IN THE CASE OF: BOARD DATE: 12 April 2016 DOCKET NUMBER: AR20140020114 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 IN THE CASE OF: BOARD DATE: 12 April 2016 DOCKET NUMBER: AR20140020114 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 to amend the decision of the ABCMR set forth in Docket Number AR20130020179, dated 16 September 2014. ___________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. IN THE CASE OF: BOARD DATE: 12 April 2016 DOCKET NUMBER: AR20140020114 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 reconsideration of his earlier request for correction of his records to show he was discharged by reason of disability. He also requests a personal hearing. 2. The applicant states he is a disabled veteran who requests the proper medical discharge for numerous health issues. He was exposed to radiation and other environmental hazards. He had two organs rupture within 30 months of each other. He was also denied a medical board after a life threatening illness. He was sent to sick call during his last assignment but nothing was done properly before his separation. He was stationed in Korea in 2009 and he was separated in 2011. 3. The applicant provides his: * Service personnel records including a photograph, certificates of awards and decorations, evaluation reports, and other personnel records * Service medical records and civilian medical records * Department of Veterans Affairs (VA) medical records/progress notes CONSIDERATION OF EVIDENCE: 1. Incorporated herein by reference are military records which were summarized in the previous consideration of the applicant's case by the Army Board for Correction of Military Records (ABCMR) in Docket Number AR20130020179 on 16 September 2014. 2. The applicant provides his service medical records, VA medical records, personnel records, and other documents. His request warrants consideration by the Board. 3. Having had prior enlisted service in the Regular Army (RA) (2 September 1982 to 2 July 1986), the applicant was appointed as a Reserve commissioned officer of the Army and executed an oath of office on 8 April 2003. He completed the Chaplain (CH) Officer Basic Course from 23 April to 23 May 2003. He was promoted to captain (CPT) with an active duty date of rank as 21 April 2003. 4. Following verification of his professional and ecclesiastical qualifications of Religious Ministry Professionals, he was appointed as an RA officer in the rank of CPT on 11 November 2005. He completed the CH Captain Career Course from January through July 2007. 5. He was considered for promotion to major (MAJ) by the Fiscal Year (FY) 2010 and the FY2011 CH MAJ Promotion Selection Boards, but he was not selected by either board. Accordingly, he was honorably discharged from the RA on 1 October 2011 as a two-time non-selection for permanent promotion. 6. His DD Form 214 (Certificate of Release or Discharge from Active Duty) shows he completed 8 years, 5 months, and 11 days of active service with entitlement to separation pay. 7. He was appointed as a Reserve commissioned officer of the Army and executed an oath of office on 2 October 2011. He was assigned to the U.S. Army Reserve (USAR) Control Group (Reinforcement). 8. On 20 March 2012, the U.S. Army Human Resources Command (HRC) published Orders B-03-202152 promoting him to MAJ with an effective date and date of rank of 7 March 2012. 9. On 4 September 2012, he tendered an unqualified resignation from the USAR and he was accordingly honorably discharged from the USAR on 1 October 2012 in accordance with AR 135-175 (Officer Separations). 10. He provides: a. A statement, dated 13 June 2013, from Mr. Ch-- Le--, a VA physician assistant (PA). He states the applicant has a past medical history of polycystic kidney disease, gastric polyposis, degenerative disc disease of the cervical spine, back pain, and polycystic liver disease. He was also exposed to radiation during his military service. He has chronic digestive issues and chronic pain issues. He opined that the applicant is eligible for a medical discharge. b. A letter of recommendation, authored by Jo---- St---. He states the applicant helped him during his ordeal dealing with the death of his father. He opines that the command climate in Afghanistan in 2009 was very strange. Soldiers were being blamed for a variety of issues. The applicant went out of his way to help others and he was always supportive. He is a decent man. c. A statement, dated 25 March 2014, from Colonel Er-- Ru-- who states the applicant served as his battalion chaplain from December 2009 to June 2011 (when he left command). During this time, he was very sick. He did not complain and did a good job but was unable to operate at 100 percent due to his gastrointestinal issues. When he arrived in Korea, he informed the chain of command of his medical issues and he had several appointments at Samsung Hospital. He (the author) assumed all the tests were leading to an MEB. When the applicant received his non-select memorandum, he (the author) assumed his separation would be delayed for the purpose of an MEB. His condition is service-connected and a reevaluation must be conducted to determine if there is cause for a medical retirement. 