ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS IN THE CASE OF: BOARD DATE: 30 August 2021 DOCKET NUMBER: AR20210006048 APPLICANT REQUESTS: in effect, to show that she is entitled to Combat-Related Special Compensation (CRSC) pay for her service-connected disability of Post- Traumatic Stress Disorder (PTSD) due to her deployment in Iraq. APPLICANT'S SUPPORTING DOCUMENTS CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record) * DA Form 2173 (Statement of Medical Examination and Duty Status), dated 10 May 2005 * DA Form 199 (Physical Evaluation Board (PEB) Proceedings), dated 14 September 2005 * DD Form 214 (Certificate of Release or Discharge from Active Duty) for the period ending on 30 November 2005 * QTC Medical Services Addendum Clarification, dated 2 November 2010 * Response to the Department of Veterans Affairs (VA) by the QTC Medical Services Addendum Clarification, dated 2 November 2010 * Veterans Affairs (VA) Rating Decision letter, dated 18 November 2010 * Letter authored by dated 14 May 2011 * DD Form 2860 (Claim for CRSC), dated 7 July 2011 * U.S. Army Human Resources Command (HRC) CRSC Branch letter, dated 28 July 2011 * Compensation and Pension Examination Note, dated 6 February 2017 * VA Rating Decision letter, dated 14 April 2017 * CRSC Reconsideration Request Form, dated 4 February 2019 * HRC, Army Personal Records Division, Reconsideration Request Response to applicant, dated 21 May 2019 * HRC, CRSC letter to applicant, dated 29 January 2019 * CRSC Reconsideration Request Form, dated 16 September 2020 FACTS: 1. The applicant states she is requesting the Board look at her records and determine that she is service connected for PTSD. HRC keeps denying her claim for CRSC, stating she has not proven her PTSD is service connected. She has asked HRC for further guidance and has not heard anything from them. When she called HRC to make sure things were okay, she was told that her case is still processing, and that she will not have an answer until then. She believes that her PTSD is service connected since she never had PTSD until she went to Iraq. 2. It is important to note that the applicant's records have multiple last names listed on her documents (); however, the social security number remains the same. 3. A review of the applicant's available service records reflects the following: a. On 1 September 1993, she enlisted in the Regular Army (RA). b. On 12 December 1996, she reenlisted in the RA. c. DA Form 1695 (Oath of Extension of Enlistment) shows she voluntarily extended her enlistment on 21 July 1997. d. Orders Number 295-0202, issued by the 203rd Personnel Services Battalion, dated 22 October 1998, show she was released from active duty and assigned to the U.S. Army Reserve (USAR) Control Group (Reinforcement), effective 30 October 1998. e. Orders Number C-02-003719, issued by the USAR Personnel Command, dated 8 February 2000, show she was voluntarily released from the USAR Control Group (Reinforcement) and assigned to the 108th Infantry Division, Augmentee, 2nd Brigade, effective 2 February 2000. f. DA Form 4836 (Oath of Extension of Enlistment or Reenlistment), shows she voluntarily extended her enlistment in the USAR on 30 July 2002. g. Memorandum for Commander, issued by Headquarters, XVIII Airborne Corps and Fort Bragg, Subject: Informal Line of Duty Determination, dated 9 June 2005, shows her final determination for injuries sustained on 1 May 2005, was "In Line of Duty" for lower back pain from a vehicle accident on 1 May 2005. h. Letter issued by HRC, Soldier Programs and Services Division, dated 13 November 2020, states, "Our records indicate that you received your final CRSC determination letter [on] 21 May 2019. That determination was final; therefore, we cannot process your request. As previously stated, your claim has previously been processed at the initial, reconsideration, and appeal levels. During each review, our staff has made every effort to consistently and fairly review all available documentation and accurately adhere to this program's standards. Your appeal rights have been exhausted." 