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Arizona National Guard pilot wins appeal of medical care denial

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Arizona Air National Guard pilot Christine Kjornes spent years battling the Department of Defense for medical benefits and pay after health conditions forced her from the cockpit.

“It’s been two and a half years of fighting a David and Goliath situation,” Kjornes said.

Part of the 161st Air Refueling Wing, Kjornes had volunteered for extra missions around the world for two decades.

“I love flying,” Kjornes said. “I’ve just been really proud to wear the uniform, and to serve.”

In 2021, Kjornes was sent to Maxwell Airforce Base in Alabama for a year-long officer training school.

Her medical records show the stress aggravated an illness that she first experienced a decade before while in pilot training.

She asked ABC15 not to identify her specific diagnosis to protect her medical privacy. She said it was “extremely hard” to report her symptoms because she knew she would likely be grounded while seeking treatment.

“There comes a certain point where once you let it go for too long,” Kjornes said, “it starts to compound, and then new problems start to arise.”

National Guard members, because they are not full-time active duty, need to obtain a Line of Duty Determination to confirm if their illness or injury is service-connected or service-aggravated.

In Kjornes’s case, her doctors and commanders at Maxwell Air Force Base agreed the illness was ILOD – in the line of duty.

Kjornes finished her training and returned to the 161st Air Refueling Wing in Phoenix.

She said she expected to be on medical continuation orders, which is paid leave to seek medical treatment as she tried to return to the cockpit.

“When I got back to my unit, they were stiff-arming me, and they were not following the process, which should have been followed,“ Kjornes said.

Her 161st Wing commanders told Kjornes the Line of Duty Determination form from Alabama had clerical errors, so they started a new form. Kjornes said the second form took nine months to complete and looked starkly different from the first.

“They omitted one of my diagnoses; they changed the diagnostic code on the other condition,” she said.

The wing commander then sent the second form to the National Guard Bureau headquarters in Arlington, Virginia, for yet another level of scrutiny. An NGB nurse practitioner reviewed medical literature and medical records. She wrote that Kjornes’s condition “preexisted this period of service” and “there is no evidence to substantiate a service aggravation beyond natural progression.”

The National Guard Bureau reversed the local recommendation. Kjornes’s illness was adjudicated as NILOD – not in the line of duty – meaning she wasn’t entitled to medical benefits or pay.

“It resulted in her having to sell her house because she didn’t have a paycheck to pay her mortgage,” said Jeremy Sorenson, a director at USJAG, which is a nonprofit group dedicated to defending the rights of injured service members.

He has been advocating for Major Kjornes, and he said the LOD denial impacted her in many ways.

“It resulted in the loss of many of her friends in the military,” Sorenson said. “As soon as this process started and went off the rails, if you will, she was looked at as an outcast by the entire unit.”

The National Guard Bureau tells ABC15 that it is the “final decision authority” on LOD cases, and “overall, their processes and systems are consistent with law, DoD policy and Air Force regulatory guidance.”

Sorenson disagreed.

“There was an outright abuse of authority by the commander of the 161st Air Refueling Wing for not processing the paperwork that she was provided, and then it was a follow-up outright abuse of authority for the National Guard Bureau to overturn a line of duty determination that had already been executed,” Sorenson said. He said USJAG is currently handling two dozen similar LOD cases in the Air National Guard across the country.

Sorenson helped Kjornes appeal to the Air Force Board for Correction of Military Records. Since 2019, the board has considered 33 Air National Guard LOD cases and overruled the National Guard Bureau 27% of the time. In all, nine cases were ruled in favor of the airmen, including Maj. Kjornes’s case

The board’s written decision said she was “the victim of an error or injustice” and “she had an unresolved ILOD condition.” The board’s decision also said the paperwork from the 161st “took approximately nine months to accomplish” and had “erroneous” information.

ABC15 asked the Arizona National Guard about the errors and delay, but a Guard spokesperson declined to comment saying they would not want to jeopardize the integrity of an ongoing investigation.

Meantime, Kjornes was entitled to back pay as well as leave time and medical benefits.

“I won,” Kjornes said.

Kjornes’s successful appeal is extremely rare.

The National Guard Bureau sent ABC15 data from September 2021 to March 2022. Of 949 cases recommended by local wing commanders to be “in the line of duty” that were reviewed at a federal level by the National Guard Bureau, 292 were ultimately adjudicated as “not in the line of duty.” That’s a 30% denial rate.

Just six Air National Guard cases a year, on average, are appealed to the Air Force Board for Corrections of Military Records, but just one or two airmen win that appeal.

Many National Guard members give up after the first denial, according to Allison Weber, a military law attorney with Tully Rinckey PLLC.

“By the end of it, they feel like they have their back turned on, and that they’re fighting against the system,” Weber said.

Weber handles dozens of cases for guard members and reservists who say they were improperly denied medical benefits. She said these denials can end military careers.

“They keep getting told they have a non-line of duty condition and they’re returned [to duty], and a lot of times they’re pushed out in some other way,” Weber said. “They may just be denied the ability to reenlist. I’ve seen sometimes it says that they’re unsuited.”

Men and women have been discharged as unsuited for military service instead of receiving a medical discharge.

“You can imagine that nobody that wants to continue their military career wants to come forward and say, ‘I got hurt,’ if they’re going to be turned on by leadership,” Sorenson said.

In October 2023, the Government Accountability Office found a 16 percentage point gap in VA disability approval rates for guard members and reservists compared to their active-duty counterparts.

So, National Guard members and reservists are more often denied monthly veteran disability checks and VA medical care.

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