RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2006-00499
		INDEX CODE:  112.00

		COUNSEL:  NONE

		HEARING DESIRED:  NO

MANDATORY CASE COMPLETION DATE:  20 AUG 07

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APPLICANT REQUESTS THAT:

Her records be changed to reflect she is medically qualified for enlistment.

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APPLICANT CONTENDS THAT:

She desires to reenlist in the service.  She indicates that she was informed by her recruiter that she was permanently disqualified for processing for the Air Force Reserves based on medical documentation she submitted at the request of her recruiter.  She provided a letter from her private doctor which indicates her present diagnosis.  

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

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STATEMENT OF FACTS:

The applicant’s military personnel records are unavailable.

Data extracted from documentation provided by the applicant indicates she enlisted in the Air Force Reserves on 15 June 1984 and served on active duty for training from 10 July 1984 through 12 October 1984.

Medical documentation provided by the applicant indicates the following:

Medical Documentation from the Mobile Urology Group, indicates on 18 April 1995 the applicant had a cysto, right stent placement removal of right percutaneous nephrostomy and right ESWL.

Medical documentation from the USA Urology Center - Progress Notes indicates on 26 April 1995, the applicant was asymptomatic as far as the headaches, nausea and vomiting until she had a right cysto retrograde and ESWL at the Springhill Hospital under spinal anesthesia approximately one week ago.  24-hours after the anesthetic, she developed what appeared to be a post spinal headache.  When she stood upright, she was in pain, experienced nausea, vomiting, and headaches.  When she laid down her condition improved.  She had two blood patches and continued to have symptoms.  The physician recommended the applicant be admitted to a medical center for consultation; however, she declined.  The applicant had not been able to work and the anesthesiologist at the Springhill Hospital recommended she be reevaluated.

Medical documentation from the USA Urology Center - Progress Notes by her nephrologists, dated 24 January 1996, indicates diagnoses of recurrent nephrolithiasis and polycystic kidney disease.  She also had recurrent kidney stone on the left side in January 1997 (requiring cystoscopy, ureteroscopy, stone manipulation, stent placement).

Medical Documentation from the Mobile Urology Group, dated 13 July 2005 indicates stable polycystic kidney disease without evidence of tumor, mass or kidney stone disease.  Her kidney function was reported to be normal and blood pressure was stable.

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AIR FORCE EVALUATION:

AFRC/RSSX recommends denial.  RSSX states the Military Entrance Processing Station (MEPS) permanently disqualified the applicant from processing based on medical documentation submitted by her, at the request of her recruiter.  Since that time, the applicant has obtained a letter from her private doctor, dated July 2005, with her present diagnosis.  The letter indicates that the applicant is still being seen by her physician on a regular basis with checks of blood work, blood pressure, urinalysis and renal ultrasound.  At this time, she is functioning normally and there are no indications of any problems from the original diagnosis of polycystic kidney disease and kidney stones.

Regardless of the applicant’s present condition, the fact remains that she is still being monitored by the original diagnosis.  Normal functionality now does not mean the condition has been resolved.  Any history of polycystic kidney disease is a permanent disqualification.  RSSX requested a determination from the Air Force Reserve Command Surgeon General’s office to confirm whether or not the applicant could even be considered for a waiver if she were to be able to accomplish a physical at the MEPS.  Per AFRC/SG, a waiver would not be considered or approved for the applicant based on her diagnosis.

The RSSX evaluation is at Exhibit B.

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

On 3 March 2006, a copy of the Air Force evaluation was forwarded to the applicant for review and response within 30 days (Exhibit C).  As of this date, no response has been received by this office.

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ADDITIONAL AIR FORCE EVALUATION:

The BCMR Medical Consultant recommends denial.  The Medical Consultant states the applicant has two related disqualifying conditions:  polycystic kidney disease and recurrent nephrolithiasis.  Polycystic Kidney disease is an inherited (autosomal dominant; 75 percent of patients have a family history) systemic disorder that commonly leads to progressive renal failure but that can also affect a number of other organ systems.  Cyst formation in the kidneys begins in very early childhood (inutero) and increase in size and number as the patient ages.  Most patients come to medical attention in middle age due to flank or back pain, blood in the urine, urinary tract infections, and kidney stones.  Later in life, progression of the condition results in progressive renal failure (associated with increasing number and size of cysts and scarring of kidney tissues; depending on the specific gene type, ranges between age 55 and 70).  High blood pressure develops in 60 to 75 percent of adults and contributes to the decline in kidney function.  In addition to cysts in the kidney, the condition is associated with the development of cysts in the liver (particularly in women as they age), diverticulosis and diverticulitis, hiatal hernias, and mitral valve prolapse on echocardiography (up to 25 percent).  Four to ten percent of patients are found to have an aneurysm in the Circle of Willis, an artery in the brain that can bleed causing devastating neurologic sequelae.  There is no specific treatment for polycystic kidney disease and treatments are directed at treating infections, kidney stones, high blood pressure, and cyst puncture/surgical decompression to relieve pressure symptoms.

Although she is reported to have normal kidney function with stable blood pressure, and no recent kidney stones, her condition remains disqualifying for service in accordance with medical standards for enlistment and reenlistment in Air Force Instruction 48-123, Attachment 3 (paragraph A3.18.6.3, Cystic or polycystic kidney, confirmed history of; and paragraph A3.18.12.1 Substantiated history of recurrent renal calculus or bilateral renal calculus at any time).  Merely a history of polycystic kidney disease and a history of recurrent nephrolithiasis are disqualifying based on the risk for recurrent complications and associated conditions that can render a service member unable to perform duties.  This is not a condition that would warrant a waiver to serve the needs of the Air Force.

The Medical Consultant’s evaluation is at Exhibit D.

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

On 2 May 2006, a copy of the Air Force evaluation was forwarded to the applicant for review and response within 30 days (Exhibit E).  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 not timely filed; however, it is in the interest of justice to excuse the failure to timely file.

3.	Insufficient relevant evidence has been presented to demonstrate the existence of an error or injustice.  After reviewing the evidence of record, we are not persuaded the applicant’s release from the Air Force was not in accordance with Air Force policy.  Her contentions are duly noted; however, in our opinion, the detailed comments provided by the BCMR Medical Consultant adequately address these allegations.  Therefore, we are in agreement with the comments and recommendations of the Air Force Offices of Primary Responsibility and adopt their rationale as the basis for our determination that the applicant has not been the victim of either an error or injustice.  In view of the above and in the absence of evidence to the contrary, we find no compelling basis to recommend granting the relief sought.

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THE BOARD DETERMINES THAT:

The applicant be notified the evidence presented did not demonstrate the existence of an error or an injustice; the application was denied without a personal appearance; and 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-2006-00499 in Executive Session on 13 June 2006, under the provisions of AFI 36-2603:

The following documentary evidence was considered:

   Exhibit A.  DD Form 149, dated 9 Feb 06, w/atchs.
   Exhibit B.  Letter, AFRC/RSSX, dated 27 Feb 06.
   Exhibit C.  Letter, SAF/MRBR, dated 3 Mar 06, w/atch.
   Exhibit D.  Letter, BCMR Medical Consultant, dated 27 Mar 06.
   Exhibit E.  Letter, SAF/MRBC, dated 2 May 2006, w/atch.