, the applicant’s military medical records were updated to include the diagnosis of PTSD.  Statements in his records indicate that the “patient’s condition is unfitting for military service” and that “an MEB will be initiated.”

	c.  On 14 May 12, the applicant was issued an AF Form 469, Duty Limiting Condition (DLC) Report, on which the military health care provider recommended duty and mobility restrictions of “no participation” because, “This member is undergoing an MEB to determine medical fitness for continued worldwide duty and retention.”  	

	d.  On 16 Aug 12, an Informal LOD Determination found the applicant’s emotional problems (“Adjustment Reaction/PTSD”) were incurred in the LOD.  

	e.  On 21 Sep 12, an Informal LOD found his shoulder injury to be “Existed Prior to Service—Service Aggravated.”   

	f.  On 28 Feb 13, the applicant was issued an AF Form 469 on which the health care provider recommended duty and mobility restrictions of “no participation” on the part of the applicant because “This member is undergoing an MEB to determine medical fitness for continued worldwide duty and retention.”  

	g.  On 26 Mar 13, the Department of Veterans Affairs (DAV) rated the applicant as having the following service-connected disabilities:  PTSD-30 percent, Tendonitis—10 percent, and Tinnitus—10 percent. 

On 10 Jul 14, AFPC/DPSD notified the AFBCMR that the applicant had completed the MEB process and been recommended for placement on the Temporary Disability Retirement List (TDRL) with a 100 percent disability rating for PTSD incurred in a combat zone, but not combat related.  
 
The remaining relevant facts pertaining to this application are described in the letters prepared by the Air Force offices of primary responsibility (OPR), which are attached at Exhibits C and D.    



AIR FORCE EVALUATION:

The AFPC/DPFA recommends denial indicating there is no evidence of an error or an injustice.  After reviewing the Command Man-day Allocation System (CMAS) there is no history or prior requests for MEDCON.  There is no evidence to suggest this case request had been submitted prior to this date.  The applicant submitted two Informal LOD determinations.  The first ILOD, signed on 21 Sep 12, states in the legal review block (9B):  “non-concur with appointing authority.  Recommend new finding:  EPTS—service aggravated.”  A preponderance of evidence does not support finding of EPTS—service aggravated.”  The second ILOD, dated 16 Aug 12, does not support the applicant’s request for MECON orders during the period of time in question.  The member was placed on a Duty Limiting Condition (DLC) during the period 4 Feb 12 through 3 Feb 14 for mobility restrictions but does not tie restrictions to duty or injuries related to any deployments or Title 10 service.  The applicant was again placed on DLC for mobility restrictions during the period 4 Feb 13 through 14 Feb 14, but again does not tie injuries or restrictions to Title 10 service.  Recommend disapproval based on lack of information or documentation that an injury occurred during Title 10 service.  The documentation provided points toward injuries existing prior to service.  It appears the Department of Veteran’s Affairs is providing compensation and care.  

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

The BCMR Medical Consultant recommends denial indicating there is no evidence of an error or an injustice.  Noting that the applicant’s shoulder ailment and PTSD were found in the LOD, it is reasonable to conclude both conditions had their origins during (or a nexus with) the applicant’s period of active service.   What cannot be assumed is that during the applicant’s period of active service either condition was impairing to the extent to warrant uninterrupted continuation of those orders, until either released to duty without restrictions or processed through the Disability Evaluation System (DES).  There is no documentation to reflect that the applicant was unable to perform or was restricted from performing his duties due to mental disorder (characterized as Adjustment Disorder on the Informal LOD document, later diagnosed as PTSD) while he was deployed under Title 10 orders.  There is no Service medical or administrative documentation to indicate the applicant sought MEDCON order, or alternatively, sought Incapacitation Pay during any portion of the aforementioned periods of time.  Although his civilian mental health provider requested relieving him from duty (initially for two weeks) as early as Apr 11, which was periodically continued through Apr 12, there is no evidence to indicate whether this information was known by or supplied to military medical officials for appropriate timely action.  Although the applicant presented Informal LOD findings for his shoulder impingement with evidence he received treatment during his deployment, there is no proof that the shoulder ailment precluded alternative duties upon his remobilization (demobilization) or rendered him non-worldwide qualified prior to or after his release from active service.  Likewise, while the applicant’s Adjustment Reaction was found to be in the LOD, and later (two months post-deployment) diagnosed as PTSD by a civilian counselor and confirmed by a military provider one year later on 23 Apr 12, there is also no evidence the applicant demonstrated a functional impairment and actually sought treatment for a mental impairment during his deployment while under Title 10 Orders.  

