MEMORANDUM OF CONSIDERATION

	IN THE CASE OF:     

	BOARD DATE:           1 July 2003                   
	DOCKET NUMBER:   AR2003090390

	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. Ted S. Kanamine		Chairperson	
	Mr. Melvin H. Meyer		Member	
	Ms. Karen Y. Fletcher		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 she be given incapacitation pay for the period 1 March to 20 May 2002.

APPLICANT STATES:  Since her command hadn’t processed the payroll for the period 1 March to 20 May prior to her placement on the Temporary Disability Retired List (TDRL), she is unable to be paid for that time.

In support of her request, she submits a letter from her regional support command informing her that since she was retired, she was no longer on her unit’s payroll and could not be paid incapacitation pay for the period 1 March to 20 May 2002. 

The applicant also submits incapacitation pay documentation in which she attests that she had not earned any civilian income from 12 February 2000 through 28 February 2002.  Also included is a military physician’s statement attesting to her inability to perform military duty from 1 March to 31 May 2002.

In addition, the applicant submits a psychiatrist statement which states she was initially hospitalized for psychiatric problems in August 1999.

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

She enlisted in the US Army Reserve (USAR) on 21 May 1992 in pay grade E-1.  She was immediately advanced to pay grade E-3.  She was given an uncharacterized discharge on 22 January 1993 for unknown reasons.

On 8 April 1993, she enlisted in the USAR once again in pay grade E-3.  She was given the Montgomery GI Bill, the Student Loan Repayment Program, and a $1,500.00 cash bonus.

She was awarded the military occupational specialty of chemical operations specialist.  She was transferred to the USAR Control Group (Annual Training) on 1 July 1995 by reason of unsatisfactory participation.

On 31 August 1995, the applicant voluntarily transferred into a new USAR unit.

On 19 September 1996, the applicant was again involuntarily transferred to the USAR Control Group (Annual Training) by reason of unsatisfactory participation.

On 9 July 1997, the applicant voluntarily transferred into a new USAR unit.

The applicant was ordered to two weeks (30 July to 15 August 1999) of active duty with her unit in El Salvador as her annual training (AT).  

On 4 August 1999, the applicant was treated for complaints of vomiting.  At that time she stated that she had discontinued taking her anti-depressant and 
anti-psychotic medications prior to going on AT because “I did not think I need them these two weeks.”  The applicant became increasingly hostile, belligerent and uncooperative, which led to her being transported back to the United States for further testing and evaluation.

On 16 August 1999, an informal line of duty (LOD) investigation was initiated.  

On 27 August 1999, the Director, Mental Health Services, Department of Veterans Affairs Medical Center, submitted a letter.  In that letter the Director stated that the applicant had been admitted for acute psychotic symptoms.  She was diagnosed as suffering from paranoid schizophrenia with acute exacerbation.  The Director continued that “Psychotic symptoms first arose in an extreme form when [the applicant] was on active duty in El Salvador with her reserve unit.”  The Director also states that their history failed to reveal that the applicant was taking any anti-psychotic medication before the acute exacerbation.  In a second statement dated 4 November 1999, the Director stated that the applicant “continues to have difficulty with concentration which had hindered her educational progress at the University of Memphis.”

On 27 July 2000, the applicant was notified that a formal LOD investigation was being initiated into her schizophrenia.  In that notification it was stated that the reason for the formal investigation was the contradiction of her telling the doctor when she was initially treated that she had been taking anti-psychotic medications, and later denying ever having taken any anti-psychotic medications.

On 28 August 2000, a formal LOD was completed.  The Investigating Officer (IO) determined that the applicant’s paranoid schizophrenia was incurred in LOD because there was no evidence that the applicant had ever taken anti-psychotic medications prior to AT.  

In the processing of that formal LOD investigation, a statement was obtained from the physician who had made the entry that the applicant had stated she had been taking anti-psychotic medications prior to AT.  In that statement, the physician said that he stood by everything he wrote in the applicant’s health records.  The physician added “Whatever the condition she has now, was present even before she came to El Salvador.  Line of duty should be denied.  It seems she is trying to make Uncle Sam responsible for her condition when the Army had nothing to do with her condition.  I will be happy to come and testify if necessary.  It will be really a shame to approve the LOD for this person.”

The applicant’s paranoid schizophrenia was approved as having been incurred in LOD.

On 3 May 2002, a Physical Evaluation Board (PEB) convened and determined that the applicant was physically unfit due to schizophrenia, paranoid type, with associated depression requiring hospitalization, medication and psychotherapy.  The PEB recommended that the applicant be placed on the TDRL due to physical unfitness.

That recommendation was approved and the applicant was placed on the TDRL.

Title 37, U.S. Code, section 204, states that a member of a reserve component of a uniformed service is entitled to the pay and allowances provided by law or regulation for a member of a regular component of a uniformed service of corresponding grade and length of service whenever such member is physically disabled as the result of an injury, illness, or disease incurred or aggravated in line of duty, while performing either active or inactive duty.  Pay and allowances may not be paid for a period of more than six months. The Secretary concerned may extend such period in any case if the Secretary determines that it is in the interests of fairness and equity to do so. 

Army Regulation 600-8-1, paragraph 41-8 states, in pertinent part, that if an existing prior to service (EPTS) condition was aggravated by military service, the finding will be in LOD.  If an EPTS condition is not aggravated by military service, the finding will be not in LOD, 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.

