MEMORANDUM OF CONSIDERATION

	IN THE CASE OF:    

	BOARD DATE:           9 October 2003                  
	DOCKET NUMBER:   AR2003087261

	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. Edmund P. Mercanti		Analyst	

  The following members, a quorum, were present:

	Mr. Raymond V. O'Connor, Jr.		Chairperson	
	Mr. Robert J. Osborn, II		Member	
	Ms. Eloise C. Prendergast		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:  Through counsel, that her discharge for physical unfitness, rated 20 percent disabled, be corrected to placement on the Retired List, preferably properly rated at 70 percent disabled, but rated at least 30 percent disabled in the alternative.

In a second application, counsel requests that the applicant be given incapacitation pay for the periods 19 September 1997 through 14 February 1998, and 11 December 1998 through 27 March 2000.

APPLICANT STATES:  Through counsel, that she was injured on 11 July 1997 when the aircraft in which she was a passenger plunged hundreds to a thousand feet due to turbulence.  She was on a 139 day tour of active duty and flying on official duty.  In that incident she injured her back, legs, arms, right shoulder, neck, lumbar, spine, rib cage and ankle/foot area.  These injuries also resulted in her developing stress urinary incontinence.

When the applicant was being boarded by a formal Physical Evaluation Board (PEB), her counsel’s request for a continuance so the applicant could have another physical examination was denied.  Counsel’s subsequent request to continue the proceedings until an already scheduled physical examination was conducted was also denied.  When the already scheduled physical examination was conducted, the applicant was diagnosed as suffering from both myofascial pain syndrome and fibromyalgia (which are different names for the same condition).  However, the Physical Disability Agency (PDA) ignored the new diagnosis because it was then committed to the findings of the formal hearing.

Counsel argues that the PDA arbitrarily and capriciously relied on a statement by a physical therapist that the applicant “will continue to be functionally independent as long as she continues her exercises” when it determined that she was only 20 percent disabled.  Counsel also argues that the PDA made its determination that the applicant’s foot/ankle injury was zero percent disabling based solely on a comment made by the applicant’s physician that she was wearing traditional footwear.  This determination does not take into consideration that the applicant injured her foot three times while on active duty, that her walking is now limited and painful, and that she must wear orthotics and special shoes for the rest of her life.

Counsel also contends that the applicant should have been rated for stress urinary incontinence since that problem had its origin after the applicant was injured on the aircraft, which links the condition to her line of duty accident.

Counsel concludes that the applicant should be granted a 40 percent disability rating for severe fibromyalgia under Veterans Administration Schedule for Rating Disabilities (VASRD) code 5025 since her pain is constant (or nearly so), and does not respond to therapy.  She should be rated as 30 percent disabled under VASRD 5284 for her foot injury.  And she should be rated as 40 percent disabled for her stress urinary incontinence under VASRD code 7512, giving her a combined rating of 70 percent disabled.

As for incapacitation pay, counsel contends that despite abundant and unrefuted evidence of service related disabling injuries and a loss of earned income, the applicant was denied incapacitation pay for the entire period between the date of her injury and the date of her discharge with severance pay.  Although the applicant was disabled when she was released from active duty on 18 September 1997, she was not given incapacitation pay until 15 February 1998.  After paying her incapacitation pay from 16 February 1998 to 10 December 1998, the applicant was again denied incapacitation pay from 11 December 1998 to 27 March 2000.  The applicant’s incapacitation pay was started once again on 28 March 2000 and was paid until the date of her retirement [sic] for physical disability on 30 April 2001.  Counsel quotes a physician who stated that the applicant has significant functional limitations which have remained unchanged since at least August 1997, and that there is no evidence to support any arbitrary assignment of a date on which to deny further incapacitation pay.  Counsel then cites numerous legal precedents in support of his contentions.

In support of the applicant’s request, counsel submits extensive documentation pertaining to the applicant’s medical treatment, medical evaluation board (MEB), and PEB.  Counsel also submits extensive documentation pertaining to the applicant’s incapacitation pay and her line of duty investigation.

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

She enlisted in the Regular Army on 10 December 1974, was awarded the military occupational specialty of medical specialist, and was promoted to pay grade E-4.  She was honorably discharged from her enlisted status on 4 February 1976 to accept a commission.

