MEMORANDUM OF CONSIDERATION

	IN THE CASE OF:         

	BOARD DATE:              26 May 1999
	DOCKET NUMBER:     AC98-05967
				     AR1999024200

	I certify that hereinafter is recorded the record of consideration of the Army Board for Correction of Military Records in the case of the above-named individual.

	Mr. Loren G. Harrell		Director	
	Ms. Joyce A. Wright		Analyst	

  The following members, a quorum, were present:

	Mr. Mark D. Manning		Chairperson	
	Mr. Arthur A. Omartian		Member	
	Ms. Barbara J. Ellis		Member	

	The Board, established pursuant to authority contained in 10 U.S.C. 1552, convened at the call of the Chairperson on the above date.  In accordance with Army Regulation 15-185, the application and the available military records pertinent to the corrective action requested were reviewed to determine whether to authorize a formal hearing, recommend that the records be corrected without a formal hearing, or to deny the application without a formal hearing if it is determined that insufficient relevant evidence has been presented to demonstrate the existence of probable material error or injustice.

	The applicant requests correction of military records as stated in the application to the Board and as restated herein.

	The Board considered the following evidence:

	Exhibit A - Application for correction of military 
                records
	Exhibit B - Military Personnel Records (including
	            advisory opinion, if any)

APPLICANT REQUESTS:  Correction of her records to show her condition as Post Traumatic Stress Disorder (PTSD) instead of “schizophrenia” and, in effect, to increase her Army disability rating from 30 percent to 100 percent based on her Department of Veterans Affairs (DVA) service connected disability rating of 100 percent.

APPLICANT STATES:  That Schizophrenia is a hereditary condition and that no one in her family has any history of this disorder.  She also states that she has been diagnosed with PTSD due to her experiences in Vietnam and has been rated 100% disabled by the VA for this condition.  She further states that her private physician clearly missed her diagnosis of PTSD.  She concludes by stating that she has tolerated this misdiagnosis for nearly 25 years and would like her records corrected.  In support of her application she submits a copy of her VA Rating Decision dated 20 February 1997, statement from her private physician dated 2 December 1996 and a copy of a progress report from the VA Medical Center in Durham, North Carolina dated 7 February 1997.  All documents submitted by the applicant including rebuttal were provided to the Board.

EVIDENCE OF RECORD:  The applicant's military records show:

On 5 September 1968 she was appointed as a Reserve commissioned officer in the Army Nurse Corps and was called to active duty on duty on 23 September 1968.  She was promoted to the rank of captain on 23 September 1970.

The applicant underwent a Medical Evaluation Board (MEB) medical examination on 15 September 1972 and was found not fit for duty with a 111114 physical profile.  The examination indicated that the applicant had a peripheral vasculitis (inflammation of a vessel) of the lower extremities and was schizophrenic (a mental condition). 

On 6 October 1972, the applicant’s case was considered by a MEB with her present and she was diagnosed with schizophrenia, undifferentiated, moderate, chronic with acute exacerbation manifested by ideas of reference, grandiose ideas, paranoid ideation and destruction fantasies; stress, minimal, routine military duty in a noncombat zone; predisposition, undetermined; impairment for further military duty, marked; impairment for social and industrial adaptability, definite.  The applicant was also diagnosed with an infected sebaceous cyst, left axilla (a fatty cyst in her left armpit) and resolving; nonspecific vasculitis, manifested clinically as erythema nodosm (an acute inflammatory skin rash), local, lower extremities.  

The MEB unanimously recommended that the patient be referred to a Physical Evaluation Board (PEB) because she was not fit to continue on active duty and should be processed for separation.  The applicant indicated that she did not want to continue on active duty.  The MEB results were approved on 11 October 1972 and she was advised of the findings of the MEB on 19 October 1972.  

On 24 October 1972 the applicant’s case was considered by an informal PEB which convened at Walter Reed Army Medical Center.  The PEB found MEB diagnosis 1 (Schizophrenia, chronic, undifferentiated type; definite) and MEB diagnosis 3 (nonspecific vasculitis, manifested clinically as erythema nodosum, lower extremities, without evidence of collagen vascular or auto-immune disease; slight) as unfitting.  MEB diagnosis 2 was considered, but found not ratable.  The PEB found the applicant unfit and recommended a combined rating of 30 percent and placement of the individual on the Temporary Disability Retired List (TDRL) with reexamination during April 1974.  The applicant concurred with the finding of the PEB and waived formal hearing of her case on 25 October 1972.

She continued to serve until she was honorably released from active duty on 17 November 1972 and was placed on the TDRL in accordance with Title 10 USC Section 1202.  She had a total of 4 years, 1 month, and 25 days of creditable service.

On 12 April 1974, the applicant underwent a TDRL medical evaluation, which determined that the diagnosed schizophrenia impaired her for further military duty and there was no further need for current treatment of her diagnosed vasculitis.  The evaluating physician, a psychiatrist, recommended the applicant’s “Temporary medical retirement be made permanent as she is not fit for duty under AR 40-501.”  The reviewing authority approved the recommendation on 18 April 1974.