11. An advisory opinion was received on 25 February 2016 from the U.S. Army Medical Department Activity, Fort Leavenworth, KS in the processing of this case. A medical provider at Munson Army Health Center stated: a. Task: The Army Review Board Agency has requested an advisory opinion regarding whether the applicant requires correction to his military record in the form of a Medical Evaluation Board and Physical Evaluation Board following cholecystectomy in November 2008 and/or following appendectomy in May 2011. All electronic medical records in the Armed Forces Health Longitudinal Technology Application (AHLTA), also known as Electronic Medical Record, (20081110-20110628), Report of Upper Endoscopy (EGD) and Colonoscopy (20090303) have been reviewed. b. Background: The applicant presented to the outside continental United States (OCONUS) site medical clinic on 10 November 2008 with a one week history of progressive right upper quadrant pain. (1) Intermittent attacks of post prandial right upper quadrant pain were reported as ongoing for a period of years, but this particular episode had become unbearable. Initial evaluation was consistent with cholelithiasis with associated biliary obstruction as evidenced by significant elevation in liver enzymes. [Applicant] received IV antibiotics upon admission in Bagram Air Base in Afghanistan. Right upper quadrant ultrasound obtained revealed a large stone in the gallbladder. The diameter of the common bile duct was estimated at 5 mm. Abdominal pain was quickly controlled. He did not have a fever or any other evidence of an underlying infection during the time of hospitalization in Bagram. Because his liver transaminases remained elevated and facilities in Germany did not have surgical equipment to explore the ducts of the liver, arrangements were made for the applicant to be transferred from Bagram to Landstuhl Army Medical Center, Germany, where he arrived on 13 November 2008. He underwent laparoscopic cholecystectomy the next day, 14 November 2008, and was cleared for hospital discharge within 72 hours of surgery. (2) Plans for his return back to Afghanistan were discussed at the first outpatient post-operative visit on 18 November 2009, provided he continued to recover well. Erratic elevation in his liver enzymes combined with persistent abdominal pain warranted additional advanced imaging in order to exclude an obstruction in the common bile duct. Retained stones in the biliary system, bilioma, and an abscess were excluded via CT and ultrasound of the abdomen. The decision was made to transfer the applicant to Walter Reed Army Medical Center in order to further investigate the source of the liver's malfunction by Gastroenterology. He underwent endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy of the common bile duct on 26 November 2008, with immediate resolution of abdominal pain and marked reduction in liver enzymes over the next 10 days. Mild irritation in the lower esophagus (consistent with Barrett's esophagitis) and a small hiatal hernia were noted as incidental findings during the ERCP. His focus of concern after recovery from the ERCP was pursuit of surgical intervention for the hiatal hernia. General surgery did not support surgical intervention for the hiatal hernia because his heartburn symptoms were reportedly mild. The surgeon advised him that treating his stomach with acid lowering agents was an appropriate step in order to allow the lining of the lower esophagus to heal and to keep the Barrett's changes from progressing. The applicant was advised that he could again address the appropriateness of undergoing surgery for the hiatal hernia once he returned to his home station (Fort Campbell, KY) especially since surveillance upper endoscopy would be necessary. (3) The applicant broached surgery for the hiatal hernia again with a different provider just prior to leaving on pass to spend Christmas with his family in Atlanta, GA. Upon Warrior Transition Unit (WTU) return in January 2009, he remained focused on surgical management for the hiatal hernia with yet another general surgeon. He was referred to GI and underwent 24 hour Ph monitoring in addition to surveillance EGD and colonoscopy. The gastroenterologist, Dr. Jo--Sa----, documented that the applicant had "NO major GI complaints" at visit dated 5 February 2009. Out-patient surveillance EGD and colonoscopy were completed on 2 March 2009 and biopsies of the lower esophagus, stomach polyps and colon polyps were submitted for pathology. The Ph probe and manometry of the esophagus completed on 10 March 2009 did not support surgical intervention for his hiatal hernia. An MRI of the abdomen (13 March 2009) revealed multiple (10-15) simple small cysts in the liver with a single 4 mm cyst in the upper pole of the right kidney. The applicant requested that a second opinion be rendered by GI as to whether he needed to undergo liver biopsy due to the cysts found in the liver and in addition, provide an additional opinion as to surgical intervention for the small hiatal hernia. Walter Reed medical personnel returned the applicant to full duty back to Fort Campbell. Prior to returning to Fort Campbell, he did meet with a gastroenterologist at National Naval Medical Center (NNMC) Bethesda (15 April 2009) who concurred with the prior GI specialist's surveillance recommendations for underlying Barrett's Esophagus. (4) The applicant was issued a medical release for reassignment/ permanent change of station on 29 July 2009 and appears to have transitioned from Fort Campbell to Korea in late November or early December 2009. He met with general surgery the first week of January 2010 to discuss surveillance EGD/Colonoscopy, surgical intervention for the hiatal hernia and an additional Gl opinion regarding the liver cysts. A second esophageal Ph study, completed on 