She served in a commissioned status, being promoted to first lieutenant, and was honorably released from active duty, at her own request, on 31 July 1979.

She was promoted to captain, was ordered to active duty in the Active Guard and Reserve (AGR) program on 3 January 1984, and was honorably released from active duty on 28 November 1986.

On 22 June 1987, the applicant was seen by an orthopedic surgeon.  At that time the applicant reported that she was struck by a car while jogging in 1982.  The applicant reported that the morning after the accident she woke up very stiff and unable to move her neck.  That afternoon she developed spasms in the right side of her neck which radiated down into the trapezius and scapular region.  During this (22 June 1987) examination, the applicant reported that she was experiencing a throbbing sensation in her right ear, and that her neck started hurting in the afternoon, a pain that radiated down into the right scapula and the right upper extremity, with accompanying tingling on the radial aspect of the forearm.  The applicant reported that she was having difficulty driving her car and shopping, and that she was no longer able to play tennis, dance or jog due to her symptoms.  The surgeon diagnosed the applicant as having chronic fatigue type of a cervical and lumbar sprain.

She entered on active duty for training (ADT) on 5 July 1987 and was honorably released from active duty on 24 November 1987.  During this tour of duty, the applicant was treated for an ankle sprain.

She was promoted to major and was ordered to active duty in support of Operation Desert Storm on 4 March 1991 and was honorably released from active duty on 19 July 1991.

On 20 April 1995, the applicant underwent a military physical examination.  In that examination she reported suffering from recurrent back pain.

She was promoted to lieutenant colonel and entered active duty on 28 April 1997.  On 26 June 1997, the applicant sought medical treatment with a complaint of pain in her legs and ankles of six month duration.  She was diagnosed as having a normal ankle.

On 25 August 1997, the Medical Department Activity (MEDDAC) at Fort McPherson, Georgia, initiated an informal line of duty (LOD) investigation.  In the processing of that investigation, a captain submitted a statement in which he said that he was on a commercial aircraft with the applicant when the plane hit air turbulence.  The applicant was in the bathroom when the turbulence was encountered.  When the applicant returned to her seat next to him, she told him 

that she was thrown against the wall of the bathroom when she was attempting to exit, and that she hurt herself.  The applicant then took a Motrin to relieve her pain.

On 10 September 1997, the applicant was given a relief from active duty physical examination.  During that examination, she reported having a painful neck joint, cramps in her right thigh, recurrent back pain, and a painful right shoulder, all secondary to a herniated disc in her back.  She also reported having experienced ribs popping out of place, heart palpitations, thyroid trouble secondary to Graves Disease, occasional sinusitis, seasonal rhinitis, irritable bowel syndrome causing indigestion, vomiting and frequent diarrhea, a history of left ankle closed reduction, and stress incontinence.  The physician conducting the examination determined that the applicant was medically qualified for separation, with no physical profile restrictions, and placed her in the best physical category (Category A).  

She was then honorably released from active duty on 13 September 1997.

On 20 July 1998, the applicant was examined by a military physician who completed an ARPC Form 3907, Physicians Incapacitation Statement, in which the physician opined that the applicant was unable to perform her military duties from 19 September 1997 to 18 March 1998.

On 11 September 1998, the applicant was examined by a military physician who completed an ARPC Form 3907, Physicians Incapacitation Statement, in which the physician opined that the applicant was unable to perform her military duties from 20 April 1998 to 11 September 1998.  The physician completed a second ARPC Form 3907 in which he opined that the applicant couldn’t perform military duties until 10 December 1998.

On 17 August 1999, an MEB was dictated based on a directive from the Total Army Personnel Command, St. Louis, Missouri (the reason for the directive is not a matter of record).  In that summary the physician reported that the applicant told him that after her injury in the aircraft in July 1997, she had severe left ankle pain and had trouble ambulating.  She stayed in her hotel room for two days and applied ice to her ankle, as well as applying massage and whirlpool therapy.  She then continued her mission, taking Motrin to alleviate headaches.  She was later given several days of bed rest for gastrointestinal problems, which helped her ankle pain.

