SYSTEM NAME:

Medical Assignment Limitation Record System  (March 18, 2011,  76 FR 14951)

SYSTEM LOCATION:

Headquarters Air Force Personnel Center, Medical Service Officer Management Division, Medical Retention Standards Branch, 550 C Street West, Randolph Air Force Base, TX 78150-4727.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:

All active duty Air Force members who develop, as determined by the local Deployment Availability Working Group, a medical condition that may warrant placement on an Assignment Limitation Code (ALC) in Military Personnel Data System (MilPDS). This includes all cases presented to a Medical Evaluation Board or Physical Evaluation Board that were returned to duty and therefore considered for an ALC. An ALC flags the member in MilPDS as medical waiver required for deployments and overseas assignments.

CATEGORIES OF RECORDS IN THE SYSTEM:

Medical Evaluation and Physical Evaluation Board packages, Report of Medical Examination, Report of Medical History, Narrative Summary, Armed Forces Health Longitudinal Technology Application (AHLTA) medical record documentation, Clinical Record Consultation Sheet, Electrocardiographic Record, Pulmonary Function Testing reports, laboratory results, commander letters, Deployment Availability Working Group summary. Personally identifiable information included in the above records includes name, Social Security Number (SSN), and date of birth.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:

10 U.S.C. 8013, Secretary of the Air Force; Air Force Instruction 36-3212, Physical Evaluation for Retention, Retirement and Separation; and Air Force Instruction 36-2110, Assignments and E.O. 9397 (SSN), as amended.

PURPOSE(S):

Collect applicable medical information and commander input to determine appropriate medical Assignment Limitation Code (ALC).

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES OF USERS AND THE PURPOSES OF SUCH USES:

In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, these records contained therein, may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:

The DoD ‘Blanket Routine Uses’ published at the beginning of the Air Force’s compilation of systems of records notices apply to this system.

NOTE: This system of records contains individually identifiable health information. The DoD Health Information Privacy Regulation (DoD 6025.18-R) issued pursuant to the Health Insurance Portability and Accountability Act of 1996, applies to most such health information. DoD 6025.18-R may place additional procedural requirements on the uses and disclosures of such information beyond those found in the Privacy Act of 1974 or mentioned in this system of records notice.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, AND DISPOSING OF RECORDS IN THE SYSTEM:

STORAGE:

Maintained in hardcopy file folders and electronic storage media.

RETRIEVABILITY:

Electronic and hardcopy files are retrieved by last name and last four digits of Social Security Number (SSN).

SAFEGUARDS:

Records are accessed by person(s) responsible for servicing the record system in performance of their official duties. Records are stored in locked rooms and cabinets and electronic records are accessible by use of the Common Access Card (CAC) and site specific login.

RETENTION AND DISPOSAL:

Retained in office files for two years or when no longer needed for reference, then destroyed by tearing into pieces, shredding, pulping, macerating, burning, or deleting.

SYSTEM MANAGER(S) AND ADDRESS:

Headquarters Air Force Personnel Center, Medical Service Officer Utilization Division, Chief, Medical Retention Standards Branch, Randolph Air Force Base, TX 78150-4727.

NOTIFICATION PROCEDURE:

Individuals seeking to determine whether this system of records contains information on themselves should address written inquiries to Headquarters Air Force Personnel Center, Medical Service Officer Management Division, Chief, Medical Retention Standards Branch, Randolph Air Force Base, TX 78150-4727.

For verification purposes, individual should provide their full name, Social Security Number (SSN), any details, which may assist in locating records, and their signature.

In addition, the requester must provide a notarized statement or an unsworn declaration made in accordance with 28 U.S.C. 1746, in the following format:

If executed outside the United States: ‘I declare (or certify, verify, or state) under penalty of perjury under the laws of the United State of America that the foregoing is true and correct. Executed on (date). (Signature)’.

If executed within the United States, its territories, possessions, or commonwealths: ‘I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on (date). (Signature)’.

RECORD ACCESS PROCEDURES:

Individuals seeking to access records about themselves contained in this system should address written requests to Headquarters Air Force Personnel Center, Medical Service Officer Utilization Division, Chief, Medical Retention Standards Branch, Randolph Air Force Base, TX 78150-4727.

For verification purposes, individual should provide their full name, Social Security Number (SSN), any details which may assist in locating records, and their signature.

In addition, the requester must provide a notarized statement or an unsworn declaration made in accordance with 28 U.S.C. 1746, in the following format:

If executed outside the United States: ‘I declare (or certify, verify, or state) under penalty of perjury under the laws of the United State of America that the foregoing is true and correct. Executed on (date). (Signature)’.

If executed within the United States, its territories, possessions, or commonwealths: ‘I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on (date). (Signature)’.

CONTESTING RECORD PROCEDURES:

The Air Force rules for accessing records and for contesting contents and appealing initial agency determinations are published in 32 CFR part 806b, Air Force Instruction 33-332, Air Force Privacy Program and may be obtained from the system manager.

RECORD SOURCE CATEGORIES:

Information obtained from military and civilian medical institutions and correspondence as related to board proceedings.

EXEMPTIONS CLAIMED FOR THE SYSTEM:

None.

FEDERAL REGISTER HISTORY: