RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS


IN THE MATTER OF:	DOCKET NUMBER:  BC-2013-05476
		
	 		COUNSEL:  NONE

			HEARING DESIRED:  NO


APPLICANT REQUESTS THAT:

His character of service be changed from uncharacterized to 
honorable.

His narrative reason for separation and separation (SPD) code of 
JFW - Discharge failed Medical/Physical Procurement Standards, be 
changed.

Any documentation stating that he had a pre-existing condition of 
anemia be removed from his records.


APPLICANT CONTENDS THAT:

He requests to have his discharge evaluated based on the evidence 
presented.  He is willing to do what it takes to maintain and 
continue on as a member of the United States Air Force. 

After receiving clearance from the Military Entry Processing 
Station and reviewing his civilian medical records, the claims 
that anemia was a preexisting condition is inaccurate.

His records do not show any signs of iron deficiency anemia.  The 
blood test results indicate his Hemocrit and Hemoglobin are within 
the range of normal for a male at his age at the time of testing.  
He was cleared of any illnesses or possible medical conditions and 
had no physical symptoms that would warrant a more detailed 
internal probe.  Once he was discharged from the Air Force, his 
test results did not indicate that he had anemia.

He understands the minimum medical requirement, but would like to 
point out that he had never been diagnosed with iron deficiency 
anemia and had no reason to be treated.  It was suggested that he 
have an endoscopy and or colonoscopy.  He declined these 
procedures for two reasons:  he preferred to be tested by his 
medical provider before having the procedure done and he disagreed 
with the diagnosis based on his prior medical history.  He felt 
like the test results during training were inaccurate.

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


STATEMENT OF FACTS:

Documentation from the applicant’s master personnel records 
indicate that he entered the Air Force on 15 February 2013; 
however, AFPC/DPSOR found the applicant entered the Air Force on 
25 June 2013 and arrived at Basic Military Training on 1 July 
2013.  His Dated Entered Active Duty will be updated upon final 
Board action.

On 27 September 2013, the applicant was notified of his 
commander’s intent to discharge him from the Air Force for 
Erroneous Enlistment.  Specifically, a medical narrative summary 
dated 9 September 2013, found that he did not meet the minimum 
medical requirements to enlist because he had anemia.  He was not 
given a disability separation because he was found unqualified.

On 27 September 2013, the applicant acknowledged his right to 
counsel and to submit statements on his behalf and to waive those 
rights.  He waived his right to counsel and to submit a statement 
on his behalf.  

The commander approved the discharge on 2 October 2013.  He was 
separated on 4 October 2013 with an entry level separation and 
uncharacterized service.  His SPD code and narrative reason for 
separation were listed as JFW – discharge failed medical/physical 
procurement standards.


AIR FORCE EVALUATION:

AETC/SGPS recommends approval.  Based on the documentation in the 
applicant’s personnel records, the separation was in accordance 
with established policy and administrative procedures.  While SGPS 
concurs with the applicant’s request, the applicant will need a 
waiver from the Reserves for reinstatement consideration.

The complete AETC/SGPS evaluation is at Exhibit C.

AFPC/DPSOR recommends denial of the applicants request to change 
his discharge characterization, to include the SPD code and his 
narrative reason for separation.

The applicant completed Basic Military Training but was kept in a 
“holdover” status and not allowed to depart for technical training 
until his medical situation could be determined.  The medical 
authorities concluded that the applicant had a preexisting 
condition that would have precluded him from joining the Air Force 
had the condition been known at the time of his enlistment.

The applicant’s service characterization is correct as reflected 
on his DD Form 214.  Airmen are given entry level separation with 
uncharacterized service when the separation is initiated within 
the first 180 days of continues active service.

Based on the documentation in the applicant’s master personnel 
records, the discharge, to include the narrative reason for 
separation, were consistent with the procedural and substantive 
requirements of the discharge regulation.  The applicant did not 
provide evidence of an error or injustice with regard to the 
processing of his discharge.  

The complete AFPC/DPSOR evaluation, with attachments, is listed at 
Exhibit D.

The BCMR Medical Consultant recommends denial.  Medical 
documentation that culminated in the applicant's discharge 
include notices of Temporary Duty Restriction, 59 MOW Forms 154; 
one issued on 30 July 2013, referring him to the Trainee Health 
clinic to see a medical specialist, and the other dated 
13 August 2013, giving notice of a referral to gastroenterology 
for evaluation of a potentially disqualifying medical condition.  
A third, and final, Duty Restriction notice completed on 
12 September 2013 identifies the applicant for Entry Level 
Separation.

The applicant has supplied a copy of a preventive medicine 
physical examination, conducted on 3 January 2013, when he was 
17, by his civilian physician.  He also supplied a Chronological 
Record of Medical Care overprint document for the purpose of 
processing an administrative separation in lieu of a Medical 
Evaluation Board.  This document indicates that the applicant 
had a diagnosis of anemia, which disqualified him for enlistment 
per DoD Instruction 6130.03, Enclosure 4.23; no consideration for 
enlistment waiver was recommended.  A narrative comment on the 
applicant's medical issue by the evaluating military provider, 
4 September 2013, reads: "Patient has a history of anemia 
consistent with iron deficiency found on screening labs during 
BMT.  He denies having symptoms of anemia.  Patient was advised 
to consider endoscopic evaluation by gastroenterology to ensure 
there is no serious underlying pathology.  However, he declined 
any further evaluation of his anemia.  We do not recommend 
waiver approval.  He is medically cleared for separation."

