MEMORANDUM OF CONSIDERATION

	IN THE CASE OF:   

	BOARD DATE:           20 July 2000                   
	DOCKET NUMBER:   AR2000035846

	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. Carl W. S. Chun		Director	
	Mr. Robert J. McGowan		Analyst	

  The following members, a quorum, were present:

	Mr. Samuel A. Crumpler 		Chairperson	
	Ms. Ann M. Campbell 		Member	
	Mr. Kenneth L. Wright 		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 he be allowed to retroactively enroll in the Continued Health Care Benefit Program (CHCBP) as of his separation date of 24 January 1998, or alternatively, that the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) cover his medical expenses for the period 8-13 February 1998.

APPLICANT STATES:  In effect, that he voluntarily separated on 24 January 1998.  He states that the Preseparation Guide he received was confusing and he did not understand that portion dealing with his health insurance options.  On 8 February 1998, he became ill and was admitted to the hospital where he was diagnosed with multiple sclerosis.  He was released from the hospital on 13 February 1998 with medical bills of approximately $13,000.  During his hospitalization, his mother contacted an official at Fort Sam Houston, Texas, on 11 February 1998 and was assured that the applicant had health insurance coverage.  Later, after it was too late to apply for CHCBP coverage, he found out that he did not have transitional health care coverage and that CHAMPUS would not pay his medical expenses.  He argues that, had he been properly informed at the time of his illness, he would have applied for CHCBP coverage.

In support of his application, he submits a photograph of himself and his wife, a statement of facts, affidavits for himself and his mother, copies of medical bills, portions of DA Pam 635-4, Preseparation Guide, and a letter from his father-in-law.

COUNSEL CONTENDS:  Essentially, as stated above; however, she adds that the Preseparation Guide outlining benefits was ambiguous and that the applicant was misinformed by an official of the Army.

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

He graduated from West Virginia University and was commissioned as a second lieutenant on 17 December 1993.  He entered on active duty on 24 January 1994 as a gold bar lieutenant at the University of West Virginia with a 4-year commitment.

Following completion of all required military training, the applicant was assigned to an infantry unit at Fort Drum, New York.  He served at Fort Drum until his voluntary separation from active duty on 24 January 1998.

In preparation for his release from active duty, the applicant received a copy of DA Pam 635-4.  Chapter 6 of that pamphlet dealt with health and life insurance matters.  It emphasized the criticality of health insurance planning and offered the following information.

“If you are separating involuntarily (emphasis added) or through 
the Special Separation Benefit (SSB) or Voluntary Separation Incentive (VSI) programs, the transitional health care system looks like this:”

-	“After you separate:  You and your family . . . may use the CHAMPUS health care plan . . . for 60 days [if you served fewer than 6 years] transitional health care.”

-	“Once your initial Transitional Health Care ends:  After this 60-day period, you and your family are no longer eligible [for the] CHAMPUS health care plan.  However, you may purchase extended transitional health care insurance [CHCBP] for up to 18 months of coverage.”

-	“If you separate voluntarily [emphasis added] without SSB or VSI, you and your family are not eligible for . . . the CHAMPUS health care plan.  However, you may purchase extended transitional health care insurance (CHCBP) for up to 18 months of coverage.  You have 60 days [emphasis added] after separation to enroll in CHCBP.  Your coverage will start the day after your separation.”

The applicant, upon separation, returned to his hometown in Ohio and accepted employment on 1 February 1998 with health insurance benefits to commence on 1 March 1998.  On 8 February 1998, he fell ill and was admitted to a hospital where he was diagnosed with multiple sclerosis.  He was discharged from the hospital on 13 February 1998.

During the applicant’s hospitalization, his mother contacted the Army at Fort Drum to inquire about his health care coverage.  She was referred to an official at Fort Sam Houston, Texas, and spoke with him on 11 February 1998.  The official queried the Defense Enrollment Eligibility Reporting System (DEERS) which still listed the applicant as an active duty soldier, thus eligible for CHAMPUS benefits. The official contends that the applicant’s mother did not state that the applicant had been separated and so he told her that her son was covered.

Apparently believing that he was covered by the no cost 60-day transitional health care program, the applicant did not purchase the fee-based CHCBP and the 60-day enrollment window expired.  Later, CHAMPUS refused to pay the applicant’s medical bills citing his ineligibility for CHAMPUS benefits.

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

1.  The applicant voluntarily separated from active duty upon completion of his 
4-year active duty commitment.  The Preseparation Guide which he was given clearly states that a soldier who voluntarily separates from active duty is not eligible for the no cost, 60-day transitional health care program.  It further states that a voluntary separatee may purchase up to 18 months of the CHCBP within 60 days of separation.

2.  The applicant’s mother contacted an Army official at Fort Sam Houston concerning her son’s health care benefits, but omitted the fact that her son was recently separated.  The official queried the DEERS system which showed that the applicant was still an active duty soldier.  Unfortunately, the DEERS system is not a real-time system and the applicant’s status change of 24 January 1998 had not been posted.  Given the circumstances, the official provided the most accurate response possible.

3.  The Board finds this entire situation regrettable.  The applicant was an intelligent young officer with an excellent record and an outstanding future in the Army.  He chose to voluntarily separate and was provided with information concerning a host of benefits and entitlements, to include transitional health care benefits.  The Board finds the language of DA PAM 635-4 clear, concise and unambiguous, and places the responsibility for understanding it clearly on the applicant.  His argument that he did not understand the health care provisions of the pamphlet is not persuasive.

4.  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

__sac___  __amc___  __klw____  DENY APPLICATION

		    Carl W. S. Chun
		    Director, Army Board for Correction
    of Military Records

INDEX

CASE ID	AR2000035846	
SUFFIX		
RECON		
DATE BOARDED	20000720	
TYPE OF DISCHARGE		
DATE OF DISCHARGE		
DISCHARGE AUTHORITY		
DISCHARGE REASON		
BOARD DECISION	DENY	
REVIEW AUTHORITY	DIRECTOR	
ISSUES         1.	136.0700	
2.		
3.		
4.		
5.		
6.