After her release from active duty, she was treated with physical therapy, chiropractor care, massage therapy and multiple orthopedic evaluations, and was 

given numerous different types of medications, including narcotic medication, with little relief.  She could not drive longer than 30 to 60 minutes or stand longer than 30 minutes without experiencing pain.  

The applicant was given a physical examination on 17 August 1999, which showed that she basically had a full range of motion in all areas and had a full measure of strength, with some pain and some tenderness associated with some movements.

The physician conducting the examination diagnosed the applicant as having mild fascial [sic] pain syndrome involving the cervical spine, the right trapezius muscle, the right shoulder girdle, the thoracic spine, the lumbar spine, the right gluteal area, the right thigh area and the left ankle.  Slight and frequent.

On 28 March 2000, the applicant was given another fitness for duty physical examination.  The reason for the referral is not a matter of record.  The medical history reported by the applicant during this examination was identical to what she reported during the 17 August 1999 physical examination, with the addition of her complaining of pain and popping in her cervical spine region and rib popping in the thoracic spine area near the inferior angle of the scapula, which she reported having started in September 1997.  This examination also showed that the applicant basically had a full range of motion in all areas and had a full measure of strength, with some pain and some tenderness associated with some movements.  A magnetic resonance imaging (MRI) which was reviewed at that time, which had been taken in August 1997, showed that she had degenerative disc disease with disc bulging at the C4-5 level.  However, her lumbar spine was within normal limits.  Her right rib series was normal.  Her thoracic spine series showed multilevel anterior osteophytes (a pathological bony outgrowth).  Her right shoulder was normal.  Her left ankle was normal.  Her right hip was normal.  Her cervical spine was normal.

The physician conducting the examination diagnosed the applicant as having myofascial pain syndrome involving the cervical spine, the right trapezius muscle, the right shoulder girdle, the thoracic spine, the lumbar spine, the right gluteal area, and the right thigh area.  Slight and frequent.  The physician stated that the applicant’s left ankle pain existed prior to service (EPTS) and was not service aggravated.

On 26 April 2000, an MEB was convened which determined that the applicant was medically disqualified due to myofascial pain syndrome involving the cervical spine, the right trapezius muscle, the right shoulder girdle, the thoracic spine, the lumbar spine, the right gluteal area, and the right thigh area.  Slight and frequent.  The MEB stated that the applicant’s left ankle pain was EPTS and was not service aggravated.  The applicant did not agree with the MEB’s findings and submitted an appeal.  
On 10 May 2000, the applicant submitted a rebuttal “correcting” some items of her MEB.  These “corrections” included the number of times she was treated for certain conditions, her prognosis, her level of pain, whether her conditions existed prior to service, and the lack of assistance she received.  This lack of assistance included her command’s failure to retain her on active duty after her aircraft accident, and the refusal of her command to take action to provide her treatment for her medical conditions after her release from active duty.

On 19 May 2000, the approving authority for the MEB considered the applicant’s appeal and confirmed the original MEB’s findings and recommendation.

On 12 June 2000, the applicant was considered by an informal PEB.  The PEB determined that the applicant was physically unfit due to myofascial pain syndrome involving the cervical spine, the right trapezius muscle, the right shoulder girdle, the thoracic spine, the lumbar spine, the right gluteal area, and the right thigh area.  The PEB rated those conditions 10 percent disabling under VASRD Codes 5099, 5021 and 5003.  The applicant nonconcurred with those findings and recommendations and demanded a formal hearing.  

On 25 August 2000, the applicant’s counsel submitted a 15 page rebuttal to the PEB’s findings and recommendation.  In that rebuttal, counsel reminds the PEB of the presumption that a soldier is in sound physical condition upon entering active service except for physical disabilities noted and recorded at the time of entry.  Therefore, any condition that is discovered after a soldier entered active service, except for congenital and hereditary conditions and EPTS conditions which has followed a natural progression, are presumed to have been incurred in line of duty.  Only a preponderance of evidence may overcome these presumptions and all reasonable doubt must be resolved in favor of the soldier.

