IN THE CASE OF: BOARD DATE: 29 March 2011 DOCKET NUMBER: AR20100020085 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 correction of his DA Form 199 (Physical Evaluation Board (PEB) Proceedings) to show he was found unfit for duty and transferred to the retired list with a permanent disability rating of 50%. 2. The applicant states, in effect, that he defers to his counsel. COUNSEL'S REQUEST, STATEMENT AND EVIDENCE: 1. Counsel requests correction of the applicant's PEB proceedings (Tab A) to show he was found unfit for duty and that he was transferred to the retired list with a disability rating of 50% based on low back pain, bilateral ankle and foot pain, and Charcot-Marie-Tooth (CMT) disease which is chronic inherited progressive muscular atrophy that affects the parts of the legs and feet innervated by the peroneal nerves first and later progresses to the hands and arms. 2. Counsel states the PEB found the applicant fit for duty. The informal PEB noted: a. Lieutenant Colonel (LTC) Mark D. M---, a Staff Judge Advocate General (JAG) Assignments Officer, advised PEB members that field grade JAG officers who can perform the mandatory tasks of carrying and firing a weapon, wearing the protective mask and chemical defense equipment, and completing an aerobic event for the Army Physical Fitness Test (APFT) can be retained and assigned duties. He added, "[a] field grade JAG Officer is not expected to perform vigorous activities on a routine basis." b. The Office of The Surgeon General (OTSG) opined that the applicant's CMT was not service aggravated. The applicant submitted a rebuttal and the PEB found the applicant fit for duty which rendered the service aggravation issue moot. c. The applicant submitted a thoroughly researched appeal of the informal PEB decision, which dealt directly with the issue of fitness for duty. d. Applicant's counsel at the time indicated the PEB relied on the uninformed opinion of LTC M---, who later stated to counsel "that he did not render any informed opinion of [the applicant's] fitness to perform as a field grade JAG and he could only render such an opinion upon evaluation of [the applicant's] entire file, including all medical and evaluation reports." e. The commander's statement was rendered by an uninformed assignments officer, not someone within the applicant's chain of command, and is contrary to the regulatory requirement. f. The PEB's use of LTC M---'s "out of hearing musings" represents a denial of due process to the applicant, as [the applicant] was denied the opportunity to examine LTC M---'s remarks. Counsel states, "On this ground alone the [informal PEB] result is fatally flawed [counsel's emphasis]." g. After failing in his appeal, the applicant accepted the results of the informal PEB because service aggravation was denied by the Surgeon General. h. After the final secretarial decision on 13 January 2010, the applicant was retained on active duty until 30 April 2010. This retention caused the applicant to have over eight years of active service, thereby invoking Title 10, U.S. Code, section 1207a (10 USC 1207a). This provision requires the disability to be deemed to have been incurred while the member was entitled to basic pay and be so considered for purposes of determining whether the disability was incurred in the line of duty. Counsel adds that the applicant's DD Form 214 shows he completed 8 years, 1 month, and 13 days of total active service. i. Since 10 USC 1207a is invoked, service aggravation is no longer an issue. Counsel states, "[t]he only issues remaining are fitness for duty, the percentage of disability and the permanency and stability of the condition [counsel's emphasis]." (1) Counsel states the information provided by applicant's former counsel in his appeal provides evidence that the applicant's conditions are permanent and will not be favorably resolved. (2) The percentage of disability is grounded in the residuals of CMT, which include: * profound weakness and sensory loss in his distal arms and legs * amplified pain and cramping systemically due to defective signals in the sensory axons * an inability to write more than a few minutes or to use a keyboard for an extended period * an inability to pull the slide back on a weapon or to load the last rounds in a magazine because of applicant's limited hand and finger strength * an inability to extend his toes (3) The disabilities include "the lower radicular group bilaterally; the sciatic nerve bilaterally and the external popliteal nerve, coupled with pain systematically." These disabilities are associated with the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) series 8500, 8600, and 8700. (4) Counsel states the