A complete copy of the BCMR Medical Consultant evaluation is at Exhibit D.



APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Copies of the Air Force and AFBCMR Medical Consultant evaluations were forwarded to the applicant on 31 Oct 13 for review and comment within 30 days.  In response, he submits additional documentation showing the DVA increased his disability rating for PTSD to 100 percent as of 9 Oct 13, stating he had shoulder surgery in May 11, and chronicling his efforts to be put on MEDCON orders and processed through the DES (Exhibit F).



ADDITIONAL AIR FORCE EVALUATION:

The BCMR Medical Consultant recommends granting the applicant’s request.  New evidence has been acquired to show that the applicant has now completed a Medical Evaluation Board (MEB) and was found unfit by a Physical Evaluation Board (PEB), with a recommendation for placement on the TDRL with a 100 percent disability rating.  The fact the applicant’s mental disorder ultimately resulted in processing through the DES leads one to believe he remained sufficiently impaired to warrant either extension/resumption of active duty orders through the time of his release from military service.  The medical condition which was found in the LOD and which resulted in the applicant’s release from service was likely caused by exposures and events while under Title 10 orders.  Thus, it is implicit, although not stated, the applicant’s DLC Report was likely initiated due to PTSD, caused by exposures while on Title 10 orders.  There is sufficient evidence, as a matter of justice, to assign the applicant active duty orders from 18 Apr 11 until the date of his release from military service (Exhibit H).



APPLICANT'S REVIEW OF THE ADDITIONAL AIR FORCE EVALUATION:

A copy of the BCMR Medical Consultant’s additional advisory was forwarded to the applicant on 25 Aug 14 for review and comment within 30 days.  As of this date, no response has been received by this office (Exhibit I).






THE BOARD CONCLUDES THAT:

1.  The applicant has exhausted all remedies provided by existing law or regulations.

2.  The application was timely filed.

3.  Sufficient relevant evidence has been presented to demonstrate the existence of an injustice.  We took notice of the applicant's complete submission in judging the merits of the case and agree with the opinion and recommendation of the BCMR Medical Consultant and adopt his rationale as the basis for our conclusion that relief should be granted.  While the Board notes the BCMR Medical Consultant’s initial recommendation to deny the applicant’s request based upon the fact that, at the time, the applicant had not been found unfit for duty, we note the applicant has now completed the MEB process and been found unfit for duty.  Therefore, we concur with the BCMR Medical Consultant’s additional advisory opinion and recommend the applicant’s record 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 he was not released from active duty on 18 April 2011, but on that date he was continued on active duty for the purpose of medical continuation and that he was retained on active duty through the final disposition of his medical case through the Disability Evaluation System (DES).



The following members of the Board considered AFBCMR Docket Number BC-2013-02125 in Executive Session on 17 Apr 14 and 25 Sep 14, under the provisions of AFI 36-2603:

	Panel Chair
	Member
	Member



All members voted to correct the records as recommended.  The following documentary evidence pertaining to AFBCMR Docket Number BC-2013-02125 was considered: 

	Exhibit A.  DD Form 149, dated 15 Apr 13, w/atchs.
	Exhibit B.  Applicant's Master Personnel Records.
	Exhibit C.  Letter, AFPC/DPFA, dated 19 Jun 13.
	Exhibit D.  Letter, BCMR Medical Consultant,
                 dated 30 Oct 13.
	Exhibit E.  Letter, SAF/MRBC, dated 13 Oct 14.
	Exhibit F.  Letter, Applicant, undated, w/atchs.  
	Exhibit G.  Email, AFPC/DPFD, dated 10 Jul 14.
	Exhibit H.  Letter, BCMR Medical Consultant, 
                  dated 1 Aug 14. 
	Exhibit I.  Letter, SAF/MRBC, dated 25 Aug 14.