4. The applicant provides the following: a. DA Form 2173, dated 10 May 2005, shows she was admitted to Womack Army Medical Center on 1 May 2005, for an injury to her lower back due to a vehicle accident, in which her car was struck on the front driver side. At the time of the accident, it was listed that she was on active duty, that there was no evidence of alcohol or drug use, and that her injury was incurred in the line of duty. b. DA Form 199, dated 14 September 2005, shows she received a PEB for post scoliosis surgery with fusion from T2 through L1. Her condition was unfitting and she was recommended for a disability rating of 40 percent. The PEB also noted the following: (1) "The Soldier's retirement is not based on disability from injury or disease received in the line of duty as a direct result of armed conflict or caused by an instrumentality of war and incurring in line of duty during a period of war as defined by law. (2) The disability did not result from a combat related injury as defined in Title 26, United States Code, section 104." (3) She concurred with the Board's findings, and waived a formal hearing of her case. c. DD Form 214 for the period ending on 30 November 2005, reflects she was honorable retired on 30 November 2005, due to a Disability, Temporary. Item 18 (Remarks) shows she served in imminent danger area in Iraq from 27 March 2003 to 23 March 2004 (Note, although this DD Form 214 shows date entered active duty as 7 July 1993, that date is incorrect because she was released from active duty on 30 October 1998 and transferred to the USAR Control Group (Reinforcement). d. QTC Medical Services Addendum Clarification letter, dated 2 November 2010, responded to the VA's questions to state if PTSD was related to the applicant's fear of hostile military or terrorist activity, to which they responded, "PTSD is related to her fear of terrorist activity when she saw them throw children in front of our military vehicles, which might have caused them to stop and then we killed." e. VA Rating Decision letter, dated 18 November 2010, shows she was granted a service connected disability for PTSD (claimed as major depression disorder) with a 30 percent rating, effective 19 November 2009. f. Letter by dated 14 May 2011, states, in part: (1) "Diagnosis: For the VA established diagnosis of PTSD, Axis I: diagnosis is the same as the established diagnosis. The current diagnosis is the same as the established diagnosis. The other diagnosis for Axis I is Major Depression, Recurrent, with Psychotic Features. The multiple Axis I diagnoses are related and the secondary diagnosis does represent a progression of the primary diagnosis because claimant's PTSD has worsened to the point that her depression is so deep that she is seeing hallucinations. The symptoms of each mental disorder can be delineated from each other. The depressed mood is more severe than that typically seen in PTSD and the hallucinations are not a hallmark of PTSD. (2) The Axis I diagnosis meets the diagnostic criteria of PTSD, according to DSM IV, because the following criteria are present: In criteria A, the claimant has been exposed to a traumatic event which involved actual death, threatened death, serious injury, threat to the physical integrity of self and threat to the physical integrity of other." g. DD Form 2860, dated 7 July 2011, reflects that the applicant applied for CRSC, based on her service during Operation Iraqi Freedom/Operation Enduring Freedom, and was injured "in Iraq when [she] was injured and thrown from [her] truck during a bombing incident." h. HRC CRSC Branch Letter, dated 28 July 2011, reflects that HRC was unable to verify a Combat-Related Disability, and noted the following regarding her conditions: * Right knee – Documentation does not show accident or incident to connect disability to a combat-related event * Migraine Headaches – No evidence in claim to show that a combat-related event caused condition * PTSD – No evidence in claim to show that a combat-related event caused condition * Scoliosis – Documentation does not show accident or incident to connect disability to a combat-related event i. Compensation and Pension Examination Note, dated 6 February 2017, shows the applicant was diagnosed with PTSD and Alcohol Use Disorder, and that her trauma was experienced while deployed to Iraq. j. VA Rating Decision letter, dated 14 April 2017, shows her disability rating for PTSD was increased to 70 percent. k. CRSC Reconsideration Request Form, dated 4 February 2019, shows she submitted a new CRSC request to HRC, based on obtaining new medical evidence. l. HRC, Army Personal Records Division, Reconsideration Request Response letter to applicant, dated 21 May 2019, states, in pertinent part: (1) "The CRSC program office has completed processing your reconsideration claim. After carefully reviewing the available documentation, I am unable to award your PTSD, Major Depression (9411) and Right Knee Condition with Pain and Weakness (5260) claims. (2) Unfortunately, the documentation you submitted did not support your personal exposure to armed conflict in relationship to your PTSD or a specific combat-related event for the remaining disabilities listed in the paragraph above. Your claim has previously been processed at the initial, reconsideration, and appeal levels." m. HRC, CRSC Letter sent to the applicant, dated 29 