conclusion that the applicant is fit for duty is difficult to imagine given the warrior ethos in the standards of the combat arms that have been inculcated into the new lawyers of the JAG Corps. He adds, "[t]here is simply no doubt that there is no room for Applicant in today's JAG Corps. His disabilities are utterly inconsistent with the warrior ethos and what is expected of today's JAG, field grade [officer] or not." j. Counsel concludes that Army Regulation (AR) 635-40 [Physical Evaluation for Retention, Retirement, or Separation], paragraph 3-13, provides that the Medical Corps and general officers will be found fit for duty if they can perform satisfactorily in any assignment appropriate for their grade, qualification, and experience. He states, "[t]his is not the standard for JAG officers, although it appears to have been applied to Applicant. Relief should be granted." 3. Counsel provides copies of the applicant's DA Form 199, medical opinions, rebuttal and PEB appeal with attachments, DD Form 214 (Certificate of Release or Discharge from Active Duty), Narrative Summary (NARSUM) Report, and three magazine articles. CONSIDERATION OF EVIDENCE: 1. The applicant had prior enlisted service in the U.S. Marine Corps from 5 February 1980 through 4 February 1986 and in the Army National Guard of the United States (ARNGUS) from 3 April 1987 through 2 April 1995. 2. The applicant was appointed as a Reserve commissioned officer in the ARNGUS on 3 April 1995. Upon completion of training he was awarded primary specialty 27A (Judge Advocate General). 3. On 6 October 2004, the applicant was notified he had completed the required years of qualifying Reserve service and is eligible for retired pay upon application at age 60. 4. On 29 July 2006, the applicant was ordered to active duty for a period not to exceed 545 days in support of Operation Enduring Freedom. He was promoted to major (O-4) on 15 September 2006 and he served in Kosovo from 18 October 2006 through 14 February 2007. 5. The applicant's DA Form 67-9 (Officer Evaluation Report [OER]) for the period 2 December 2005 through 1 December 2006 is an annual report and shows in: a. Part IV (Performance Evaluation - Professionalism): (1) Army Values - An "X" in the "Yes" block for all 7 of the identified virtues. (2) Leader Attributes/Skills/Actions - An "X" in the "Yes" block for "Physical" and also an "X" indicating that it was 1 of 6 out of the 15 categories that best described the applicant. b. The applicant's rater evaluated the applicant's performance and potential as "Satisfactory Performance, Promote." c. The senior rater evaluated the applicant's promotion potential to the next higher grade as "Fully Qualified." He also commented that the applicant had the potential to serve at the next higher grade. 6. The applicant's OER for the period 2 December 2006 through 5 March 2007 is a 60-day option report and shows in: a. Part IV: (1) Army Values - An "X" in the "No" block for 5 of the 7 identified virtues. (2) Leader Attributes/Skills/Actions - An "X" in the "Yes" block for "Physical." b. The applicant's rater evaluated the applicant's performance and potential as "Unsatisfactory Performance, Do Not Promote." He also commented that the applicant "attempted to quantify his poor personal conduct as related to the medical condition with his feet. However, that excuse was a thinly veiled attempt to cover [applicant's] inadequacies and had nothing to do with his condition. The medical condition never prevented [the applicant] from recreation or taking trips off Camp Bondsteel." c. The senior rater evaluated the applicant's promotion potential to the next higher grade as "Do Not Promote." He also commented that the applicant "does not possess the motivation, nor the ethical values to be a Soldier. Do not retain." 7. Headquarters, U.S. Army Human Resources Command, Alexandria, VA, Orders A-03-705245, dated 6 March 2007, show the applicant was voluntarily retained on active duty to participate in the Reserve Component Medical Holdover Medical Retention Processing Program for completion of medical care and treatment. 