13 January 2010 at Samsung Medical Center, was consistent with severe gastroesophageal reflux disease. In preparation for surgical consideration of the hiatal hernia, he underwent additional testing at Samsung Medical Center: (a) barium swallow with small bowel follow-thru, and (b) esophageal manometry, the latter of which revealed periodic sluggish peristalsis of material thru the stomach. Repeat EGD on 6 October 2010 did not reveal any pre-malignant or malignant changes in the esophagus, but the surgeon (Dr. Jo-- K--) did refer the applicant back to Gastroenterology at Samsung so that some of the larger polyps in the stomach could be removed in a more controlled surgical setting. Dr. K-- reassured the applicant that as long as the gastric polyps were benign, that he would be a good candidate for a Nissen fundoplication. (5) On 29 December 2010, the applicant fell on the ice and struck his head. He did not lose consciousness, exhibit alteration of consciousness or suffer from amnesia as a result of this event, but he did report some mild dull pain and stiffness in his neck and lower back. His physical exam the day of the fall was completely normal. The gastric polyps removed by Samsung GI were all benign, but there remains a small possibility that some of the polyps could undergo malignant change. It is for this reason that the applicant was told that undergoing a Nissen fundoplication would not be advised and that he would need annual surveillance of his esophagus and stomach. When the applicant met with Dr. K-- on 20 April 2011, he informed the physician that he would be separated from military service in October 2011. The applicant presented with an acute surgical abdomen due to a ruptured appendix on 23 May 2011 and underwent an emergent laparoscopic appendectomy at Samsung the same day. He recovered rapidly and was well enough to be discharged three days later with two weeks of convalescent leave. When he completed out-patient oral antibiotics, he began to experience itching and a mild rash. These symptoms were felt to be compatible with a drug reaction. The last three entries seen in the electronic record are for Optometry (24 June 2011), treatment of a superficial burn from his oven (27 June 2011) and a separation physical on 28 June 2011. c. Discussion Points: The following points were raised by the applicant in his petition: (1) Relationship between the reported remote radiation exposure and the development of Barrett's esophagus, gastric and colon polyps: (a) Fort Hood, TX currently encompasses 340 square miles. Its inception began in January 1942 as a testing and training facility during World War II for newly developed tank destroyers. Field artillery and infantry training units replaced the tank destroyer battalions in 1944 as mission requirements changed. In the mid 1950's, the training of combat units and reactivation of the 4th Armored Division populated most of the post as the conflict in Germany continued. In the 1960's, Fort Hood served as the primary training site for soldiers destined for Vietnam. The 1970s brought an era of testing, training, and introduction of new equipment and operational tactics. (b) Project 76 involved construction of a Cold War era bunker and tunnels on the west side of Fort Hood in 1947. It represented the Army's only known storage facility of atomic weapons. The bunker was decommissioned in the 1960s, the last nuclear weapon removed in 1967. More recently (2002) the bunker and tunnels were converted for training operations in order to provide troops with the experience of combat operations underground. (c) Gastric polyps develop over time in response to damage to the stomach lining, regular use of certain medications, or more rarely, are inherited. It is well known that exposure to very high doses of ionized radiation is linked to colorectal cancer; however, no direct link between exposure to ionized radiation and the formation of gastric polyps is identified in the medical literature. (2) Reported rupture of the gall bladder while on duty in Afghanistan: The clinical medical evidence as to the applicant's gallbladder does not support that the organ had ruptured while he was in Afghanistan. (3) Relationship of perforation of the appendix to the reported remote exposure to radiation: There is no clinical correlation found between the applicant's reported exposure to ionized radiation in the 1980's and the acute perforation appendicitis he experienced in May 2011. (4) Denial of a Medical Evaluation Board following a life threatening illness: The available clinical medical records do not include discussion as to eligibility for Integrated Disability Evaluation System (IDES) processing as a result of (a) bout of cholecystitis, (b) discovery of Barrett's Esophagus, or (c) following surgical intervention for the acute perforation appendicitis. (5) Reassignment/permanent change of station of "ill" Soldiers: The applicant was medically cleared to change stations six months prior to his transition to Korea. The available medical records support that he was in very good health prior to leaving Fort Campbell according to a periodic physical dated 9 November 2009. (6) Lack of proper medical care prior to separation: The quality of medical care afforded to the applicant during the 2008 episode of acute cholecystitis in 2008 and 2011 appendix rupture was not found to be sub-standard in any manner. Surgical intervention was appropriately swift and life-saving in nature. (7) Scarring of the colon: The applicant's colonoscopy