The applicant’s case was considered by a PEB convened on 11 June 1974 at Fort Gordon, Georgia.  The PEB found her schizophrenic condition as 10 percent disabling and vasculitis condition as “inactive” with no rating.  This PEB found the applicant unfit and recommended that she be separated from the service with severance pay.

On 20 June 1974, an addendum to the TDRL medical examination was prepared.  In summary, this addendum addressed the applicant’s condition as tenuous line “between intensive outpatient therapy and necessitating repeated inpatient hospitalization”.  The physician recommended return of the TDRL evaluation to the PEB for review, that the applicant be retained on the TDRL for another 18 month period and the next TDRL examination be conducted at the Naval Regional Medical Center where she is under going therapy.

Another PEB was convened at Fort Gordon, Georgia on 24 June 1974 to reconsider the TDRL examination of 18 April 1974 and the 20 June 1974 addendum.  The PEB found the applicant unfit and recommended retention on the TDRL with reexamination during December 1975.  In its remarks, the PEB stated that the applicant’s condition had not stabilized and recommended that she be retained on the TDRL and reexamined at a later date.  The applicant was notified by mail of the PEB’s decision.

The applicant underwent a TDRL medical examination on 3 December 1975.
This evaluation found her condition of chronic, undifferentiated schizophrenia in “tenuous remission”, stress; minimal and impairment for further military duty is total.  The psychiatrist recommended that the applicant’s temporary medical retirement be made permanent, as she is not fit for duty.  The evaluation was approved.  

On 22 December 1975, the applicant’s case was reconsidered by an informal PEB, which convened once again at Fort Gordon, Georgia.  The PEB found her schizophrenic condition as 30 percent disabling.  The PEB found the applicant unfit and recommended a combined rating of 30 percent and that she be permanently retired from the service.  In its remarks the PEB concurred and stated that her current evaluation indicated little change in her condition and recommended permanent retirement

On 9 January 1976, the U.S. Army Physical Disability Agency reviewed and approved the recommendations of the PEB.  On 29 February 1976, the applicant was removed from TDRL and was placed on the on the Permanent Disability Retired List (PDRL) on 1 March 1976 with 30 percent disability.

Immediately after the applicant had been discharged and placed on the TDRL, she filed a claim with the Department of Veterans Affairs (DVA) on 18 November 1972 for service-connected disability for schizophrenia, undifferentiated type and nonspecific vasculitis, lower extremities.  On 15 March 1973, the DVA rated her 30 percent disabled for schizophrenia and 0 percent for nonspecific vasculitis for a combined rating of 30 percent 

The applicant reapplied to the DVA on 11 January 1983 for an increase in compensation for undifferentiated schizophrenia and nonspecific vasculitis.  The DVA denied increase in compensation on 1 August 1983.

The applicant once again reapplied to DVA for an increase in compensation on 29 October 1996 for her PTSD condition and nonspecific vasculitis, lower extremities.  She was awarded 100% disability for PTSD and 0% for her vasculitis, lower extremities, on 21 February 1997.

The applicant submitted an appeal to the Board of Veterans (BVA) on 29 October 1997 for a service connected disability for “delayed stress”.  However, the applicant’s case is currently under review.

In the processing of this case, a staff advisory opinion (COPY ATTACHED) was obtained from the Department of the Army Review Board (DARBA) medical advisor.  A copy of the advisory opinion was forwarded to the applicant on 9 December 1998.  She responded on 30 January 1998 by submitting essentially copies of the same documents, which accompanied her application.  

The medical advisor indicated that after a complete and careful review of all medical records submitted, especially the Medical Board Narrative Summary (NARSUM) of 13 August 1972, TDRL NARSUM of 18 April 1974 and 3 December 1975, that there was no medical indication to change the current diagnosis.  He also indicated that the various narrative summaries do not stipulate the required stressor of extreme nature that is the diagnostic criteria for PTSD.  The MEB NARSUM enumerates several life stressors.  To wit: “Patient appears quite concerned that she may have a fatal illness and a collagen vascular disease such as polyarteritis.”  At this time the patient relates that she found that in her records there were some poor efficiency reports on her which she felt were incorrect.”  He further indicated that she expressed frequent anger at Army policies.”  None of the documented stressors satisfy the diagnostic criteria for nor warrant a diagnosis of PTSD.  The medical advisor concludes by indicating that “Per DSM-IV (Diagnostic Manual of Mental Disorders-4th Ed), the diagnosis of schizophrenia, undifferentiated, moderate, chronic is appropriate.”

Title 38, United States Code, sections 310 and 331, permits, the VA to award compensation for a medical condition which was incurred in or aggravated by active military service.  The VA, however, is not required by law to determine medical unfitness for further military service.  The VA, in accordance with its own 
policies and regulations, awards compensation solely on the basis that a medical condition exists and that said medical condition reduces or impairs the social or industrial adaptability of the individual concerned.  Consequently, due to the two concepts involved, an individual's medical condition, although not considered medically unfitting for military service at the time of processing for separation, discharge or retirement, may be sufficient to qualify the individual for VA benefits based on an evaluation by that agency.