8. A DA Form 199 shows a PEB convened on 13 October 2009. The Disability Description section shows "Informal Reconsideration" and that the applicant's case, which was previously considered on 25 June 2009, was reconsidered in accordance with AR 635-40, paragraph 4-20e; the applicant's DA Form 199, dated 25 June 2009, was superseded; and upon re-evaluation, the applicant was determined fit for further duty. a. Based on a detailed review of the evidence of record, the PEB concluded that the applicant's low back pain, bilateral ankle and foot pain, and CMT disease do not cause any functional impairment which prevents his satisfactory performance of duty. The applicant was found fit for duty in his current grade and specialty. b. The PEB re-evaluated the impact of the applicant's medical conditions on his ability to perform his military duties as a field grade staff JAG officer and found the applicant fit. Specifically, the PEB also found: (1) The applicant's DA Form 3349 (Physical Profile) [dated 23 January 2009] allows him to carry and fire his assigned weapon, wear the protective mask and chemical equipment, and perform an alternate aerobic event for an APFT, and shows he may perform most duties of a field grade JAG officer, but no vigorous activities. (2) The PEB noted that a field grade JAG officer is not expected to perform vigorous activities on a routine basis. (3) On 27 August 2009, the Deputy Director, Health Policy and Service, OTSG, opined that the applicant's CMT disease, which the PEB does not find unfitting, existed prior to service and was not aggravated by military service. (4) It notes the applicant was mobilized in July 2006, served in Kosovo from October 2006 through February 2007, and went into medical hold on 22 February 2007. A NARSUM shows, "[s]oldier was [medically evacuated] from Kosovo due to progressive inability to function in a hostile environment due to this condition (CMT disease)." (5) An 18 December 2008 medical record from Doctor P--- noted the applicant had a gradual onset of low back pain that had been occurring in an intermittent pattern for years. From a physical examination of the applicant's spine he observed normal gait and posture and 5/5 bilateral lower extremity muscle strength. He also noted "[m]ovements, no pain and full range of motion (ROM)." (6) A NARSUM noted, "pain on the bottom of his right/ foot/plantar fascia since the surgery (March 2007,…) and minor pain in his right ankle." (7) The PEB contacted LTC Mark D. M---, Staff JAG Assignments Officer, who noted that field grade JAG officers who can perform the mandatory tasks of carry and fire an assigned weapon, wear the protective mask and chemical defense equipment, and complete an aerobic event for an APFT can be retained and assigned duties. 9. Headquarters, Department of the Army, letter Number 635-08-1, paragraph 7c, requires Sections III and IV of the Commander's Performance and Functional Statement (DA Form 7652) be completed by the officer's Staff Judge Advocate, Command Judge Advocate, or legal agency/section supervisor. 10. A DA Form 7652, dated 10 September 2009, submitted by LTC Thomas G--- noted "Not Observed" to all of Section IIIB and also noted, "I do not recommend retaining this Soldier. While Soldier possesses mental attitude and skills to perform as a 27A, Soldier is not able to meet the physical demands associated with uniformed service." 11. The PEB disagreed with this "unobserved" assessment and found the applicant fit for further duty. a. The applicant's OER for the period 2 December 2005 through 1 December 2006 reflects satisfactory duty performance with the Senior Rater noting "[applicant] has the potential to serve at the next higher grade once he completes the Judge Advocate Advanced Course and the Army's Intermediate-Level Education program. b. The PEB noted the applicant's serial profile was subject to a request for reconsideration by the unit commander, that deployability is a command decision, and the inability to deploy cannot be used as the sole basis to determine unfitness. c. The PEB found the applicant physically fit with the disposition that the applicant be returned to duty as fit. 12. On 29 October 2009, after having received a full explanation of the findings and recommendations of the PEB and being advised of his legal rights, the applicant indicated with his signature that he did not concur. He submitted his written appeal and requested a formal hearing of his case, which he understood was at the discretion of the PEB President. 13. On 6 January 2010, the applicant indicated with his signature that he concurred with the PEB findings and recommendations and waived formal hearing of his case. 14. U.S. Army Physical Disability Agency (USAPDA), Washington, DC, memorandum, dated 13 January 2010, Subject: Approval of the PEB Action Under Provisions of AR 635-40 [RE: Applicant], approved the PEB findings. The findings of fit were based on the preponderance of evidence provided to the PEB and that the applicant's case is considered closed and complete. 