RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2002-01096
		INDEX CODE:  110.00

	APPLICANT	COUNSEL:  None

	SSN	HEARING DESIRED: No

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APPLICANT REQUESTS THAT:

His reenlistment code be changed to allow him to re-enlist the Air Force.

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APPLICANT CONTENDS THAT:

His diagnosis of exercised induced asthma was erroneous.  

Applicant's complete submission, with attachments, is at Exhibit A.

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STATEMENT OF FACTS:

On 27 December 1997, the applicant enlisted in the Regular Air Force as an airman basic for a period of four years.  He served as a Aircraft Structural Maintenance Journeyman.

The applicant, in 1999, experienced a variety of ailments to include neck and back pain, headaches and light-headedness that were aggravated by wearing the protective equipment he was required to wear for his job.  The applicant was diagnosed as having a degenerated intervertebral disc in his neck.

An occupational respirator medical evaluation was conducted on 2 November 1999 and it was noted that the applicant had not been using the protective equipment for one month and his symptoms were resolving.  The applicant also reported that the ventilation system at work was not functioning properly.  During the evaluation the applicant stated he experienced shortness of breath while he wore the protective respirator equipment in the Spring of 1999 without recurrence.  The applicant also experienced a cough when running, shortness of breath going up the stairs out of proportion to his young age and prior level of fitness.  The applicant’s pulmonary function tests that were conducted in September 1998 and August 1999 were compared and 
revealed a mild reduction in the applicant’s lung capacity.  Based on the symptoms the applicant was experiencing he was referred for exercise testing to evaluate him for asthma.  The exercise test revealed a 13 percent reduction in his one-second forced expiratory volume which resolved with treatment with inhaled medication used to reverse bronchospasm.  He was diagnosed with mild exercise induced asthma.  On 7 December 1999, the applicant was restricted from duty that required him to use the respirator on the basis of his respiratory condition.  A medical evaluation board (MEB) was convened on 8 December 1999.  The MEB referred him to the Physical Evaluation Board (PEB).  The PEB found the applicant’s condition to be unfitting for continued service and disability retired the applicant with a 10 percent disability rating (discharge with severance pay).  The applicant agreed with the findings of the PEB.

Applicant was honorably discharged on 6 March 2000, with severance pay with a disability rating of 10 percent.  He served two years, two months and eight days of active service.  

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AIR FORCE EVALUATION:

The Chief Medical Consultant, AFBCMR, states the Air Force medical standards regarding asthma are very strict, and even mild asthma is a disqualifying condition for continued service, even if it does not directly interfere with the individuals work performance.  The military’s experience with asthma has been that it limits the individual’s ability for deployment and overseas assignments due to the problems with disease flare ups when in an uncontrolled environment.  In addition to being diagnosed with mild exercise induced bronchospasm, he was also diagnosed with degeneration of one of the intervertebral discs in his neck.  A condition, such as this, with frequent absences from work, is deemed an unfitting condition for continued active service.  

The applicant contends that he does not have exercise induced asthma.  He has provided documentation from a civilian pulmonary specialist that supports his contention.  The Medical Consultant further states a more detailed review of the applicant’s case found that his diagnosis was based on the exercise test.  The Air Force pulmonary specialist reviewed the test and interpreted it as negative, thus, confirming the impression of the civilian specialist’s that there were additional technical problems limiting the validity of the test.  With an equivocal exercise test, many lung specialists recommend a more specific test such as the methacholine challenge test (or a histamine challenge test).  This was not done in the applicant’s case.  Another consideration is whether the applicant was exposed to noxious fumes at work as a result of the faulty ventilation system at work.  However, no evidence was presented showing whether or not 
the applicant’s work environment had been evaluated for exposure of fumes from a faulty ventilation system.

The Medical Consultant further states it appears there was an insufficient evaluation to properly diagnose asthma or exercise induced asthma, and the MEB process proceeded with incomplete and inaccurate information.  It is likely the applicant does not have asthma and his respiratory symptoms at the time may have been related to occupational exposures.

The Medical Consultant recommends the applicant’s request to have his RE code changed be reconsidered and granted.  The Medical Consultant further recommends the applicant undergo a pulmonary evaluation with a methacholine challenge test (or histamine challenge test) and an orthopedic evaluation of his spine.  Furthermore, if the reenlistment RE code upgrade is granted, the applicant must meet all medical standards for reenlistment.

A copy of the Air Force evaluation is attached at Exhibit C.

