BOARD DATE: 7 June 2016 DOCKET NUMBER: AR20160005433 BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ___x_____ __x______ __x__ DENY APPLICATION 2 Enclosures 1. Board Determination/Recommendation 2. Evidence and Consideration BOARD DATE: 7 June 2016 DOCKET NUMBER: AR20160005433 BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. __________x________________ CHAIRPERSON I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. BOARD DATE: 7 June 2016 DOCKET NUMBER: AR20160005433 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documents provided, if any). 2. Military Personnel Records and advisory opinions (if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests, in effect, correction of her DA Form 3947 (Medical Evaluation Board (MEB) Proceedings), convened on 19 May 2015, to add the diagnosis of left hip pain as an unfitting condition for reconsideration by a physical evaluation board (PEB). 2. The applicant states, in effect, she complained about having left hip pain since September 2013 and was never given proper care. In November 2013, she started having right knee pain. She received a profile for her knee but was told she did not need one for her hip as she already had a lower extremity profile. She feels it is an injustice not to consider her hip as an unfitting condition. She feels her doctors brushed her off on the issue and minimized her injury, as she had gained weight due to being injured for so long with no resolution. They attributed her hip pain to her weight. She feels her QTC Medical Services, Incorporated (a firm contracted by the Department of Veterans Affairs (VA) to perform Compensation and Pension examinations for veterans) report written by Dr. G was untrue. She had flare-ups with her hip and pain that were not listed accurately in the report. 3. The applicant provides a VA Form 3288 (Request for and Consent to Release of Information from Individual's Records), a one-page self-authored statement addressing a QTC visit, and nine medical documents created on 21 December 2015. CONSIDERATION OF EVIDENCE: 1. The applicant enlisted in the Regular Army on 13 November 2012. She completed training and was awarded military occupational specialty (MOS) 92Y (Unit Supply Specialist). The highest rank/grade she attained while serving on active duty was specialist (SPC)/E-4. 2. An MEB convened on 19 May 2015 and after consideration of clinical records, laboratory findings, and physical examinations, the MEB determined the applicant was medically unacceptable due to a right knee meniscal tear. a. The MEB also considered the additional diagnoses and found them to be medically acceptable: arthritis, degenerative, right elbow; arthritis of first tarsometatarsal joints, bilateral; hip strain with iliotibial band syndrome (diagnosed by VA as "no diagnosis"); thoracolumbar strain (diagnosed by VA as "no diagnosis"); work-related stress (diagnosed by VA as "occupational problem"); and bilateral patellar chondromalacia. b. The MEB recommended the applicant’s referral to a PEB. The applicant was counseled and did not agree with the board's findings and recommendation on 22 June 2015. Her record does not contain nor does she provide the exact reasoning for non-concurrence. c. The approving authority considered the appeal and the report of the MEB and forwarded it to the PEB on 9 July 2015. 3. A formal PEB was convened at Joint Base Lewis-McChord, Fort Lewis, WA on 1 September 2015, before which she appeared with counsel. The PEB found the applicant's condition prevented her from performing the duties required of her grade and MOS and determined that she was physically unfit due to a right knee meniscal tear that began in 2013. 4. The PEB noted that the other diagnoses, as outlined above and as listed in her MEB, met medical retention standards, were not listed on a physical profile as limiting any of her functional activities, were not commented upon by her commander as hindering her performance, and her case file contained no evidence that these diagnoses independently or combined rendered her unfit for her assigned duties. 5. The PEB also considered her contention of left hip pain. The DA Form 199-1 (Formal PEB Proceedings) show the board determination with respect to this condition: Evidence was presented that onset of symptoms approximately 2 years ago led to limitations in training and work activities. However, this condition was determined not to fail retention standards by the MEB and was addressed in detail in the response to MEB Appeal of 8 April 2015. Some of the factors for that decision hinged on no permanent profiles, no radiological findings, a benign C&P examination, and a diagnosis of iliotibial band syndrome (January 2015). Although the diagnosis appears provisional, this Board cannot base a finding of unfitness based on speculation that a more substantive condition lies hidden from current view. Since iliotibial band syndrome is an overuse syndrome with a high rate of therapeutic success, and [the] Soldier has not had the opportunity yet to receive definitive treatment, this Board finds condition not unfitting for duty. The previous determination of the informal board is sustained. 6. The PEB recommended the applicant's separation with a 10 percent (%) disability rating and entitlement to severance pay. 7. She acknowledged she had been advised of the findings and recommendation of the PEB and that she had received a full explanation of the results of the findings and recommend and her legal rights pertaining thereto. She did not concur with the PEB's findings and recommendation and submitted a written appeal on 13 October 2015. Her written appeal was not available for review. She did not request reconsideration of her VA ratings. 8. The PEBs findings and recommendation were approved by the U.S. Army Physical Disability Agency (USAPDA) on 30 November 2015. 