RECORD OF PROCEEDINGS
         AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2004-01628
		INDEX CODE:  122.00

		COUNSEL:  NONE

		HEARING DESIRED: NO

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APPLICANT REQUESTS THAT:

His line of duty (LOD) determination be changed from “No” to “Yes” for Menieres Syndrome, the diagnosis used to medically disqualify and retire him.

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APPLICANT CONTENDS THAT:

The “system” refused to connect his illness to his military service.  His illness stemmed from the first anthrax vaccination he received in January 2000.  He still suffers from Menieres Syndrome, from Chronic Fatigue Syndrome (CFS) and fibromyalgia.  On 25 February 2002, the only diagnosis used to retire him was Menieres Syndrome.  But he also suffered from CFS and fibromyalgia that were not diagnosed at that time.  Today, he contends he still has all these illnesses without any improvement.

In support of his appeal, the applicant has provided copies of an anthrax brochure, a veteran’s administration (VA) letter showing service connection, medical summaries, pertinent parts of his VA medical record, and a Department of Veteran’s Affairs (DVA) Rating Decision.  

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

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STATEMENT OF FACTS:

The applicant joined the Oregon Air National Guard (ORANG) on 30 April 1984.  He progressed through the enlisted ranks to the grade of technical sergeant (TSgt/E-6) with a date of rank (DOR) of 23 March 1992.  He concurrently served in the federal civil service as an ANG fulltime technician.  He received three anthrax vaccinations (8 and 22 January 2000, and 5 February 2000).  The period just after the administration of each shot, the applicant experienced a number of symptoms such as severe chills, tachardia, shortness of breath, and dizziness among others.  Most of the symptoms subsided and resolved within one day, the dizziness, shortness of breath, and rapid pulse remained.  From the period of March 2000 through November 2000, he was evaluated several times regarding the above symptoms and others such as decreased ability to concentrate, explain things, understand directions, and slight short-term memory loss.  He was also evaluated for inner ear problems that would account for his dizziness.  After a civilian neurologist found evidence of right vestibular nerve damage, he advised the applicant’s unit to not give the applicant further anthrax injections.  In May 2000, he was placed on a profile and limited duty, able to perform only paperwork (approximately 10% of his normal duties).  By July 2000, a possible diagnosis of Meniere’s disease was considered.  In November 2000, his commander, after consultation with medical personnel, decided that there was no relationship between the Meniere’s disease and any current vaccinations in use.  In February 2001, allergies were ruled out as well as evaluations from Ear, Nose and Throat (ENT) personnel.  In May 2001, the National Guard Bureau (NGB) found him no longer qualified for World Wide Military Duty.  NGB’s LOD determination was “No” based on the diagnosis of Meniere’s disease.  He was allowed to continue unit training assemblies (UTA’s) at modified work profile.  In February 2002, he was medically discharged from the ORANG and placed on the Reserve Retired List, eligible for Reserve retired pay at age 60.  At the time of his discharge he had served a total of 26 years, 10 months, and 7 days of combined active and Reserve service.  He was honorably discharged in the grade of TSgt.

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AIR FORCE EVALUATION:

The BCMR Medical Consultant notes that the applicant, while reportedly “well” prior to January and February 2000 when he received the anthrax vaccinations, was discharged for medical disqualification for a number of symptoms including fatigue, dizziness, insomnia, and anxiety, all lumped under the label of Meniere’s disease.  Further, while the applicant demonstrated transient objective inner ear abnormalities suggestive of Meniere’s disease in the months following the anthrax vaccinations, it had been resolved upon retesting the following year in a pattern consistent with the rare reports in medical literature of similar transient abnormalities following a variety of vaccinations.  

Current expert review committees have not found any scientific (statistical, epidemiological), evidence to support a causal relationship between anthrax vaccinations and Meniere’s disease, CFS, fibromyalgia syndrome, chronic cognitive disorders, and chronic anxiety.  Even though rare events are impossible to prove or disprove, an Institute of Medicine report specifically emphasizes that even when there is a statistically significant association observed, there is not necessarily a causal association and concluded that most of the statistically significant associations seen did not indicate a causal relationship.
Adverse effects attributable to anthrax vaccination include local injection site and transient systemic reactions that resolve.  There are a large number of different medical conditions that have been noted to infrequently occur in temporal relationship with anthrax vaccination without evidence of causation including diseases of the skin, blood, psychiatric illness, neurological disease, cardiac disease, musculoskeletal, kidney, liver, gastrointestinal, endocrine, and lung diseases.  These observed conditions occur at similar rates as those observed with other routine vaccinations.

Symptoms of fatigue, mood-cognition, and musculoskeletal complaints occur infrequently following anthrax vaccination.  The Walter Reed Vaccine Healthcare Center documentation (included in the applicants case file) indicates the applicant’s complaints occur in “…at least 2-3% of anthrax vaccines”, but are transient in the majority of cases and are rarely persistent.  Thus, persistent/chronic fatigue, mood-cognition, and musculoskeletal complaints (i.e. fibromyalgia syndrome) occur in 1 percent or less.  Presently, there is no scientific evidence that shows a causal relationship between anthrax vaccination and the applicant’s condition.  The occurrence of conditions with these features (CFS and fibromyalgia syndrome) is estimated to occur in the general population ranging from 1 to 4 percent for fibromyalgia syndrome and 1 percent for CFS.  Thus, the less than 1 percent occurrence of CFS or fibromyalgia syndromes in temporal relationship to anthrax vaccination does not exceed the expected occurrence in the non-vaccinated general population.  In the absence of other scientific evidence linking the vaccination with the syndrome, the temporal relationship does not establish causality as statistically it is no more likely that a chance occurrence.

Applicant incurred his chronic disability while in civilian status and thus was not eligible for military disability compensation.  Any notion of proximate causation at present is purely speculative and does not meet the standard required by the disability system.  The applicant submits a DVA rating decision granting service connection for Meniere’s disease as evidence to support his request.  Operating under different laws with a different purpose, determinations made by the DoD under Title 10 and the DVA under Title 38 are not determinative or binding on decisions made by the other.

The BCMR Medical Consultant is of the opinion that no change in the records is warranted.  Action and disposition in this case are proper and equitable reflecting compliance with Air Force directives that implement the law.

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

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

A copy of the Air Force evaluation was forwarded to the applicant on 4 January 2005 for review and comment within 30 days.  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.  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 and sympathize with his medical condition; however, we agree with the opinion and recommendation of the Air Force office of primary responsibility and adopt its rationale as the basis for our conclusion that the applicant has not been the victim of an error or injustice.  The evidence presented by the applicant, while compelling, failed to show a causal relationship between his conditions and the anthrax injections he received.  Therefore, in the absence of evidence to the contrary, we find no compelling basis to recommend granting the relief sought in this application.

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THE BOARD DETERMINES THAT:

The applicant be notified that the evidence presented did not demonstrate the existence of material error or injustice; that the application was denied without a personal appearance; and that the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application.

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The following members of the Board considered AFBCMR Docket Number BC-2004-01628 in Executive Session on 24 February 2005, under the provisions of AFI 36-2603:

The following documentary evidence was considered:

    Exhibit A.  DD Form 149, dated 14 May 04, w/atchs. 
    Exhibit B.  Applicant's Master Personnel Records.
    Exhibit C.  Letter, BCMR Medical Consultant, dated 30 Dec 04.
    Exhibit D.  Letter, SAF/MRBC, dated 4 Jan 05.