Title 10, United States Code, chapter 61, provides disability retirement or separation for a member who is physically fit to perform the duties of his officer, rank, grade or rating because of disability incurred while entitled to basic pay.

Title 10, United States Code, section 1201, provides for the physical disability retirement of a member who has impairment rated at least 30 percent disabling.

Army Regulation 40-501, at paragraph 3-3a, provided, in pertinent part, that performance of duty despite impairment would be considered presumptive evidence of physical fitness.

Army Regulation 40-501, chapter 7, physical profiling, provides that the basic purpose of the physical profile serial system is to provide an index to the overall functional capacity of an individual and is used to assist the unit commander and personnel officer in their determination of what duty assignments the individual is capable of performing, and if reclassification action is warranted.  Four numerical designations (1-4) are used to reflect different levels of functional capacity in six factors (PULHES): P-physical capacity or stamina, U-upper extremities, L-lower extremities, H-hearing and ears, E-eyes, and S-psychiatric.  Numerical designator "4" indicates that an individual has one or more medical conditions or physical defects of such severity that performance of military duty must be drastically limited.  The numerical designator "4" does not necessarily mean that the individual is unfit because of physical disability as defined in Army Regulation 635-40.

Army Regulation 635-40, paragraph 2-2b, as amended, provides that when a member is being separated by reason other than physical disability, his continued performance of duty creates a presumption of fitness which can be overcome only by clear and convincing evidence that he was unable to perform his duties or that acute grave illness or injury or other deterioration of physical condition, occurring immediately prior to or coincident with separation, rendered the member unfit.

Army Regulation 635-5 serves as the authority for the preparation and issuance of the DD Form 214.  It states, in pertinent part, that a DD Form 214 will be issued to each individual discharged, retired or placed on the Temporary Disability Retired List (TDRL).  It further states that a DD Form 214 will not be issued to personnel who are being removed from the TDRL.

DISCUSSION:  Considering all the evidence, allegations, and information presented by the applicant, together with the evidence of record, applicable law and regulations, and advisory opinion(s), it is concluded:

1.  The applicant was properly retired by reason of temporary disability and placed on the TDRL.  Accordingly, her DD Form 214 was properly prepared in accordance with applicable regulations in effect at the time.

2.  The Board noted the applicant’s contentions that schizophrenia is a hereditary condition and that she was diagnosed with PTSD due to her experiences in Vietnam and has been rated 100% disabled by the DVA for this condition.  However, these contentions are not a basis for changing her DD Form 214 since that document does not refer to the medical condition in question.

3.  After a thorough review of the aforementioned summaries, the Medical Advisor concluded that the diagnosis of schizophrenia, undifferentiated, moderate, chronic was appropriate at that time.
4.  The Army Board for Correction of Military Records was created to correct errors and injustices in the military records of both active duty and former service members.  However, it is not the policy of the Board to create or alter service medical records.  Because such records merely reflect the observations and opinions of medical examiners at the time they were recorded.  The applicant’s official medical records were constructed by competent medical authorities to reflect the applicant’s medical condition while she was on active duty and during the MEB and PEB processes.  Therefore, this Board finds no basis to change the applicant’s medical records.

5.  Records provided indicate that he VA, some 20 years after the applicant’s retirement, has awarded her for a medical condition that did not exist at the time of her medical retirement, which that agency has determined to be related to military service.  However, that rating action by the VA does not necessarily demonstrate any error or injustice on the part of the Army.  The VA, operating under its own policies and regulation, assigns disability ratings as it sees fit.  Any rating action by the VA does not necessarily constitute an error or injustice on the part of the Department.

6.  In order to justify correction of a military record the applicant must show to the satisfaction of the Board, or it must otherwise satisfactorily appear, that the record is in error or unjust.  The applicant has failed to submit evidence that would satisfy the aforementioned requirement.

7.  In view of the foregoing, there is no basis for granting the applicant's request.

DETERMINATION:  The applicant has failed to submit sufficient relevant evidence to demonstrate the existence of probable error or injustice.

BOARD VOTE:

________  ________  ________  GRANT

________  ________  ________  GRANT FORMAL HEARING

MDM____  AAO____  BJE_____  DENY APPLICATION

						Loren G. Harrell
						Director

INDEX

CASE ID	AR1999024200	
SUFFIX		
RECON	YYYYMMDD	
DATE BOARDED	19990526	
TYPE OF DISCHARGE	HD	
DATE OF DISCHARGE	19721117	
DISCHARGE AUTHORITY	AR .  .  .  .  .  	
DISCHARGE REASON		
BOARD DECISION	DENY	
REVIEW AUTHORITY		
ISSUES         1. 179		
2.		
3.		
4.		
5.		
6.