9. She was honorably discharged on 2 March 2016, under the provisions of chapter 4, Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation), due to disability, severance pay, non-combat (enhanced). The DD Form 214 (Certificate of Release or Discharge from Active Duty) she was issued shows she completed 3 years, 3 months, and 16 days of net active service. 10. The applicant provides: a. VA Form 3288, authorizing the release of her records to the Puget Sound Healthcare System, Tacoma, WA. b. A one-page self-authored statement addressing a QTC visit with a Dr. G., stating, in effect, the following: * she was referred to as a "he" throughout the entire report by Dr. G * the doctor did not conduct a range of motion nor did he measure her range of motion * the report states she did repetitive motion exercise of movements, which she contends she did not * the report stated she did not have any issues with flare-ups, but she contends she continuously had flare-ups on a daily basis * the report stated no record of a profile existed for her left hip, but she contends she had a profile for it * the report stated she performed straight leg raises, but she contends she never did any * she contends the doctor did not conduct a proper range of motion test on her back c. Nine medical documents, created on 21 December 2015, showing she was evaluated and treated for conditions as they related to her left hip and left knee. REFERENCES: 1. Army Regulation 40-501 (Standards of Medical Fitness) governs medical fitness standards for enlistment; induction; appointment, including officer procurement programs; retention; and separation, including retirement. Once a determination of physical unfitness is made, the PEB rates all disabilities using the VA Schedule for Rating Disabilities (VASRD). Ratings can range from 0 percent to 100 percent, rising in increments of 10 percent. 2. Army Regulation 635-40 establishes the Army physical disability evaluation system and sets forth policies, responsibilities, and procedures that apply in determining whether a Soldier is unfit because of physical disability to reasonably perform the duties of his office, grade, rank, or rating. a. Paragraph 3-1 provides that the mere presence of impairment does not, of itself, justify a finding of unfitness because of physical disability. In each case, it is necessary to compare the nature and degree of physical disability present with the requirements of the duties the member reasonably may be expected to perform because of his or her office, rank, grade or rating. The Army must find that a service member is physically unfit to reasonably perform their duties and assign an appropriate disability rating before they can be medically retired or separated. b. Paragraph 3-5 provides that there is no legal requirement in arriving at the rated degree of incapacity to rate a physical condition which is not in itself considered disqualifying for military service when a Soldier is found unfit because of another condition that is disqualifying. Only the unfitting conditions or defects and those which contribute to unfitness will be considered in arriving at the rated degree of incapacity warranting retirement or separation for disability. 3. Title 10, U.S. Code, section 1203, provides for the physical disability separation of a member who has less than 20 years of service and a disability rating at less than 30 percent. DISCUSSION: 1. The applicant's request for correction of her DA Form 3947 to add the diagnosis of left hip pain as an unfitting condition for reconsideration by a PEB was carefully considered. 2. The evidence shows she underwent an MEB that found only one condition (right knee meniscal tear) did not meet retention standards and recommended referral to a PEB. She was also evaluated for arthritis, degenerative, right elbow; arthritis of first tarsometatarsal joints, bilateral; hip strain with iliotibial band syndrome (diagnosed by VA as "no diagnosis"); thoracolumbar strain (diagnosed by VA as "no diagnosis"); work-related stress (diagnosed by VA as "occupational problem"); and bilateral patellar chondromalacia. These conditions met retention medical standards, meaning she could perform her duties with no profile limitations or restrictions. 3. She did not concur with the findings and recommendation of the MEB and it is assumed it is for her condition of left hip pain. However, this condition was considered by the MEB, determined to meet retention medical standards and the approving authority considered her non-concurrence and forwarded the results to the PEB for action. 4. The formal PEB reviewed her diagnoses and found her physically unfit due to right knee meniscal tear. The other diagnoses mentioned above, to include hip strain with iliotibial band syndrome (left hip pain) were considered and deemed to be medically acceptable. The formal PEB recommended separation with entitlement to severance pay with a 10 percent disability rating. 5. She did not concur with the findings and recommendation and submitted a written appeal. Her written appeal was not available for review. Further, she did not request reconsideration of the VA rating. The USAPDA reviewed her case and approved the results of the PEB on 30 November 2015. 6. The applicant contends she was not afforded the proper care for her medical conditions. There is a presumption of regularity in the conduct of government affairs. There is no evidence in her record nor does she provide evidence that shows she was denied proper medical care during her military service or during the medical evaluation process. 7. The applicant’s separation with severance pay was accomplished in compliance with law and regulations. There is no evidence of error or injustice in this case. She has not submitted substantiating evidence or an argument that would show an error or injustice occurred in her case. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20160005433 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20160005433 6 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2