RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2004-02366
		INDEX CODE:  100.06
		COUNSEL:  None

		HEARING DESIRED:  No

MANDATORY CASE COMPLETION DATE:  1 FEB 06 

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APPLICANT REQUESTS THAT:

His reenlistment eligibility (RE) code be changed so he will be eligible to enlist for active duty or Reserve status.

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APPLICANT CONTENDS THAT:

The Department of Veterans Affairs (DVA) evaluation found nothing wrong with him and he has had no recurrence of idiopathic rhabdomyolysis, which prompted his medical discharge with severance pay in 2003.  

[Note:  The AFBCMR Medical Consultant advises that rhabdomyolysis is the abnormal, excessive breakdown of muscle tissue.  Muscle enzymes are released into the blood stream, in particular myoglobin, that can result in renal failure and other complications.  Causes are variable, including high levels of exertion, trauma, infections, drugs, and underlying muscle disease (i.e., metabolic, degenerative, and inflammatory disease processes).  Heavy exertion in hot climatic conditions that also results in dehydration and possibly electrolyte depletion can cause this condition in otherwise normal individuals, as well as in those predisposed to underlying muscle disease.  A variety of underlying diseases of muscle, including genetic disorders of muscle metabolism, muscle function, or inflammatory disease, can predispose to this condition.]

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

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STATEMENT OF FACTS:

The applicant’s medical pre-screening evaluations on 9 Jul 99 reported no abnormalities or conditions.  His Individual Assessment Report in the USAF Fitness Program indicated he had exceeded the Air Force aerobic fitness standard by one point.  On 23 Sep 99, the applicant enlisted for four years in the Regular Air Force and served as an aerospace maintenance apprentice/journeyman.  

On 17 Aug 01, while on temporary duty (TDY), the applicant was admitted to the Milford Memorial Hospital in Milford, DE, for abdominal pain which increased with movement and activity.  The pain began after he had exercised three days prior.  Two days prior to that, his urine had begun to turn brownish.  He had very high levels of muscle enzyme in the blood and urine.  The applicant was admitted for intravenous hydration to prevent kidney damage, and his abdominal pain resolved essentially after two days, and urinalysis returned to normal.  The diagnosis was rhabdomyolysis and the applicant was discharged on 22 Aug 01.  He returned to normal activities in approximately six weeks.  

On 22 Apr 03, the applicant was found guilty of disobeying a lawful order, issued to him on 29 Jul 02, forbidding him from driving on Dover AFB, by driving on or about 7 Apr 03, in Eagle Heights Housing Area, Dover AFB.  The applicant did not make a personal appearance but submitted a written statement, but the commander imposed Article 15 punishment in the form of reduction from senior airman (SRA) to airman first class (A1C), and 30 days correctional custody, deferred until 30 Apr 03.  The applicant’s appeal was denied.  

In May 03, the applicant experienced a milder episode, apparently after running while TDY at Keesler AFB, MS, and was hospitalized for treatment.  He underwent a comprehensive evaluation at Walter Reed Army Medical Center, including a muscle biopsy, which failed to show evidence of underlying muscle disease that would predispose him to rhabdomyolysis.  He was placed on a physical profile on 7 May 03, restricting him from running, lifting more than 20 lbs, prolonged standing, frequent stair climbing, or physical training.

On 22 May 03, the commander found the applicant guilty of dereliction of duty in failing to comply with Keesler AFB Correctional Custody Facility rules, between, on or about 1-5 May 03, and for failing to obey a lawful order to clean the bathroom floors on or about 9 May 03, and imposed nonjudicial punishment in the form of reduction from A1C to airman.  The applicant had submitted a written statement but did not request a personal appearance.  He did not appeal the Article 15. 

A Narrative Summary, dated 17 Jul 03, reported no one had yet determined the cause of both episodes of rhabdomyolysis, which were considered idiopathic.  The applicant’s physical exam revealed no additional significant medical findings.  After a lengthy discussion, the applicant decided he did not wish to continue with his military career and would welcome separation.  The Summary noted that, given the past two episodes, it was highly likely there would be future episodes of rhabdomyolysis when he was physically challenged.  The applicant was continued on physical profile.