January 2019, shows the following conditions were verified as: (1) Combat-Related: * Bladder Dysfunction * Bowel Dysfunction * Migraine Headaches * Sensory Deficit Right Lower Extremity * Scoliosis, Thoracic Spine S/P Fusion T12 –L1 (2) Unable to Verify as a Combat-Related Disability: * Right Knee Condition with Pain and Weakness Previously Claimed as Right Knee Surgery * PTSD n. CRSC Reconsideration Request Form, dated 16 September 2020, shows she submitted another CRSC request based on new medical evidence, which may verify her combat-related link to her PTSD. 5. MEDICAL REVIEW: The Army Review Boards Agency (ARBA) Medical Advisor was asked to review this case. Documentation reviewed included the applicant’s ABCMR application and accompanying documentation, the military electronic medical record (AHLTA), the VA electronic medical record (JLV), the electronic Physical Evaluation Board (ePEB), the Medical Electronic Data Care History and Readiness Tracking (MEDCHART) application, and the Interactive Personnel Electronic Records Management System (iPERMS). The ARBA Medical Advisor made the following findings and recommendations: a. The applicant is applying to the ABCMR requesting they reverse the United States Army Human Resources Command’s (USA HRC) previous determinations that her mental health condition is non-combat related and therefore not eligible for Combat Related Special Compensation (CRSC). She states: “I am requesting the Board look at my records and see that I am service connected for PTSD. CRSC keep denying me saying that I have not proven service connected. I believe that my PTSD is service connected. I never has PTSD until I went to Iraq.” b. The Record of Proceedings details the applicant’s military service and the circumstances of the case. Her DD 214 shows she entered the regular Army on 7 July 1993 and was placed on the temporary disability retirement list on 30 November 2005 under provisions in in Paragraph 4-24b(2) of AR 635-40, Physical Evaluation for Retention, Retirement, or Separation (1 September 1990). It shows she served in Iraq from 27 March 2003 thru 23 March 2004. Her Physical Evaluation Board (PEB) Proceedings (DA Form 199) shows her sole unfitting condition was “Status post scoliosis surgery with fusion from T2 thru L1”, and that it was rated at 40%. Documentation of her subsequent retirement for this condition was not submitted with the application or found in iPERMS. c. Documentation shows the applicant’s PTSD has been service connected by the Veterans Benefits Administration: “Posttraumatic Stress Disorder, Major Depression [PTSD - Combat/Fear - Easing Standard).” d. In a 2 November 2010 memorandum from her provider, he wrote “PTSD is related to her fear of terrorists’ activity when she saw them throw children in front of military vehicles, which might have caused them to stop and then be killed.” e. In her 2011 CRSC claim, the applicant stated “I was in Iraq when I was injured and thrown from my truck. During a bombing incident.” f. The applicant had thoracic spine radiographs taken in August 2003. The reason for the study written on the request: “patient has mid back pain since Feb-March, has bounced about in truck.” Subsequent studies mention this same mechanism of injury, and there is no mention of her vehicle being struck by an explosive device. g. A Statement of Medical Examination and Duty Status (DA Form 2173) states the applicant sustained an increase in her low back pain when the vehicle she was struck by a second vehicle on 1 May 2005 in h. Her initial PTSD Disability Benefits Questionnaire is not available for review. Her stressors were noted in a psychologist’s evaluation on 13 May 2011: “In regards to re-experiencing the traumatic event: *There are recurrent recollections of the event which continue to persist. The recollections are described as: she thinks about an explosion that occurred in Iraq that blew the windows out of her room. She also thinks about a mortar that landed in front of the guard shack. She also thinks about running over babies that were thrown in front of their trucks.” i. Section b(3) of 26 U.S. Code §?104 requires there be a direct cause and effect relationship: (3) Special rules for combat-related injuries: For purposes of this subsection, the term “combat-related injury” means personal injury or sickness— (A) which is incurred— (i) as a direct result of armed conflict, (ii) while engaged in extra-hazardous service, or (iii) under conditions simulating war; or (B) which is caused by an instrumentality of war. j. The applicant is not in receipt of a Purple Heart and no corroborating documentation was found. A note in paragraph 630502 of DoD FMR 7000.14-R Volume 7B Chapter 63 CRSC notes the requirement for