report (3 March 2009) does not support the presence of scarring in any portion of the colon as claimed on his application to this Board, signed by him on 4 October 2014. d. Conclusion: The legal basis for commissioned officer promotions is contained in Title 10, United States Code (USC). Army Regulation (AR) 600-8-29 (Officer Promotions), chapter 1-13 outlines the potential outcomes an active duty officer who has failed to be selected for promotion as does AR 600-8-24. According to the medical service treatment records, the applicant informed Dr. K-- in April 2011 that he would be leaving active duty military service on 1 October 2011. f. Recommendation: The applicant is not eligible for a Medical Evaluation Board as a result of the 2008 episode of cholecystitis or the May 2011 acute abdomen due to perforation of the appendix. Both of these conditions were expeditiously treated and the Soldier recovered successfully so as to return to duty without significant physical limitations. 12. The applicant responded to the advisory opinion on 18 March 2016. He stated: a. His wounds are largely hidden from view. He may look okay, but he is not. He was poisoned by radiation during the Cold War. His entire gastrointestinal system is scarred, and he continues to suffer. When he discussed his digestive issues with Army Medical, he would be told it "was not that bad," or he would be completely ignored. No one cared if he defecated in his pants. Even an official at the VA, Ch-- Le--, has told him, "I have never had another patient like you." Mr. Le-- has been the only PA who has truly listened to his physical complaints. Due to hazardous exposures, he suffers ill health with his gastrointestinal tract. Mr. Le-- has recommended him for a medical discharge. b. As a former Army chaplain, he worked daily, did not have weekends off, and slept little. His hours were extended. He was on call 24/7 for emergencies. If he were not available, someone could die. His records will show that he was the most dedicated and accomplished chaplain in the U.S. Army. He was essentially worked to the point of collapse, and near death. He prevented multiple murders and intervened to halt numerous suicide attempts. He took this nervous energy to his gut. His duties were most stressful. He never lost a Soldier to suicide. He had to be constantly on the alert to prevent tragedy. This stress would eventually take its toll on his already weakened digestive tract from earlier radiation exposures. His stomach and bowels remain delicate, like glass. He was always in the right place at the right time. Being not one to complain, he kept going until he had two organs rupture within 30 months of each other: the gallbladder in 2008 during his deployment to Afghanistan followed by his appendix just before his separation from Korea in 2011. c. He has never heard of anyone having two organs explode within such a span of time. These problems all had their origin from radiation exposure from his enlistment at Fort Hood. After his separation, he went to seminary. A 15 year break in service would follow. He then volunteered in 2003 to be an Army chaplain. In Afghanistan his gallbladder burst at a remote site. It took two days to get to the hospital and another three days to be evacuated due to weather delays. He was approaching death when he arrived in Germany on day five. The evening before his surgery, he was approached by two doctors. They simply told him that it didn't look good for him. He responded, "If anyone is ready to go, it is me. Do the best you can. I am fine either way." They shook their heads and walked away in silence. By this time he was going septic. He was in very bad shape. What saved him was his physical conditioning before the deployment. He had been a runner in his youth. By the grace of God, and this inner strength, he survived that major surgery. d. After surgery, he remained quite ill at Landstuhl. He would spend three nights in the emergency room vomiting his guts out. No one knew what was wrong with him. They had failed to detect a massive gallstone that was blocking his tract. He was then sent to Walter Reed for a period of four months (November 2008-April 2009). There the stone was retracted, and he continued my treatments, being passed from one doctor to another. He was also diagnosed with a hiatal hernia. It looked like a gunshot. His stomach had burned him with severe acid reflux in theater. One doctor told him that his stomach was abnormal. However he did not write this down. During and after Afghanistan he has had difficulty with his bowels. Finally at Walter Reed the pieces were coming together on why he had been so sick. His weakened gastrointestinal tract had failed him under the trials and stress of combat operations. This is the first time that he had realized how sick he was. His body had finally told him that it had enough and everything stopped for him. e. He was sent back to Fort Campbell out of shape and found himself still quite weak. They had a Brigade Surgeon at that time named MAJ Gr---. There were many complaints levied against his person and practice. He soon found out for himself how true his Soldiers' complaints were. The Brigade Surgeon was of no help to him either. He briefly spoke to him, and did not even examine him. He was unfit for duty and requested a Medical Evaluation Board. It was denied. Despite his protests, no one helped him, to include the Installation Chaplain, (Colonel) Bo---. He told him to simply not give up. He (the applicant) was in a