The Court of Claims and the Comptroller General of the United States have held that short periods of active duty do not give rise to the presumption of the cause of an illness or disease.

In accordance with MEDLINE Plus Health Information, schizophrenia is a serious brain disorder.  It is a disease that makes it difficult for a person to tell the difference between real and unreal experiences, to think logically, to have normal emotional responses to others, and to behave normally in social situations.  Schizophrenia is a complex and puzzling illness.  Even the experts in the field are not exactly sure what causes it.  Some doctors think that the brain may not be able to process information correctly.  Genetic factors appear to play a role, as people who have family members with schizophrenia may be more likely to get the disease themselves.  Some researchers believe that events in a person's environment may trigger schizophrenia.  For example, problems during intrauterine development (infection) and birth may increase the risk for developing schizophrenia later in life.  Psychological and social factors may also play some role in its development.  However, the level of social and familial support appears to influence the course of illness and may be protective against relapse.  There are five recognized types of schizophrenia: catatonic, paranoid, disorganized, undifferentiated, and residual.  Features of schizophrenia include its typical onset before the age of 45, continuous presence of symptoms for six months or more, and deterioration from a prior level of social and occupational functioning.  People with schizophrenia can have a variety of symptoms.  Usually the illness develops slowly over months or even years.  At first, the symptoms may not be noticed.  For example, people may feel tense, may have trouble sleeping, or have trouble concentrating.  They become isolated and withdrawn, and they do not make or keep friends.  As the illness progresses, psychotic symptoms develop:

	Delusions -- false beliefs or thoughts with no basis in reality. 

	Hallucinations -- hearing, seeing, or feeling things that are not there. 

	Disordered thinking -- thoughts "jump" between completely unrelated topics (the person may talk nonsense). 

	Catatonic behavior -- bizarre motor behavior marked by a decrease in reactivity to the environment, or hyperactivity that is unrelated to stimulus. 

	Flat affect -- an appearance or mood that shows no emotion. 

No single characteristic is present in all types of schizophrenia.  The risk factors include a family history of schizophrenia.  Schizophrenia is thought to affect about 1% of the population worldwide.  Schizophrenia appears to occur in equal rates among men and women, but women have a later onset.  For this reason, males tend to account for more than half of clients in services with high proportions of young adults.  Although the onset of schizophrenia is typically in young adulthood, cases of the disorder with a late onset (over 45 years) are known.

Paranoid schizophrenia is associated with feelings of being persecuted or plotted against.  Affected individuals may have grandiose delusions associated with protecting themselves from the perceived plot.  The key schizophrenic symptoms are delusions and/or auditory hallucinations.  Paranoid schizophrenia usually does not involve the disorganization of speech and behavior seen in other subtypes of the disorder.  Typical patients with paranoid schizophrenia are tense, suspicious, guarded, and reserved.

In the processing of this case, the staff of the Board found it necessary to contact the finance and accounting office (F&AO) which paid the applicant’s incapacitation pay.  The F&AO stated that the applicant received incapacitation pay from 16 August 1999 to 28 February 2002.  The applicant was paid a total of $59,792.00 in incapacitation pay during that time.  The F&AO stated that the applicant does not have an exception to policy to extend her incapacitation pay beyond 28 February 2002.
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 became disabled due to schizophrenia and received incapacitation pay since her hospitalization during her AT in 1999 to the date of her placement on the TDRL.  As such, she has received considerably more than the 6 months limitation of incapacitation pay .

2.  As such, the Board is essentially presented with a single issue:  Does the applicant’s case meet the criteria of fairness and equity to warrant an exception to policy to further extend her incapacitation pay beyond the 6-month limitation of such pay.

3.  In this regard, the applicant was on the sixth day of a two week period of active duty when she was treated for schizophrenia.  When she was originally treated, she stated that she had discontinued taking previously prescribed psychotic medication prior to AT.  She later denied ever having taken any psychotic medication, and neither the VA or the physicians to whom she signed a release of information had any record of prescribing the applicant such medication.  However, this does not necessarily mean that the applicant was not taking psychotic medication.  She could have been prescribed that medication by a physician who she did not name or, therefore, sign a release to.  In addition, the Director of Mental Health Services at the DVA Medical Center stated that the applicant had a history of having difficulty with concentration which had hindered her educational progress at the University of Memphis.  Problems concentrating is one of the early symptoms of schizophrenia.

4.  Upon careful examination of the evidence of record, the symptoms and developmental elements of schizophrenia, and the law governing the extension of incapacitation pay, the Board does not believe that it is fair and equitable to further extend the applicant’s incapacitation pay.  The preponderance of evidence supports a finding that the applicant’s schizophrenia existed prior to her entry on active duty during her AT, and there is no evidence of any event which may have aggravated that condition.  While the applicant may have received an approved LOD, incapacitation pay and was placed on the TDRL, those actions do not in any way mandate that her incapacitation pay should be further extended beyond the 6-month statutory limitation.

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

___tsk___  ___mhm_  ____kyf__  DENY APPLICATION

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

INDEX

CASE ID	AR2002080394	
SUFFIX		
RECON	YYYYMMDD	
DATE BOARDED	20030701	
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.	128.10	
2.		
3.		
4.		
5.		
6.