15. Headquarters, U.S. Army Garrison, Fort Eustis, VA, Orders 120-0010, dated 30 April 2010, released the applicant from active duty, not by reason of physical disability, on 30 April 2010, and assigned him to his USAR unit. 16. The applicant's DD Form 214 shows he entered active duty this period on 29 July 2006, was honorably released from active duty on 30 April 2010 based on completion of required active service, and he transferred to his USAR unit. At the time he had completed 3 years, 9 months, and 2 days of net active service this period; 4 years, 4 months, and 11 days of total prior active service; and 20 years, 11 months, and 15 days of total prior inactive service. 17. In support of his application, the applicant and his counsel provide the following documents: a. PEB proceedings, dated 13 October 2009, USAPDA memorandum, dated 13 January 2010, OTSG memorandum, dated 27 August 2009, and DD Form 214 that were previously considered in this Record of Proceedings. b. Walter Reed Army Medical Center (WRAMC), Office of the Center Judge Advocate, Washington, DC, memorandum, dated 9 September 2009, Subject: Request for a Medical Opinion [Applicant], submitted by LTC Paul F. F--, JAG, USAR (applicant's counsel at the time). He provided an account of the applicant's military career, CMT disease, and aggravating conditions, along with references to medical literature on CMT. He concluded "[t]he [medical] opinion rendered in the 27 August 2009 [OTSG] memorandum is both legally and factually insufficient as it neither states how the presumption of sound condition was overcome nor does it cite any facts providing the foundation for the opinion." c. WRAMC, Office of the Center Judge Advocate, Washington, DC, memorandum, dated 29 October 2009, Subject: Appeal of Informal PEB decision pertaining to [applicant], submitted by LTC F---, JAG, USAR (applicant's counsel at the time). The document summarized information in the exhibits provided in support of the applicant's appeal. (1) Chronological Record of Medical Care (Neurology Clinic, WRAMC), dated 2 October 2009, shows the applicant was referred for assessment of upper and lower muscle strength for MEB evaluation. The prognosis section shows, "[applicant] has profound weakness and sensory loss in his distal arms and legs." It concludes, "[h]owever, a more important question is if the disease contributed to the sudden and severe worsening of the patient's back and other orthopedic problems while deployed. Undoubtedly, this is the case." (2) "Facts About Charcot-Marie-Tooth and Related Diseases" and "Charcot-Marie-Tooth Disease Fact Sheet" from the Muscular Dystrophy Association Publications website that shows some people with CMT experience pain caused by "defective signals in the sensory axons." (a) Material from the Charcot-Marie-Tooth Association (CMTA) website that describes treatment and management of CMT and provides a list of members of the CMTA Medical Advisory Board. (b) An article titled, "The Basics of Charcot-Marie-Tooth Disease" by Linda Crabtree, Founder of CMT International, updated in 2001, and a white paper titled, "Engaging With Charcot-Marie-Tooth Disease: A Grounded Theory Approach" by Nicolaas Willem Alberts, dated November 2008. (c) An article titled "Charcot-Marie-Tooth Hereditary Neuropathy Overview" by Thomas D. Bird, MD, revised on 16 April 2009. (3) A DA Form 3349, dated 22 October 2009, that shows the applicant was placed on a permanent physical profile and not allowed to carry and fire his assigned weapon, or wear the protective mask and chemical equipment; however, he can perform an alternate aerobic event for an APFT and march with standard field gear, except rucksack. [The applicant's former counsel states the findings of the PEB on 13 October 2009 are incorrect regarding this information given this updated DA Form 3349]. (4) Physical Medicine and Rehabilitation, Greater Chesapeake Orthopaedic Association, LLC, Consultation Note, dated 24 August 2009, that shows, "[r]egarding [the applicant's] capability to perform active duty as a soldier, clearly with the amount of neuromuscular compromise of the upper and lower extremities, the patient is not capable to perform in the military. Therefore, he is advised to pursue medical retirement." (5) Johns Hopkins Medicine, Clinic Note, dated 13 October 2009, dictated by David R. Cornblath, MD, that shows the "[a]pplicant is a 47-year old man who by history and physical examinations appears to have rapidly progressive CMT 1A. The issue is why is this, as this would be unusual in the routine course of events of CMT 1A. I believe he should have a reevaluation, which could be done either at Hopkins or at the military. (The doctor's 22-page Curriculum Vitae is also provided.) (6) Chronological Record of Medical Care, Camp Atterbury Clinic, dated 1 October 2006, that shows the applicant was seen for frequent heartburn, the physical findings were normal, and he