very bad situation. His options at this point were either to go to his next assignment sick, or resign. This is the sad truth of it all. By this time he could no longer run. He had a walking profile. He pushed myself to finish his final physical fitness test at his maximum weight of 205 pounds and somehow he made it. f. Fort Campbell was a very stressful post to work on. At this time they were leading the Army in completed suicides. He prevented two murders and over a dozen suicide attempts while stationed there. His command told him that they had never seen any problems like this before, and that he was making it all up! He never lost a Soldier to suicide, and would be the only chaplain during their deployment not to lose a single Soldier in combat operations. He always helped his Soldiers, even if it made him unpopular with the command. They didn't want him around anymore, even for a medical board. He was then knowingly sent away sick. Nothing was done properly to help him. Jon--- Str---k's letter will give the Board an idea what he went through in this toxic environment. This is a very important detail which the Board must understand. Upon reporting to Camp Humphreys, he informed his Battalion Commander (then Lieutenant Colonel E--- R---) that he was sent to him sick. Colonel R---'s memo speaks clearly that he was unfit for duty. He had a number of appointments in Korean hospitals. One Army doctor in Yongsan rechecked his colon. He told him that he was once at pre-cancer. No other Army doctor even mentioned this. He would discuss his discomfort with the physician assistants but they did not care. g. Ultimately, his combat deployment to Afghanistan with the 101st had broken his health. He now could no longer run, had ragged breathing, and would have to work being sick. He kept going until his appendix ruptured just before his separation. It almost killed him. All of these problems can be traced to his exposures at West Fort Hood. With the Army he has experienced the three D's: Deny, Delay, & Die. It is very upsetting. His health was destroyed in service and he is presently rated at 50 percent by the VA. The best way to describe what he has been through is in the following quote: "An error does not become truth by reason of multiplied propagation, nor does truth become error because nobody sees it." Progress has been slow in getting his health concerns properly addressed after his separation. Since the Army failed to properly diagnose him, the VA is doing what they can. He is now on the national registry for radiation exposures from the Cold War. This is most significant. For over 30 years ago, he had to work in a chamber where atomic bombs were stored at the former Site Baker (West Fort Hood, Texas). The radiation symbols were painted on the walls, and he is very much a victim of this exposure. h. He now has two organs which are missing, and continues to suffer with digestive issues. This is all connected to his service history extending to his enlistment from 1982-1986. The letter from Ro--- L. Van S--- is most important to this fact. Finally the question is this: Does the Army live up to its values by fairly treating its Soldiers and veterans? If he is denied a proper medical discharge for facing death from these exposures, he will have to say "No." He was one of the top chaplains in the U.S. Army and has been mistreated. He has reported his promotion issue to the U.S. Army Criminal Investigation Command (CID) and if properly investigated, will lead the Board to a fraudulent promotion. He has reported this felony numerous times to CID. This is why he was involuntarily put out of the Army. The Board should see to it that a CID agent interviews him. It is time for this truth to be revealed, too. 13. The applicant's promotion issue is addressed via a separate case before this Board. He also provides his VA rating decision, dated 18 February 2016. It shows the VA awarded him service-connected disability compensation for post-traumatic stress disorder at 30 percent, traumatic brain injury at 10 percent, and esophagitis reflux with Barrett's esophagus at 10 percent. REFERENCES: 1. AR 635-40 (Physical Evaluation for Retention, Retirement, or Separation) establishes the Army physical disability system (PDES) 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 or her office, grade, rank, or rating. a. The PDES assessment process involves two distinct evaluations, the medical evaluation board (MEB) and the physical evaluation board (PEB). The purpose of the MEB is to determine whether the service member's injury or illness is severe enough to compromise his or her ability to return to full duty based on the job specialty designation of the branch of service. A PEB is an administrative body possessing the authority to determine whether a service member is fit for duty. A designation of "unfit for duty" is required before an individual can be separated from the military because of an injury or medical condition. Service members who are determined to be unfit for duty due to disability are either separated from the military or permanently retired, depending on the severity of the disability and length of military service. Individuals who are separated receive a one-time severance payment, while individuals who retire based on disability receive monthly military retirement payments and have access to all other benefits afforded to military retirees. b. Paragraph 3-2b (Processing for Separation or Retirement from Active Duty) states disability compensation is not an