On 29 Jul 03, a Medical Evaluation Board (MEB) referred the applicant to an Informal Physical Evaluation Board (IPEB) for idiopathic rhabdomyolysis.

On 30 Jul 03, the commander provided his input to the MEB, indicating the applicant was not working in his primary Air Force Specialty Code (AFSC).  The profile restrictions prevented him from working a full shift, impaired his ability to perform his duties, and precluded his deployment.  Further, the applicant was currently awaiting an administrative discharge following a demonstrated pattern of misconduct, pending the results of the MEB.  The commander recommended the applicant be discharged without delay.

In a rebuttal dated 8 Aug 03, the applicant advised he was not performing in his AFSC because of the idiopathic rhabdomyolysis, which curtailed his correctional custody.  He countered the commander’s claim that he was unable to work a full shift or was a “problem child.”  He accepted the fact that he was going to be discharged from the Air Force.

On 25 Aug 03, the IPEB found the applicant’s idiopathic rhabdomyolysis unfitting with a disability rating of 10%.  Discharge with severance pay was recommended.  The applicant agreed with the findings and waived his right to a Formal PEB.  The administrative discharge process against the applicant was terminated.

On 27 Oct 03, the Secretary of the Air Force (SAF) Designee directed the applicant be discharged for physical disability with severance pay in the grade of airman.

On 12 Dec 03, the applicant was honorably discharged for disability with 10% severance pay, after 4 years, 2 months and 20 days of active service.  He was issued an RE code of “2Q” (Personnel medically retired or discharged).

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AFBCMR MEDICAL CONSULTANT EVALUATION:

The Medical Consultant provides details of the applicant’s medical history.  He notes the underlying predisposing reason for recurrent rhabdomyolysis remains unexplained in many individuals after appropriate clinical evaluation. Such individuals are asymptomatic in between episodes and may remain free of problems when not exposed to triggering conditions (hence the applicant’s negative DVA examination).  A single episode of rhabdomyolysis due to unusual causes (extreme heat stress, trauma, serious illness) in the absence of underlying muscle abnormalities or disease may not necessarily be considered unfitting for continued military service.  However, two episodes occurring with exertion and conditions encountered routinely by military members indicate a disqualifying predisposition to recurrent episodes.  The recent normal DVA evaluation confirms the evaluation performed at Walter Reed Army Medical Center, but does not indicate the applicant will not experience recurrent abnormal muscle breakdown, interfering with performance of duties.  A history of even a single episode is disqualifying for enlistment.  Action and disposition in this case were proper and equitable and no change in the records is warranted.

A complete copy of the evaluation is at Exhibit C.

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

A complete copy of the Air Force evaluation was forwarded to the applicant on 10 Jun 06 for review and comment within 30 days.  As of this date, this office has received no response.

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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.  After a thorough review of the evidence of record and the applicant’s submission, we are not persuaded his RE code should be changed to allow reenlistment.  The applicant’s contentions are duly noted; however, we do not find these assertions, in and by themselves, sufficiently persuasive to override the Medical Consultant’s assessment.  The DVA evaluation was noted, but it does not guarantee that the physical stress of military duty would not result in the applicant experiencing recurrent abnormal muscle breakdown.  We believe neither the applicant nor the Air Force should be exposed to this very real risk.  Further, as pointed out by the Medical Consultant, a history of even a single episode is disqualifying for enlistment.  We therefore adopt the rationale expressed as the basis for our decision that the applicant has not sustained his burden of having suffered either an error or an injustice.  In view of the above and absent persuasive evidence to the contrary, we conclude this appeal should be denied.  
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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 this application in Executive Session on 26 Jul 05 under the provisions of AFI 36-2603:

The following documentary evidence relating to AFBCMR Docket Number BC-2004-02366 was considered:

   Exhibit A.  DD Form 149, dated 27 Jul 04, w/atchs.
   Exhibit B.  Applicant's Master Personnel Records.
   Exhibit C.  Letter, AFBCMR Medical Consultant, dated 7 Jun 05.
   Exhibit D.  Letter, SAF/MRBR, dated 10 Jun 05.