was treated for Esophagitis Chronic Reflux. (7) American Radiology Service, Magnetic Resonance Imaging of the Cervical Spine, dated 11 July 2008, and Chronological Record of Medical Care, dated 24 September 2009, that documents the applicant's degenerative disease of the cervical spine, most marked at C4-5. (8) Johns Hopkins Medicine, Medical Record, dated 25 August 2009, that documents the applicant's degenerative disease of the cervical spine. d. A NARSUM, Neurology Department, Veterans Affairs Hospital, Virginia Beach, VA, based on an examination of the applicant on 5 November 2008, that shows the applicant's various diagnoses. The Disposition section shows, "Refer to PEB for final disposition." e. Three magazine articles that discuss pursuit of the Warrior Ethos through training initiatives for new Judge Advocate lawyers with the goal for JAG officers in the Army to be warriors first and lawyers second. 18. Title 10, U.S. Code, section 1207a (Members with over eight years of active service: eligibility for disability retirement for pre-existing conditions), provides that members with over eight years of active service who would be covered by section 1201, 1202, or 1203 of this title, but for the fact that the member's disability is determined to have been incurred before the member became entitled to basic pay in the member's current period of active duty, the disability shall be deemed to have been incurred while the member was entitled to basic pay and shall be so considered for purposes of determining whether the disability was incurred in the line of duty. 19. AR 635-40 sets forth policies, responsibilities, and procedures in determining whether a Soldier was unfit because of physical disability to reasonably perform the duties of his or her office, grade, rank, or rating: a. Chapter 3 provides policies governing standards of unfitness because of physical disability. (1) Paragraph 3-1 (Standards of unfitness because of physical disability), in pertinent part, 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 Soldier reasonably may be expected to perform because of their office, grade, rank, or rating. (2) Paragraph 3-2 (Presumptions), in pertinent part, states the following presumptions will apply to physical disability evaluation. Subparagraph b (Processing for separation or retirement from active service) provides: (3) Disability compensation is not an entitlement acquired by reason of service-incurred illness or injury; rather, it is provided to Soldiers whose service is interrupted and they can no longer continue to reasonably perform because of a physical disability incurred or aggravated in service. (4) When a Soldier is being processed for separation or retirement for reasons other than physical disability, continued performance of assigned duty commensurate with his or her rank or grade until the Soldier is scheduled for separation or retirement, creates a presumption that the Soldier is fit. (5) The presumption of fitness may be overcome if the evidence establishes that the Soldier was, in fact, physically unable to perform adequately the duties of his or her office, grade, rank or rating for a period of time because of disability. There must be a causative relationship between the less than adequate duty performance and the unfitting medical condition or conditions. An acute, grave illness or injury or other significant deterioration of the Soldier's physical condition that occurred immediately prior to, or coincident with processing for separation or retirement for reasons other than physical disability and which rendered the Soldier unfit for further duty. b. Chapter 4 provides procedures governing eligibility for disability evaluation. Paragraph 4-18 (Initial processing) provides: (1) Upon receipt of a case by the PEB, the case file will be reviewed to ensure it is complete. If documents are missing, action will be taken to complete the file. When the case file is complete it may be referred to the board for evaluation. (2) The PEB may return a case to the MTF commander for additional information. However, efforts should be made to resolve all issues without returning the case. When circumstances permit resolution of the problem by discussion, a memorandum of the discussion must be included in the case file as an exhibit. When return of the case to the MTF is necessary, the reason for its return will be clearly stated in the letter of transmittal. Examples of reasons for which a case may be returned are as follows: (a) further physical examination, clarification, or preparation of additional records is required; (b) additional description and information by the medical board of the Soldier's defects and their