MEMORANDUM OF CONSIDERATION

	IN THE CASE OF:   

	BOARD DATE:            23 March 2000                  
	DOCKET NUMBER:   AR1999028347

	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. Edmund P. Mercanti		Analyst	

  The following members, a quorum, were present:

	Ms. Shirley L. Powell		Chairperson	
	Mr. Roger W. Able		Member	
	Mr. James E. Anderholm		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:  That his discharge for physical disability, existing prior to service (EPTS), be corrected to a medical retirement.

APPLICANT STATES:  He had served on active duty for almost 6 continuous years and was physically sound when he initially enlisted.  The VA has awarded him a 70 percent disability for the same condition that the Army has classified EPTS.

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

He enlisted in the Regular Army on 11 June 1991, was awarded the military occupational specialty (MOS) of Patriot Missile Crewmember, and was promoted to pay grade E-4.

On 3 January 1995, then having less than 4 years of continuous active service, the applicant experienced a sudden onset headache with neck stiffness.  He was hospitalized and treated for a subarachnoid hemorrhage caused by a communicating artery aneurysm.

Subsequent to his surgery and convalescence he noted several problems which didn’t improve, including short term memory loss, impaired learning of new information, headaches, anxiety, depression and insomnia.  He later began to experience seizures, which were controlled by medication.

On 30 October 1996 a Physical Evaluation Board (PEB) was convened and determined that the applicant was physically unfit but that the unfitting condition was EPTS and not service aggravated.  Based on those findings the PEB recommended that he be discharged without disability benefits.

The applicant submitted a rebuttal to those findings and recommendation and demanded a formal hearing.  In response to the rebuttal the medical member of the informal PEB made a memorandum for record in which he stated that in the conduct of the applicant’s PEB the chief of the neuropathology at the Armed Forces Institute of Pathology had been questioned concerning the origin of subarachnoid hemorrhage caused by a communicating artery aneurysm.  The chief of neuropathology had stated that aneurysms of the cerebral circulation are considered as congenital developmental anomalies of the muscular layer of arteries and, as such, are EPTS in nature.  Rupture of these aneurysms are not an unexpected medical sequela of the condition and is one avenue of the natural progression of the disease.

Since the informal PEB determined that its findings and recommendation were appropriate, the applicant’s case was referred to a formal PEB which was convened on 3 December 1996.  The formal PEB made the same findings and recommendation as the informal PEB.  The applicant appealed the formal PEB’s findings and added a memorandum from one of the neurosurgery consultants to The Surgeon General which stated that the accepted medical principle of an aneurysm being congenital has been called into serious question by notable medical authorities, with the suggestion that aneurysms may be formed as a result of a combination of different factors, of which hemodynamic stress is very important.  The consultant to The Surgeon General opined that the PEB’s erred in their finding that the applicant’s condition was EPTS.

The applicant’s appeal was apparently disapproved and he was discharged for physical disability EPTS on 23 March 1997.

Army Regulation 635-40, paragraph 3-2, specifies that a presumption will be made that a soldier was in sound physical and mental condition upon entering active service except for physical disabilities noted and recorded at the time of entry, and that any disease or injury discovered after a soldier entered active service, with the exception of congenital and hereditary conditions, that was not due to the member’s own misconduct, will be considered in line of duty.  Paragraph 4-19b of this regulation states that a physical evaluation board (PEB) may decide that a soldier’s physical defect was EPTS, but must then determine whether the condition was aggravated by military service.  If the PEB determines that a soldier has an unfitting EPTS condition which was service aggravated, the PEB must determine the degree of disability that is in excess of the degree existing at the time of entrance into the service.  The method of determining the percentage of disability to be awarded in such cases is outlined in appendix B, item B-10 of this regulation. 

The Merck Manual of Diagnosis and Therapy, Subarachnoid Hemorrhage, states that hemorrhage from aneurysm usually arises from outpouchings at arterial bifurcations at or near the base of the brain, points where the muscular coat is poorly developed, thus predisposing to aneurysm formation.

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

1.  The applicant’s physical disability stemmed from a condition which is listed in the Merck Manual as congenital.

2.  While the applicant has submitted an opposing point of view from a notable medical authority, there are always opposing points of view in medical matters.  That is why the term “accepted medical principle” is used by physicians.  The PEB’s have no choice but to use accepted medical principles in the absence of some evidence which would show that the medical principle was not applicable in that particular case.

3.  The applicant is a little misleading in his statement that he had almost 6 years of continuous active service and, therefore, should be medically retired.  While he had 5 years, 9 months and 13 days of continuous active service when he was discharged, he had less than 4 years of continuous active service when he had his aneurysm.

4.  The Board is empathetic towards the applicant’s situation, but does not see any error or injustice in which to base a recommendation to change his records.  The Board is heartened that the VA, which has more flexibility in the laws governing granting physical disability compensation than does the military, have seen fit to grant the applicant a disability rating for his medical condition.

5.  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

_slp_____  __rwa___  _jea_____  DENY APPLICATION

						Karl F. Schneider
						Director, Army Review Boards Agency

INDEX

CASE ID	AR1999028347 	
SUFFIX		
RECON	YYYYMMDD	
DATE BOARDED	20000323	
TYPE OF DISCHARGE	(HD, GD, UOTHC, UD, BCD, DD, UNCHAR)	
DATE OF DISCHARGE	YYYYMMDD	
DISCHARGE AUTHORITY	AR .  .  .  .  .  	
DISCHARGE REASON		
BOARD DECISION	DENY	
REVIEW AUTHORITY		
ISSUES         1.	108.05	
2.		
3.		
4.		
5.		
6.