Counsel then provided a synopsis of the applicant’s military history, which included her breaking her foot while on active duty in 1978.  It also included her being hit by a car while on active duty in 1979 which resulted in her re-injuring her ankle, as well as her injuring her neck and lower back.  It also included her re-injuring her ankle while jogging while on active duty in 1987.  Counsel then reiterates what occurred during the period of active duty in which the applicant was allegedly injured when the aircraft in which she was a passenger rapidly lost altitude.  Counsel continued with a history of the applicant’s line of duty investigation, MEB and PEB.  Based on that history, counsel argued that the preponderance of evidence showed that the applicant’s urinary incontinence, her fibromyalgia, and her broken foot were all service related and should, based on his interpretation of the VASRD, be rated 70 percent disabling.

On 7 September 2000, the applicant was examined by a rheumatologist.  At that time, the applicant reported that “she had experienced many of these things [the symptoms for which she had been treated] prior to the [aircraft] accident but they became much worse after that event.  She also reports having a hit & run accident where she was hit as a pedestrian in August 1984 and did report some of these symptoms at that time but not to any degree such as that after the airplane incident.”  The applicant continued that she was having considerable morning stiffness lasting 20-30 minutes and also stiffness after sitting or standing in one place.  She reported having disturbed and unrefreshing sleep, which was somewhat improved with medication.  She also reported having “frequent abdominal pain, bloating and intermittent episodes of constipation and diarrhea.  Other symptoms include painful sexual intercourse, increased urinary urgency and frequency, increased sensitivity to cold and damp weather, dry eyes/mouth, and swelling of her fingers without joint swelling . . . Further symptoms include occasional lightheadedness, short term memory loss, anxiety, depression as well as increased sensitivity to light and noise.  She experiences a great deal of pain that is worsened with cool and damp weather and is improved somewhat by taking [medication] and Epsom salt baths.  Painful areas include the right side of her spine, neck, shoulders, thoracic and sacral areas and hips.  She states that the pain is intermittent in these areas and may be worse some days than others.”  The rheumatologist diagnosed the applicant as having myofascial pain syndrome and fibromyalgia syndrome.

On 1 September 2000, the applicant’s counsel submitted an appeal of the findings of the applicant’s line of duty investigation.  In that appeal, he contested the investigation’s findings that the applicant’s injuries to her back, legs, arms, right shoulder, neck, lumbar spine, ankle/foot, and rib cage, as well as her stress urinary incontinence, had existed prior to her entry on active duty.  He detailed portions of the regulation which govern line of duty investigations, and he summarized the applicant’s military career.  Counsel concluded that based on the applicant’s military history and regulatory guidance, all of the disabilities which were determined to have existed prior to service on her line of duty investigation were, in fact, incurred or aggravated while on active duty in line of duty.

On 7 December 2000, the Total Army Personnel Command (PERSCOM) sent the applicant a letter informing her that after administrative, legal and medical reviews, it was determined that the greater weight of evidence supported the findings that her left “sinus taris” syndrome, myofascial pain syndrome and fibromyalgia were incurred in line of duty due to her injury on 11 July 1997.  However, her stress urinary incontinence was determined to have been EPTS, and therefore not in line of duty, not due to own misconduct.  The PERSCOM informed the applicant that its determination was made after coordination with the Office of The Surgeon General.  

On 25 January 2001, a formal PEB was convened which determined that the applicant was physically unfit due to myofascial pain syndrome involving the cervical spine, the right trapezius muscle, the right shoulder girdle, the thoracic spine, the lumbar spine, the right gluteal area, and the right thigh area.  The PEB rated those conditions 20 percent disabling under VASRD Codes 5099, 5021 and 5003.  The PEB also determined that the applicant’s left ankle pain was not incurred while she was entitled to basic pay, and was not a proximate result of performing her duties.  The applicant’s counsel appealed the formal PEB’s findings and recommendation both telephonically and in a letter dated 8 February 2001.

On 25 January 2001, the PDA responded to a “recent telephone call” from the applicant’s counsel.  In that letter, the PDA stated that it had inadvertently failed to rate her left ankle pain.  The PDA stated that the applicant had reported having “minimal discomfort” during a range of motion manipulations of her ankle, and she reported obtaining some relief by wearing cowboy boots.  The PDA continued that the majority of her discomfort and requirement for medications was her myofascial pain syndrome, not her ankle.  As a result, the PDA amended the applicant’s DA Form 199 to show that the applicant’s left ankle pain was incurred while the applicant was entitled to basic pay, and was a proximate result of performing her duties.  However, the PDA rated the condition zero percent disabling.  