entitlement acquired by reason of a service-incurred illness or injury; rather, it is provided to Soldiers whose service is interrupted and who can no longer continue to reasonably perform because of a physical disability incurred or aggravated in service. When a Soldier is being processed for separation or retirement for reasons other than physical disability, continued performance of assigned duties 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. The presumption of fitness may be overcome if the evidence establishes that: (1) the Soldier was, in fact, physically unable to adequately perform the duties of his or her office, grade, rank, or rating for a period of time because of a disability. There must be a causative relationship between the less than adequate duty performance and the unfitting medical condition or conditions; (2) an acute, grave illness or injury or other significant deterioration of the Soldier's physical condition 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. 2. AR 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, disabilities are rated using the VA Schedule of Rating Disabilities. 3. Title 10, U.S. Code, section 14506 (Effect of failure of selection for promotion: reserve majors of the Army, Air Force, and Marine Corps and reserve lieutenant commanders of the Navy) states unless retained as provided in section 12646, 12686, 14701, or 14702 of this title, each reserve officer of the Army, Navy, Air Force, or Marine Corps who holds the grade of major or lieutenant commander who has failed of selection to the next higher grade for the second time and whose name is not on a list of officers recommended for promotion to the next higher grade shall, if not earlier removed from the reserve active-status list, be removed from that list in accordance with section 14513 of this title on the later of (1) the first day of the month after the month in which the officer completes 20 years of commissioned service, or (2) the first day of the seventh month after the month in which the President approves the report of the board which considered the officer for the second time. 4. Directive Type memorandum (DTM) 11-015 explains the Integrated Disability Evaluation System. It states: a. The IDES is the joint DOD-VA process by which DOD determines whether wounded, ill, or injured Service members are fit for continued military service and by which DOD and VA determine appropriate benefits for Service members who are separated or retired for a Service-connected disability. The IDES features a single set of disability medical examinations appropriate for fitness determination by the Military Departments and a single set of disability ratings provided by the VA for appropriate use by both departments. Although the IDES includes medical examinations, IDES processes are administrative in nature and are independent of clinical care and treatment. b. Unless otherwise stated in this DTM, DOD will follow the existing policies and procedures requirements promulgated in DOD Directive 1332.18 and the Under Secretary of Defense for Personnel and Readiness Memoranda. All newly-initiated, duty-related physical disability cases from the Departments of the Army, Air Force, and Navy at operating IDES sites will be processed in accordance with this DTM and follow the process described in this DTM unless the Military Department concerned approves the exclusion of the Service member due to special circumstances. Service members whose cases were initiated under the legacy DES process will not enter the IDES. c. IDES medical examinations will include a general medical examination and any other applicable medical examinations performed to VA Compensation and Pension (C&P) standards. Collectively, the examinations will be sufficient to assess the member’s referred and claimed condition(s) and assist the VA in ratings determinations and assist military departments with unfit determinations. d. Upon separation from military service for medical disability and consistent with Board for Corrections of Military Records (BCMR) procedures of the Military Department concerned, the former Service member (or his or her designated representative) may request correction of his or her military records through his or her respective Military Department BCMR if new information regarding his or her service or condition during service is made available that may result in a different disposition. 5. AR 15-185 (ABCMR) prescribes the policies and procedures for correction of military records by the Secretary of the Army, acting through the ABCMR. a. The ABCMR reviews all applications that are properly before them to determine the existence of error or injustice. The Board directs or recommends changes in military records to correct the error or injustice, if persuaded that material error or injustice exists and that sufficient evidence exists on the record and/or recommends a hearing when appropriate in the interest of justice. b. The ABCMR begins its consideration of each case with the presumption of administrative regularity. The applicant has the burden of proving an error or injustice by a preponderance of the evidence. The ABCMR will decide cases on the evidence of record. The ABCMR is not an investigative body. c. Applicants do not have a right to a hearing before the ABCMR. The Director or the ABCMR may grant a formal hearing whenever justice requires. 