RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2011-01350
		COUNSEL:  NONE
		HEARING DESIRED:  NO

_________________________________________________________________

APPLICANT REQUESTS THAT:

Her condition of Factor V Leiden Blood Clotting Disorder and the 
damage she received from thrombus to her right jugular vein be 
reevaluated and categorized as Existed Prior to Service (EPTS)-
Service Aggravated.  
_________________________________________________________________

APPLICANT CONTENDS THAT:

She believes her line of duty (LOD) determination was not taken 
seriously because she was a Reservist that was getting ready to 
retire.  Her LOD consideration was to include damage from 
thrombus which occurred to her right jugular vein.  She now has 
Post Phlebotic Syndrome because the vein was stretched out.  Her 
original blood clot was from a mutation called Factor V Leiden, 
but her condition worsened by the size of the clot, which caused 
her vein to be enlarged.  This has caused constant pain that is 
not getting any better.  She would like her LOD to follow normal 
procedures and be looked at seriously.  

In support of her appeal, the applicant provides copies of the 
Informal LOD Determinations; extended active duty orders; DD Form 
214, Certificate of Release or Discharge from Active Duty; 
civilian and military medical records; electronic communications; 
and a personal memorandum.  

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

_________________________________________________________________

STATEMENT OF FACTS:

The applicant is a former member of the Air Force Reserve (AFRES) 
who retired in the grade of master sergeant (E-7).  According to 
the Informal LOD Determinations, dated 1 June 2010 and 14 June 
2010, the applicant’s condition of Factor V Leiden Mutation was 
found to be “EPTS-LOD not applicable” due to the fact the 
applicant’s condition was genetic and clearly pre-existed prior 
to service.  Therefore, the LOD consideration was cancelled.  

_________________________________________________________________



AIR FORCE EVALUATION:

AFRC/SGP recommends denial.  SGP states that an Informal LOD was 
cancelled by the Readiness Management Group (RMG) on 30 June 
2010.  There was no evidence provided indicating the applicant’s 
genetic and clearly pre-existing condition was permanently 
worsened beyond natural progression as a result of her military 
duties.  A formal review by the Headquarters Air Force Reserve 
Command LOD Board medical and legal officers was never 
accomplished due to this case being cancelled.  

The complete SGP evaluation is at Exhibit B.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

She understands that Factor V Leiden Blood Clotting Disorder is 
hereditary, but the LOD should be about the damage the blood clot 
caused, not because of the Factor V Leiden Blood Clotting 
Disorder.  She is at high risk for blood clots and is now 
currently taking 12 milligrams of Warfarin daily to keep her 
blood running thin and to prevent another mishap like the one 
that happened while she was on active duty.   

The applicant’s complete rebuttal is at Exhibit D.

_________________________________________________________________

BCMR MEDICAL CONSULTANT’S EVALUATION:

The BCMR Medical Consultant recommends granting the applicant 
relief in the form of assigning a finding of in-the-line-of-duty 
(ILOD) for her secondary condition of Post-Phlebitic Syndrome and 
venous insufficiency of the right internal jugular vein.  The 
BCMR Medical Consultant acknowledges that the applicant’s Factor 
V Leiden mutation is genetic in origin which, by definition, is 
considered to have existed prior to service.  However, with 
respect to the applicant’s claimed diagnosis of Post-Phlebitic 
[or Phlebotic] Syndrome, the BCMR Medical Consultant opines that, 
but not for the venipuncture that resulted in thrombophlebitis in 
the right upper extremity (site of attempted blood collection), 
the applicant may not have developed the internal jugular vein 
thrombosis; given there was no direct precipitating trauma to her 
internal jugular or subclavian veins, as may occur with central 
vein catheterization, infection, or an indwelling venous line.  
Additionally, the fact the applicant was pregnant with twin 
gestations introduced an additional factor contributing to her 
hypercoagulable state.  Thus, while the applicant’s Factor V 
Leiden mutation is clearly EPTS her newly diagnosed 
thrombophlebitis, which initially involved only the right upper 
extremity, but which has been implicated in the clot development 
within her right internal jugular vein, should be considered a de 
novo service-incurred event with the resultant sequalae of 
residual Post-Phlebitic Syndrome with venous insufficiency, as 
demonstrated on duplex ultrasound.  

The complete BCMR Medical Consultant’s evaluation, with 
attachment, is at Exhibit E.

_________________________________________________________________

APPLICANT'S REVIEW OF BCMR MEDICAL CONSULTANT’S EVALUATION:

She agrees with the BCMR Medical Consultant’s findings and 
recommendation.  

The applicant’s complete response to the BCMR Medical 
Consultant’s evaluation is at Exhibit F.

_________________________________________________________________

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.  After 
considering the totality of the evidence before us, the Board 
agrees with the opinion by the BCMR Medical Consultant that 
although the applicant’s condition of Factor V Leiden Blood 
Clotting Disorder is a genetic disorder and existed prior to 
service, her secondary condition of Post-Phlebitic Syndrome and 
venous insufficiency was more than likely caused by a 
venipucture that resulted in thrombophlebitis of the right 
jugular vein and should be considered service-incurred.  
Therefore, in the interest of equity and justice, we recommend 
the applicant’s records be corrected as indicated below.

_________________________________________________________________

THE BOARD RECOMMENDS THAT:

The pertinent military records of the Department of the Air Force 
relating to APPLICANT be corrected to show that on 30 June 2010 
her condition of Post-Phlebitic Syndrome and venous insufficiency 
of the right internal jugular vein was found to be service-
connected and in the line of duty.  

_________________________________________________________________



The following members of the Board considered this application in 
Executive Session on 9 February 2011, under the provisions of AFI 
36-2603:

	, Panel Chair
	, Member
	, Member


All members voted to correct the records, as recommended.  The 
following documentary evidence for AFBCMR Docket Number BC-2011-
01350 was considered:

      Exhibit A.  DD Form 149, dtd 29 Mar 11, w/atchs.
	Exhibit B.  Letter, AFRC/SG, dtd 13 Sep 11.
	Exhibit C.  Letter, SAF/MRBR, dtd 28 Oct 11.
	Exhibit D.  Letter, Applicant, dtd 7 Nov 11.
      Exhibit E.  Letter, BCMR Medical Consultant, dtd 24 Jan 12, 
        w/atch.
	Exhibit F.  Email, Applicant, dtd 26 Jan 12.




								
								Panel Chair

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