On 6 February 2001, the applicant was examined by a military physician who completed an ARPC Form 3907, Physicians Incapacitation Statement, in which the physician opined that the applicant was unable to perform her military duties from 11 December 1998 to 8 April 2000.

Fibromyalgia is a common condition characterized by widespread pain in joints, muscles, tendons, and other soft tissues.  Some other problems commonly linked with fibromyalgia include fatigue, morning stiffness, sleep problems, headaches, numbness in hands and feet, depression, and anxiety.  Fibromyalgia can develop on its own, or secondary to other musculoskeletal conditions, such as rheumatoid arthritis, or systemic lupus.

Diagnosis of fibromyalgia requires a history of a least three months of widespread pain, and pain and tenderness in at least 11 of 18 tender-point sites.  These tender-point sites include fibrous tissue or muscles of the neck, shoulders, chest, rib cage, lower back, thighs, knees, arms (elbows) and buttocks.

The overwhelming characteristic of fibromyalgia is long-standing, body-wide pain with defined tender points.  Tender points are distinct from trigger points seen in other pain syndromes.  (Unlike tender points, trigger points can occur in isolation and represent a source of radiating pain, even in the absence of direct pressure.)  Fibromyalgia pain can mimic the pain experienced by people with various types of arthritis.  With fibromyalgia syndrome alone, the significant joint swelling, destruction, and deformity seen in patients with diseases, such as rheumatoid arthritis, does not occur.

The soft-tissue pain of fibromyalgia is described as deep-aching, radiating, gnawing, shooting or burning, and ranges from mild to severe.  Fibromyalgia sufferers tend to waken with body aches and stiffness.  For some patients, pain improves during the day and increases again during the evening, though many patients with fibromyalgia have day-long, unrelenting pain.  Pain can increase with activity; cold, damp weather; anxiety; and stress.

The cause of this disorder is unknown.  Physical or emotional trauma may play a role in development of the syndrome.  A number of lines of evidence suggest that fibromyalgia patients have abnormal pain transmission responses.  It has been suggested that sleep disturbances, which are common in fibromyalgia patients, may actually cause the condition.  Another hypothesis suggests that the disorder may be associated with changes in skeletal muscle metabolism, possibly caused by decreased blood flow, which could cause chronic fatigue and weakness.  Others have suggested that an infectious microbe, such as a virus, triggers the illness.  At this point, no such virus or microbe has been identified.

Pilot studies have shown a possible inherited tendency toward the disease, though evidence is very preliminary. 

Stress incontinence is a bladder storage problem in which the strength of the urethral sphincter is diminished, and the sphincter is not able to prevent urine flow when there is increased pressure from the abdomen.  Stress incontinence may occur as a result of weakened pelvic muscles that support the bladder and urethra, or because of malfunction of the urethral sphincter.  Prior trauma to the urethral area, neurological injury, and some medications may weaken the urethra.  (MEDLINE PLUS)

Army Regulation 600-8-1, paragraph 41-8 states, in pertinent part, that if an EPTS condition was aggravated by military service, the finding will be in line of duty.  If an EPTS condition is not aggravated by military service, the finding will be not in line of duty, not due to own misconduct, EPTS.  Specific findings of natural progress of the pre-existing injury or disease based on well established medical principles alone are enough to overcome the presumption of service aggravation.

Army Regulation 635-40, the regulation which governs PEB’s, paragraph 4-19b, states that a 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.  

Army Regulation 135-381 and title 37, U.S. Code, section 204, provide for continuation of pay and allowances under certain circumstances to reservists who are disabled in line of duty as a direct result of the performance of their duties.  To receive continuation of pay, referred to as incapacitation pay, reservists must either be unable to perform their normal military duties or be able to show a loss of nonmilitary income.  If the reservist continues to work at his or her civilian job, the amount of money earned is deducted from the incapacitation pay.  Entitlement to incapacitation pay is limited to 6 months unless the Secretary of the Army finds that it is clearly in the interest of fairness and equity to extend the incapacitation pay.  Only in the most meritorious cases will incapacitation pay be extended past the 6-month limitation.