6. Title 10, U.S. Code, section 1201, provides for the physical disability retirement of a member who has at least 20 years of service or a disability rated at least 30 percent. Title 10, U.S. Code, section 1203, provides for the physical disability separation with severance pay of a member who has less than 20 years of service and a disability rated at less than 30 percent. 7. Title 38, U.S. Code, sections 1110 and 1131, permits the VA to award compensation for a medical condition which was incurred in or aggravated by active military service. a. An Army disability rating is intended to compensate an individual for interruption of a military career after it has been determined that the individual suffers from an impairment that disqualifies him or her from further military service. The VA, which has neither the authority, nor the responsibility for determining physical fitness for military service, awards disability ratings to veterans for conditions that it determines were incurred during military service and subsequently affect the individual’s civilian employability. b. The VA can evaluate a veteran throughout his lifetime, adjusting the percentage of disability based upon that agency's examinations and findings. However, these changes do not call into question the application of the fitness standards and the disability ratings assigned by proper military medical authorities during the applicant's processing through the Army PDES. DISCUSSION: 1. The applicant's request for a personal appearance hearing was carefully considered. However, by regulation, an applicant is not entitled to a hearing before the ABCMR. Hearings may be authorized by a panel of the ABCMR or by the Director of the ABCMR. In this case, the evidence of record and independent evidence provided by the applicant is sufficient to render a fair and equitable decision at this time. As a result, a personal appearance hearing is not necessary to serve the interest of equity and justice in this case. 2. The applicant contends that he should have been medically separated by reason of disability. A thorough review of the documents he provided does not support his contention, a. In order to ensure all Soldiers are physically qualified to reasonably perform the duties of their grade and military specialty, medical retention qualification standards are established in chapter 3 of AR 40–501. These standards include guidelines for applying them to fitness decisions in individual cases and these guidelines are used to refer Soldiers to an MEB. b. These standards and guidelines do not mean that when a Soldier possesses one or more of the listed conditions or physical defects signifies automatic disability retirement or separation from the Army. The fact that a Soldier may have one or more defects sufficient to require referral for evaluation, or that these defects may be unfitting for Soldiers in a different office, grade, rank, or rating, does not justify a decision of physical unfitness. c. The applicant previously served on active duty as an enlisted Soldier from September 1982 to July 1986. After a break, he served on active duty as a commissioned officer from April 2003 to October 2011 during which he deployed to Afghanistan and served in Korea. He twice failed promotion selection and, as required by law, he was discharged from active duty on 1 October 2011. d. Following his discharge from active duty, he accepted a Reserve commission on 2 November 2011, but then resigned this commission and he was honorably discharged from the U.S. Army Reserve on 1 October 2012. e. During his assignment to Fort Campbell, Afghanistan, and Korea, he experienced medical conditions that required medical intervention in the form of hospital admittance and surgical intervention. In each case, his medical conditions were expeditiously treated and he recovered successfully so as to return to duty without significant physical limitations. f. The advisory opinion addressed each of his contentions, from a medical standpoint. His response to the advisory opinion highlighted his performance, achievements, and support to Soldiers that is required by virtue of his position. But he provides no medical documentary evidence that shows: * he was issued a permanent physical profile that assigned any functional limitations to the performance of his duties * his commander observed, found, or determined he was unable to perform the duties required of his grade or specialty because of an unfitting medical condition g. His service was not interrupted by any medical condition. It was interrupted by his non-selection for promotion. h. The fact that the VA awarded him service-connected disability compensation is noted. An Army disability rating is intended to compensate an individual for interruption of a military career after it has been determined that the individual suffers from an impairment that disqualifies him or her from further military service. The VA does not determine military fitness; rather, it awards disability ratings to veterans for conditions that it determines were incurred during military service and subsequently affect the individual’s civilian employability. 3. The applicant is not eligible for an MEB as a result of the 2008 episode of cholecystitis or the May 2011 acute abdomen due to perforation of the appendix. Both conditions were expeditiously treated and he recovered successfully so as to return to duty without significant physical limitations. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20140020114 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20140020114 16 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2