An aspie misunderstanding or...

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I think this is very common NT behavior. It's also common for NTs to say things are a joke that really weren't because they're trying to avoid upsetting the other person. I'm an Aspie who sometimes tells his girlfriend that something was a joke when she starts to get upset at me over it. It sometimes works.

I talked to him about this stuff yesterday and he said "you're not putting yourself in my shoes"

That sounds more like an aspie problem, apparently I don't "act" like I care about his medical problems (even though I do)

Why does he put his leg on your body? Does it ease his pain? Does he want sex?

Ask him why you’re not “putting himself in his shoes.” If he doesn’t answer directly, insist that he does answer directly. It’s only fair that you know the answer.

Perhaps he’s just playing you.

The leg thing he says is for comfort.

I wish you could find some other way to comfort him, since you don’t like the leg thing.

It's really complicated... Part of it is his mental health profile, he's got PTSD because he lost his first wife to death, and on top of that borderline so he has an extreme fear of abandonment, he's afraid to loose me but at the same time he don't understand why I don't show more empathy toward him.

When I had that brief job where I was totally separated from him I would call him lovengly on the phone every night and ironically our relationship was better... I need a job or something to do away from the apartment pretty badly.

Absence does make the heart grow fonder....

Does he qualify for a PTSD service dog?
That could help him to feel affection and also keep him occupied when you aren't home.