HQ AETC/SGPS reviewed the applicant’s request and recommends the applicant, at his expense, obtain a full methacoline challenge test and if the result is negative, a waiver to re-enter active duty will be considered.  However, if the test is in anyway positive the previous medical disqualification will be sustained (Exhibit D).

HQ AFPC/DPPAE, also reviewed the application and states the applicant was separated with an RE code of 2Q, “Personnel medically retired or discharged.” They further state that based on the BCMR Medical Consultant’s evaluation, they concur that the RE code should be changed.  They recommend the applicant’s RE code be changed to a “3K.”

A copy of the Air Force evaluation is attached at Exhibit E.

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Copies of the Air Force evaluations were forwarded to the applicant on 10 January 2003, for review and response.  As of this date, no response has been received by this office.

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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 error or injustice to warrant partial relief.  The AFBCMR Medical Consultant indicates he believes there was an insufficient evaluation of the applicant’s condition to properly diagnose asthma or exercise induced asthma and, as such, the MEB process proceeded with incomplete and inaccurate information.  The Medical Consultant believes that it is likely the applicant does not have asthma and his respiratory symptoms during the contested time period may have been related to occupational exposures in his job as an aircraft structural maintenance journeyman.  However, based on the available evidence we cannot determine with any degree of certainty whether the applicant’s present medical condition may or may not be unfitting.  Therefore, while we note the recommendations of both the Medical Consultant and the office of primary responsibility to change the applicant’s RE code, we are reluctant to grant an RE code that allows reenlistment when the applicant may prove to be unfit.  We believe the most appropriate action at this point is that the applicant undergo a complete medical assessment, to include a pulmonary evaluation with full methacholine challenge or histamine challenge test and a full orthopedic evaluation to ascertain the underlying cause of his neck and back pain.  Invitational orders should be issued allowing the applicant to be medically evaluated at Wilford Hall Medical Center to determine if he is able to meet military service medical requirements.  This will also afford him the opportunity to demonstrate or provide evidence of his alleged fitness.  The medical determination as to whether or not he is fit for military duty will then be forwarded to this Board for final consideration.  We therefore recommend the applicant’s records be corrected to the extent indicated below.

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THE BOARD RECOMMENDS THAT:

The pertinent military records of the Department of the Air Force relating to APPLICANT, be corrected to show that invitational orders be issued authorizing travel via aeromedical airlift to Wilford Hall USAF Medical Center, Texas, within 120 days of this decision for the purpose of evaluation of his medical condition, to include a pulmonary evaluation with methacholine challenge or histamine challenge testing, and an orthopedic evaluation of his spine, and that the results of the evaluation be forwarded to the Air Force Board for Correction of Military Records at the earliest practicable date so that all necessary and appropriate actions may be completed.

It is further directed that the charges for the physical examination be waived.

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The following members of the Board considered AFBCMR Docket Number BC-2002-01096 in Executive Session on 25 March 2003, under the provisions of AFI 36-2603:

All members voted to correct the records as recommended.  The following documentary evidence was considered:

   Exhibit A.  DD Form 149, dated 19 Feb 02, w/atchs.
   Exhibit B.  Master Personnel Records.
   Exhibit C.  Letter, AFBCMR Medical Consultant, dated 
               13 May 02.
   Exhibit D.  Letter, HQ AETC/SGPS, dated 24 Sep 02.
   Exhibit E.  Letter, HQ AFPC/DPPAE, dated 2 Jan 03.
   Exhibit F.  Letter, SAF/MRBR, dated 10 Jan 03.

					

AFBCMR BC-2002-01096

MEMORANDUM FOR THE CHIEF OF STAFF

	Having reviewed and considered the recommendation of the Air Force Board for Correction for Military Records and under the authority of Section 1552, Title 10, United States Code (70A Stat 116) it is directed that:

	The pertinent military records of the Department of the Air Force relating to APPLICANT, SSN, be corrected to show that invitational orders be issued authorizing travel via aeromedical airlift to Wilford Hall USAF Medical Center, Texas, within 120 days of this decision for the purpose of evaluation of his medical condition, to include a pulmonary evaluation with methacholine challenge or histamine challenge testing, and an orthopedic evaluation of his spine, and that the results of the evaluation be forwarded to the Air Force Board for Correction of Military Records at the earliest practicable date so that all necessary and appropriate actions may be completed.

	It is further directed that the charges for the physical examination be, and hereby are, waived.