effect on the Soldier's functional ability to perform duty are necessary for proper PEB evaluation of the case; (c) further observation, evaluation, and reconsideration by a medical board is required; or additional information from the command concerning the Soldier's ability to perform the duties of his or her office, grade, rank, or rating must be provided for proper PEB evaluation of the case. DISCUSSION AND CONCLUSIONS: 1. The applicant and counsel contend that the applicant's PEB proceedings should be corrected to show he was found unfit for duty and transferred to the retired list based upon permanent disability with a rating of 50% based upon low back pain, bilateral ankle and foot pain, and CMT disease because he had over eight years of active service and he is eligible for disability retirement for pre-existing conditions. 2. The applicant's and his counsel's contentions, along with the evidence they provided in support of this application, and the evidence of record was carefully considered. a. The applicant's OER for the period 2 December 2006 through 5 March 2007 shows the applicant's performance was unsatisfactory as a commissioned officer in his rank and as a JAG officer. It also shows the rater rendered a positive assessment of the applicant's physical fitness. In fact, the rater specifically commented that the applicant, "attempted to quantify his poor personal conduct as related to the medical condition with his feet." However, he noted his performance had nothing to do with the applicant's medical condition as evidenced by his off-duty recreation. b. On 13 October 2009, an informal PEB reconsidered the applicant's 25 June 2009 informal PEB based on a detailed review of the evidence of record. (1) The PEB found the applicant physically fit with the disposition that the applicant be returned to duty as fit. The applicant did not concur with the informal PEB proceedings. (2) On 29 October 2009, the applicant and his former counsel submitted a detailed appeal of the informal PEB findings and recommendations. (a) The appeal addressed matters related to the applicant's medical conditions and the opinion rendered by LTC M---, Staff JAG Assignments Officer, and the professional opinions and information in the medical literature submitted. All of this information was considered by the PEB. (b) A Soldier's ability to perform in a given career field is precisely one of the factors the PEB considers in making a fitness determination. Consequently, the information from LTC M--- was a valid consideration. (c) The updated physical profile, dated 22 October 2010, was also included in the applicant's appeal. It is noted that it shows the applicant is not allowed to carry and fire his assigned weapon or wear the protective mask and chemical equipment. It also shows the applicant can perform an alternate aerobic event for an APFT and that he can march with standard field gear, except the rucksack. However, this physical profile is not dispositive evidence that the applicant's medical condition is unfitting. The profile may render the applicant nondeployable, but that fact is not a basis on which to rest a fitness determination. (3) The PEB found the applicant physically fit with the disposition that the applicant be returned to duty as fit. (4) On 6 January 2010, the applicant concurred with the informal PEB proceedings and waived a formal hearing of his case. (5) The PEB proceedings were approved on 13 January 2010. 3. Records show the applicant was voluntarily retained on active duty to participate in the Reserve Component Medical Holdover Medical Retention Processing Program for completion of medical care and treatment. This resulted in the applicant being credited with more than 8 years of active service. However, counsel's argument that this invoked 10 USC 1207a and the applicant is eligible for disability retirement for pre-existing conditions is moot because the applicant was found medically fit for duty at the time he was separated. 4. The applicant and his counsel provide no evidence that demonstrates the approved informal PEB proceedings were in error, arbitrary and capricious, or unjust. 5. In view of all of the foregoing, it is concluded the applicant's informal PEB is correct in both law and regulation. Therefore, the applicant is not entitled to the requested relief. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ___X____ ___X___ ___X____ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined that 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. ABCMR Record of Proceedings (cont) AR20100020085 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20100020085 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1