documentation, stating in part: “An uncorroborated statement in a record that a disability is combat-related will not, by itself, be considered determinative for purposes of meeting the combat- related standards for CRSC prescribed herein. CRSC determinations must be made based on the program criteria.” k. To award CRSC for PTSD under the category of armed conflict, she must submit official documentation that shows how the condition is combat-related as defined by CRSC program guidance. Official documentation includes wartime chain of command endorsements which confirms exposure to armed conflict (Wartime chain of command must be First Sergeant and/or Company Commander or higher), copies of combat decorations (certificates, combat badges, and DA Form 638s), and evaluation reports which support exposure to armed conflict. l. It is the opinion of the ARBA Medical Advisor there is insufficient probative evidence upon which to reverse the previous non-combat related determination for her mental health condition, and thus such a reversal is unwarranted. BOARD DISCUSSION: 1. After reviewing the application, all supporting documents, and the evidence found within the military record, the Board found that relief was not warranted. The applicant’s contentions, the military record, a medical review, and regulatory guidance were carefully considered. The Board concurred with the advising official’s findings. The applicant is noted that applicant's statement that may support application to HRC for receipt of the Combat Action Badge (CAB) (with supporting evidence) if she believes the incidents she described found in her medical record are worthy of such badge. The CAB is one form of evidence that could support exposure to an armed conflict. Based upon a preponderance of the evidence, the Board determined there is insufficient evidence to grant relief. 2. The Board concurred with the administrative notes below and recommended the correction is completed to more accurately depict the military service of the applicant. BOARD VOTE: Mbr 1 Mbr 2 Mbr 3 : : : GRANT FULL RELIEF : : : GRANT PARTIAL RELIEF : : : GRANT FORMAL HEARING :X :X :X DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: Except for the correction addressed in Administrative Note(s) below, the Board found 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. ADMINISTRATIVE NOTE(S) The applicant’s DD Form 214 for the period ending 30 November 2005 shows she deployed to Iraq in block 18; however, her foreign service is not recorded in block 12f. Please amend her DD Form 214 by amending block 12f to show “0000 11 27.” REFERENCES: 1. Department of Defense (DOD) Financial Management Regulation 7000.14-R Volume 7B (Military Pay Policy – Retired Pay) provides in Chapter 63 (Combat Related Special Compensation (CRSC)) that CRSC is special compensation to members of the Uniformed Services who have retired pay reduced because of receiving U.S. Department of Veterans Affairs (VA) disability compensation where a portion of such VA disability compensation is the result of disabilities that are combat-related as determined by the Military Department. The CRSC program became effective 31 May 2003. Payments are made on the first day of the first month following the month in which the compensation accrued, provided the member is receiving VA disability compensation for a disability that has been determined to be combat-related by the Military Department. a. CRSC is a monthly entitlement. A retiree is entitled to CRSC for each month during which, for the entire month, the member has applied for and elected CRSC under these provisions, meets preliminary CRSC criteria, and meets final CRSC criteria. b. With regard to the effective date, payments are made on the first day of the first month following the month in which the compensation accrued, provided the member is receiving VA disability compensation for a disability that has been determined to be combat-related by the Military Department. A member may submit an application for CRSC at any time and, if otherwise qualified for CRSC, compensation will be paid for any month after May 2003 for which all conditions of eligibility were met. c. Disability ratings by the Secretary of the Military Department concerned (or designee), as of the date on which the member retired, may be used to help make determinations of whether the member meets preliminary CRSC criteria. The actual computation of the amount of CRSC payable to an eligible retiree is based solely on VA disability determinations and the amount of VA compensation paid, without regard to any disability that is not combat-related. d. When the VA makes a retroactive increase in a member's VA disability compensation pertinent to a member's