The applicant was officially disqualified for general service due 
to iron deficiency anemia.  He has supplied a post-service 
metabolic panel and blood cell count collected soon after his 
date of separation, which shows his hemoglobin of 14.7 [normal 
12.6 to 17.7] and hematocrit of 45.4 [normal 37.5 to 51.0], both 
falling within the normal range.  Likewise, a measurement of the 
applicant's serum iron, iron saturation and iron binding capacity 
all also fell within normal range; as did measurements of his 
serum folate, vitamin B-12, and ferritin.

A memo from the applicant's physician noted his [marginally] 
elevated serum calcium level, but also stated "Patient is no 
longer anemic.  No further work-up necessary at this time." 
Another memo supplied by the applicant's civilian physician, 
states, "the applicant is under my medical care and this letter 
is to confirm that he does not have anemia."  The applicant also 
supplied a copy of the results of blood testing from 26 December 
2010, which also showed his hemoglobin [13.9] and hematocrit 
[42.6] to be within normal range. 

While the applicant has demonstrated that his previously 
identified iron deficiency has been corrected, there is no 
knowledge of whether he was under undisclosed treatment prior to 
the re­evaluation.  There also remains a possibility of 
laboratory error during his military service, as there is also no 
evidence a repeat study was conducted to confirm the abnormality.

Nevertheless, the Medical Consultant believes the Air Force 
officials acted within their authority to separate the applicant 
and had no recourse but to release him without a waiver for a 
disqualifying medical condition, iron deficiency anemia, IAW DoDI 
6130.03, particularly in the context of his refusal to undergo 
recommended diagnostic evaluations to identify a possible 
treatable or serious cause of the deficiency, such as peptic 
ulcer disease or, worse, an occult malignancy.  Moreover, since 
the disqualifying anemia was discovered within the first 180 days 
of service and without an opportunity to determine its cause, it 
was likely assumed to have existed prior to the applicant's entry 
to military service and resulted in the administrative separation 
in lieu of an MEB.  Again, acknowledging that the military was 
denied the opportunity to consider existence of a medical 
condition incurred or was permanently aggravated during his 
brief period of active service. 

In conclusion, if it is proven the applicant no longer has iron 
deficiency anemia and does not require supplemental iron, then 
allowing him to reenlist is not unreasonable.  None of the 
applicant's physical examinations documented a rectal evaluation 
and testing for occult blood in the stool, which is a serious 
clinical practice deficiency in the evaluation of anemia; 
particularly in a male patient.  Therefore, the Medical 
Consultant recommends the applicant submit a more current 
complete blood count, serum iron, iron-binding capacity, and 
ferritin, the result of a rectal examination to confirm absence 
of blood in the stool, and a statement that he has not required 
treatment to receive a prompt favorable recommendation from this 
Medical Consultant.

The Medical Consultant recommends denial of the applicants request 
pending receipt of more current information that he does not have 
anemia and has not required treatment for anemia.

The complete BCMR Medical Consultant’s evaluation is at Exhibit E.


APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

The applicant maintains he has never been diagnosed or treated for 
anemia prior to basic military training or after his discharge.  
He has followed the BCMR Medical Consultant’s advice and has had 
the recommended tests performed.  Once he receives the results, he 
will forward for review; however, as of this date, those results 
have not been received.

The applicant’s complete response is at Exhibit G.


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.  We took notice 
of the applicant’s complete submission in judging the merits of 
the case; however, the majority of the Board is not persuaded by 
the evidence submitted in his appeal that a change in the record 
is warranted.  While the majority of the Board notes AETC/SGPS’ 
recommendation to grant the request, the evidence of record 
indicates that the applicant was afforded due process at the time 
of his discharge and the majority finds the evidence submitted 
insufficient to determine otherwise.  Therefore, the Board 
majority agrees with the opinion and recommendation of the 
AFPC/DPSOR and the BCMR Medical Consultant and adopts their 
rationale as the basis for our conclusion that the applicant has 
not been the victim of an error or injustice.  Therefore, in the 
absence of evidence to the contrary, the Board majority finds no 
basis to recommend granting the relief sought in this application.


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.


The following members of the Board considered AFBCMR Docket Number 
BC-2013-05476 in Executive Session on 16 September 2014 and 
10 April 2015 and 28 April 2015, under the provisions of AFI 36-
2603:


	

By a majority vote, the Board voted to deny the application.  Mr. 
XX voted to partially grant and submitted a minority report which 
is located at Exhibit H.  The following documentary evidence 
pertaining to AFBCMR Docket Number BC-2013-05476 was considered:

	Exhibit A.  DD Form 149, dated 18 Nov 13, w/atchs.
	Exhibit B.  Applicant's Master Personnel Record Excerpts.
	Exhibit C.  Letter, AETC/SGPS, dated 6 Jan 14.
	Exhibit D.  Letter, AFPC/DPSOR, dated 13 Jan 14, w/atchs.
	Exhibit E.  Letter, BCMR Medical Consultant, 17 Jul 14.
	Exhibit F.  Letter, SAF/MRBR, 25 Jul 14. 
	Exhibit G.  Letter, Applicant’s Response, dated 23 Aug 13.  
	Exhibit H.  Minority Report, dated 1 May 15.