A government watchdog report confirms shortcomings in the benefits process for certain military service members who reported getting hurt or sick on duty.
The Air Force Inspector General inquiry report included 12 recommendations for improvements in the Line of Duty [LOD] determination process.
For nearly two years, the ABC15 Investigators have looked into Air National Guard member complaints that they were improperly denied medical care and pay.
Trevor Cummings, 43, from Montana, said his LOD denial related to an abdominal tumor was denied, leading to the end of his military career in 2022.
He says he now has stage 4 cancer and is working part-time at an auto parts store to make ends meet.
“I'd really like to just spend all my time with my family,” Cummings said.
He was a tech sergeant at the 120th Airlift Wing in Montana and spent more than two decades in the military. He said his overseas missions exposed him to burn pits.
In 2019, he came home from a three-month overseas deployment feeling sick.
Doctors found a quickly growing abdominal tumor, which was classified as gastrointestinal stromal cancer.
Medical reports show the tumor measured 7 cm, which is larger than a tennis ball.
“They surgically removed the cancer, and then began my fight with the Guard and the Air Force,” Cummings said.
Cummings applied for an LOD determination, which is used to confirm whether an illness, injury, or disease was either sustained during a period of military service or made worse by military duties. If so, the National Guard is legally obligated to cover medical care expenses and certain pay benefits.
“It should have been a rubber stamp,” Cummings said.
Cummings said he got initial approval, but at National Guard Headquarters, the Air Reserve Command LOD Board denied him.
“It was so frustrating,” he said. “And I was so helpless.”
Cummings is one of several Air National Guard members who told the ABC15 Investigators that they were improperly denied LOD benefits.
“It's been two and a half years of fighting a David and Goliath situation,” Christy Kjornes told ABC15 in February 2024. She ultimately prevailed during an appeal to approve her LOD condition, and she medically retired from the Arizona Air National Guard in September 2024.
“We just had a sense that it wasn't right. What we were facing wasn't right,” said Lt. Col. Richard Cullen in June 2024.
At the time, Cullen had seven medical claims approved at the local level and later formally denied. He appealed. As of this month, he said four of the cases were now being found in the line of duty.
“It's either incompetency, apathy, or corruption,” said Lt. Col. Mitch Hall, who served with Cullen in the Washington National Guard. “You kind of feel abandoned.”
He is in the process of determining whether he will receive a medical retirement.
Retired guard member Jeremy Sorenson advocates for other airmen, and he questioned whether some LOD board denials were cost-driven.
“They spend a lot of effort to say that chronic injuries, illnesses, diseases, which generally are the ones that result in some sort of disability compensation, that those didn't happen in the line of duty,” Sorenson said.
An Air Force Inspector General Inquiry report, completed in December 2024, included LOD document reviews, an in-depth look at 11 representative cases, and interviews with commanders.
According to the report, nearly 1700 LOD determination requests were filed in the Air National Guard and Air Force Reserves over a 15-month period from January 2023 to March 2024.
In both the guard and reserves, approximately, 70% of applications were approved as in the line of duty. But 30%, or nearly 500, service member cases were denied for benefits after being found not in the line of duty.
The Air Force Inspector General found “significant shortcomings and inconsistencies in existing ARC LOD policies and processing," and that contributed to an “apparent failure to adequately support ARC service members who were experiencing health challenges and eroded their trust.”
However, the report also said, “this inquiry did not uncover evidence of a deliberate effort to deny ARC service members medical entitlements by way of NILOD determinations due to monetary considerations.”
The inspector general made 12 recommendations for improvement, but the Air Force has not yet implemented most of the changes in the 11 months since the report was issued.
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An Air Force spokesperson told ABC15 in a statement that it did complete the recommended creation of a list of medical specialists available to advise the LOD board on complex cases.
Within six months, the Air Force expects to publish a revised policy governing the LOD process and criteria.
According to the Air Force spokesperson, adding resources for patient support and improved staff training will require additional budget approvals.
Sorenson, the advocate, said the inquiry’s results “held nobody accountable.” He was frustrated that reforms were not being implemented more quickly.
“I believe that if Secretary Hegseth for the DOD and if Secretary Meink of the U.S. Air Force, engaged on this matter, it could be resolved in days,” Sorenson said.
“It strictly takes the senior leadership to put out directives to follow the law,” he said.
Meantime, Sorenson sees the effects of denials on Air National Guard members.
“It destroys their families. It destroys their health. It results in mental health problems,” he said.
For Cummings, the Montana airman, the program changes come too late.
He appealed the LOD denial, but the military boards held firm. The decision was that Cummings’s abdominal tumor was so big, it must have started forming before his 3-month deployment, so he wasn’t eligible.
“If you Googled the average doubling time of a gastric tumor, this website comes up that they used as proof against me,” Cummings said.
Because the cancer was found not in the line of duty, Cummings wasn’t eligible for continued medical coverage or military pay.
He was discharged from the National Guard. He also said he had to leave his civilian job on base because it was contingent on his military status.
“I was so angry; I couldn't believe that I had devoted 23 years of my life to an organization that turned its back on me in my time of need,” Cummings said. “I was a piece of paper on their desk, and that was it.”
Cummings told ABC15 his cancer has since returned.
Because his type of cancer is presumed to be caused by his prior military burn pit exposure under federal law, Cummings said the Department of Veterans Affairs gave him a 100% disability rating. The VA also provides his cancer care.
Without the LOD approval, Cummings said he did not qualify for medical retirement, so he couldn’t access other benefits that would lighten his family’s financial burden.
“Eventually, if enough people find out, the public's got to be outraged,” Cummings said.
Cummings said he exhausted all of his appeal options inside the military, but he can continue his case in the federal court system.