combat-related disabilities under CRSC, DFAS and VA will exchange data to determine the additional retroactive amount that the member is entitled to receive as the result of CRSC. DFAS will compute the additional entitlement and advise VA in order for VA to pay the member the appropriate additional authorized VA disability compensation. Any increase affecting CRSC qualified disabilities in the current month requires that CRSC be re-computed. e. Section 630502 states, a combat-related disability is a disability with an assigned medical diagnosis code from the VA Schedule Rating of Disabilities (VASRD). The Military Departments will determine whether a disability is combat-related based on the following criteria: * as a direct result of armed conflict * while engaged in hazardous service * in the performance of duty under conditions simulating war, or * through an instrumentality of war f. The Department will record for each disability determined to be combat-related which of the circumstances provided qualifies the disability as combat-related. A determination of combat-relatedness (see section 6306) will be made with respect to each separate disability with an assigned medical diagnosis code from the VASRD. A retiree may have disabilities that are not combat-related. Such disabilities will not be considered in determining eligibility for CRSC or the amount of CRSC payable. An uncorroborated statement in a record that a disability is combat-related will not, by itself, be considered determinative for purposes of meeting the combat-related standards for CRSC prescribed herein. CRSC determinations must be made on the basis of the program criteria. g. Section 6306 (Determinations of Combat Relatedness). (1) Direct Result of Armed Conflict: a. The disability is a disease or injury incurred in the line of duty as a direct result of armed conflict. To support a combat-related determination, it is not sufficient to only state the fact that a member incurred the disability during a period of war, in an area of armed conflict, or while participating in combat operations. There must be a definite causal relationship between the armed conflict and the resulting disability. b. Armed conflict includes a war, expedition, occupation of an area or territory, battle, skirmish, raid, invasion, rebellion, insurrection, guerilla action, riot, or any other action in which Service members are engaged with a hostile or belligerent nation, faction, force, or with terrorists. (2) In the Performance of Duty Under Conditions Simulating War. In general, performance of duty under conditions simulating war covers disabilities resulting from military training, such as war games, practice alerts, tactical exercises, airborne operations, leadership reaction courses, grenade and live fire weapon practice, bayonet training, hand-to-hand combat training, repelling, and negotiation of combat confidence and obstacle courses. It does not include physical training activities such as calisthenics, jogging, formation running, or supervised sport activities. (3) Instrumentality of War: a. There must be a direct causal relationship between the instrumentality of war and the disability. It is not required that a member's disability be incurred during an actual period of war. The disability must be incurred incident to a hazard or risk of the service. b. An instrumentality of war is a vehicle, vessel, or device designed primarily for military service and intended for use in such service at the time of the occurrence or injury. It may also include such instrumentality not designed primarily for military service if use of or occurrence involving such instrumentality subjects the individual to a hazard peculiar to military service. Such use or occurrence differs from the use or occurrence under similar circumstances in civilian pursuits. c. A determination that a disability is the result of an instrumentality of war may be made if the disability was incurred in any period of service as a result of such diverse causes as wounds caused by a military weapon, accidents involving a military combat vehicle, injury or sickness caused by fumes, gases, or explosion of military ordnance, vehicles, or materiel. d. For example, if a member is on a field exercise, and is engaged in a sporting activity and falls and strikes an armored vehicle, then the injury will not be considered to result from the instrumentality of war (armored vehicle) because it was the sporting activity that was the cause of the injury, not the vehicle. On the other hand, if the individual was engaged in the same sporting activity and the armored vehicle struck the member, then the injury would be considered the result of an instrumentality of war. //NOTHING FOLLOWS//