Title 10, United States Code, chapter 61, provides disability retirement for a member who has more than 20 years of service or a disability rated at 30 percent or greater.

Title 10, United States Code, section 1203, provides for the physical disability discharge with severance pay of a member who has less than 20 years service and a disability rated at less than 30 percent.

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.  Many lengthy and detailed arguments have been submitted by the applicant’s counsel in conjunction with her line of duty investigation, her MEB, her PEB, her incapacitation pay, and her request to this Board.  

2.  However, all of these arguments hinge on whether the applicant’s disability was incurred while she was on active duty and such disability terminated her military career.  In this regard, the undisputed facts of the case are that the applicant:

	- had a history of ankle, back, neck, shoulder and arm pain prior to her entry on active duty in 1997, which had caused her difficulty driving her car and shopping, and prevented her from playing tennis, dancing or jogging.

	- was on 139 days of active duty as a reservist when she was on a commercial airline traveling in conjunction with her active duty orders when the aircraft encountered turbulence.

	- was in the bathroom when the turbulence was encountered.  
	- has a creditable witness that the plane encountered turbulence.

	- does not have any witnesses to her being injured.

	- had no visible wounds.

	- did not seek medical attention upon exiting the aircraft.

	- by her own admission, successfully completed her mission.

	- was found to have a full range of motion in all areas and have a full measure of strength, with some pain and some tenderness associated with some movements, during all of her physical examinations.

	- was consistently diagnosed as having myofascial pain syndrome, which is also known as fibromyalgia.  These are conditions for which there is no definitive cause.

3.  When taking these facts and applying them to the applicant’s request for incapacitation pay, there is no indication that the applicant was unable to perform her military duties due to a condition which was incurred or aggravated to any significant degree by military service, for the following reasons:  

	- there is no definitive cause for fibromyalgia.  Therefore, it can not be said with any degree of certainty that a trauma caused the applicant to contract this condition.  This fact, when coupled with the fact that the applicant admitted to having symptoms which would appear to be early manifestations of fibromyalgia prior to her entry of active duty in 1997, results in the greater weight of evidence being that the fibromyalgia was not incurred or aggravated while she was on active duty in 1997.  Since the applicant’s fibromyalgia is the condition which is the predominant cause of her disability, it would not appear that she was entitled to any incapacitation pay, much less more incapacitation pay.

	- the applicant has received 1 year, 1 month and 27 days of incapacitation pay, which is more than twice the statutory maximum allowed without a finding that hers would be considered one of the most meritorious cases which would warrant such an extension.  Since the greater weight of evidence shows that her fibromyalgia was not service related, her case certainly doesn’t meet the statutory criteria for yet another extension of incapacitation pay beyond the 
6-month limit. 

4.  When taking the facts in paragraph 2 and applying them to the applicant’s request for an increase in her disability rating, the following has to be concluded:

	- since the applicant had admitted to having symptoms which would appear to be early manifestations of fibromyalgia prior to her entry on active duty in 1997, the greater weight of evidence would indicate that her fibromyalgia was not incurred while she was on active duty in 1997.  The question then becomes whether it was aggravated to a significant degree by her period of active duty in 1997.  In this regard, since there is no definitive cause for fibromyalgia, it can not be said with any degree of certainty that a trauma aggravated the applicant’s pre-existing condition.  As such, it would appear that she was not entitled to any rating for that condition by the Army, much less a rating greater than what she received.  

	- as for the applicant’s foot/ankle injury, while she professes to experience a great deal of pain from that injury, and professes to have significant physical limitations as a result of that injury, her medical examinations have consistently shown that her injury is healed and she has a normal foot and ankle.  Without definitive medical documentation to show that the previous examinations of her foot and ankle were wrong, there is no basis for granting her a rating greater than the zero percent rating that she has already been assigned.

	- as for the applicant’s stress urinary incontinence, there is absolutely no evidence which would show that this condition is service related.  As such, there is no basis for giving her a disability rating for this 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

___ecp___  ___rvo__  ____rjo__  DENY APPLICATION

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

INDEX

CASE ID	AR2003087261	
SUFFIX		
RECON	YYYYMMDD	
DATE BOARDED	20031009	
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.	128.14	
2.	108.02	
3.		
4.		
5.		
6.