IN THE CASE OF: BOARD DATE: 22 November 2016 DOCKET NUMBER: AR20150011726 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: 22 November 2016 DOCKET NUMBER: AR20150011726 BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. ___________x______________ CHAIRPERSON I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. IN THE CASE OF: BOARD DATE: 22 November 2016 DOCKET NUMBER: AR20150011726 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 records to show he retired instead of having been discharged to attend civilian school. 2. The applicant states he currently receives 90 percent service-connected disability from the Department of Veterans Affairs (VA). He needs his military status changed to retired in order to receive mail through an Army Post Office so he can receive medicine and medical supplies from the United States. There is no VA hospital in Thailand. He was supposed to receive a medical evaluation board (MEB) while on active duty, but since he was 8 months from his separation date, he did not receive an MEB. 3. The applicant provides: * DD Form 214 * Honorable Discharge Certificate * VA Form 21-0960C-8 (Headaches (Including Migraine Headaches) Disability Questionnaire) * VA Form 21-0960L-2 (Sleep Apnea Disability Benefits Questionnaire) * VA rating decision CONSIDERATION OF EVIDENCE: 1. The applicant enlisted in the Regular Army on 16 February 2005 and he held military occupational specialty 11B (Infantryman). 2. He served through two reenlistments in a variety of stateside or overseas assignments, including Iraq from October 2005 to September 2006 and Afghanistan from July 2010 to April 2011. 3. His last reenlistment was for a 6-year term, executed on 9 October 2007. He attained the rank/grade of staff sergeant/pay grade E-6 on 1 May 2011. 4. He was honorably discharged on 10 July 2013 in accordance with paragraph 5-16 of Army Regulation (AR) 635-200 (Active Duty Enlisted Administrative Separations) to attend civilian school. His DD Form 214 shows: * he completed 8 years, 4 months, and 25 days of active service * he was assigned Separation Code "KCF" * awards including the Purple Heart (3rd Award) and Combat Infantryman Badge 5. He provides two VA questionnaires related to migraine headaches and sleep apnea. He also provides his VA rating decision, dated 2 July 2014. It shows the VA awarded him a combined rating of 90 percent for the following service-connected disabilities effective 11 July 2013: * post-traumatic stress disorder (PTSD), 70 percent * traumatic brain injury (TBI), zero percent * obstructive sleep apnea, 50 percent * headaches, 30 percent * tinnitus, 10 percent * hearing loss (left ear), zero percent 6. The Board forwarded the applicant's records to the Army Review Boards Agency medical advisor to determine if medical condition(s) warranted separation through medical channels or if medical condition(s) were not considered during separation processing. a. A review of the applicant's electronic medical record (AHLTA) revealed encounters between 9 March 2005 and 25 May 2013, dental procedures in 2005, and a history and physical on 22 August 2007 when he was medically cleared for Airborne School. An audiology evaluation on 27 August 2007 due to "2215 results" showed left unilateral hearing loss that met H (Hearing) 1 standards. Ringing in the left ear started during deployment to Iraq in 2006. Examination with the left ear canal clear found scar tissue as well as a retracted pocket. The diagnostic impression was sensorineural hearing loss of the left ear. b. He was evaluated for being "tired" on 20 June, 27 June, and 9 July 2008 with a diagnosis of beta thalassemia trait. Evaluation by Hematology with lab results were consistent with beta thalassemia trait with the patient being asymptomatic. His doctor noted, "This disease should not impact this Soldier's abilities to perform his duties and requires no profile or duty restriction." c. An initial mental health evaluation, dated 15 June 2009, shows he self-referred for anger, with assessment for interpersonal relationship problems and insomnia. A follow-up mental health evaluation on 22 July 2009 shows an unchanged assessment with low risk for safety concerns. d. A Physical Exam Phase II for Special Forces (SF) completed on 16 July 2009 shows the applicant stated "Denies any medical problems." He noted he had beta thalassemia trait, a chest x-ray on 11 June 2008 was normal, and the SF Physical Part II was completed. e. He had Lasik surgery on 6 October 2009. f. He completed a DD Form 2796 (Post Deployment Health Assessment) [appears it was a pre-deployment screening] on 9 July 2010. On 25 July 2010 while in theater, he was seen and treated for a concussion received during an improved explosive device (IED) incident (he also had a history of exposure to IEDs in 2005 and 2006), both mounted, with no loss of consciousness, and no perceived cognitive deficits. Computed topographies (CT) provided an impression of a concussion, periodontal lesions due to traumatic occlusion, contusion with intact skin surface (face), and contusion with intact skin surface (knee). g. He was seen in theater on 26 July 2010 for assessment of combat stressors due to recent exposure to an IED on 25 July 2010, with no loss of consciousness, initial nausea, dizziness/blurry vision and headache. The treatment plan included follow-up at the TBI clinic. He was seen on 27 July 2010 for a neurology evaluation. This evaluation shows his pain was zero out of ten, no reported loss of consciousness, no amnesia, or no focal neurological deficits. He had a mild headache and nausea. He had mild blurred vision in his right eye, without pain. There appeared to be no lasting problems after 2005-2006 IED blasts. He was seen again on 20 December 2010 for neurology evaluation of IED blast on 19 December 2010 with no loss of consciousness, confusion or amnesia, with no headache, no tinnitus, no nausea or cognitive problems. His CT was normal. He also had left heel pain and right shin pain with a puncture wound to right shin. On 22 December 2010, he was evaluated for a left heel contusion. h. On 23 December 2010, he consulted with a mental health counselor and it was determined he was experiencing normal combat stress reactions related to a recent traumatic event (IED). i. A mental health evaluation conducted on 14 January 2011 shows he was diagnosed with an anxiety disorder not otherwise specified (NOS) from routine military stressors. He followed up with mental health on 16 February 2011 and his PTSD checklist score was below the PTSD diagnosis threshold. His diagnostic reevaluation was anxiety disorder NOS related to combat stressors. A reevaluation on 14 March and 11 April 2001 shows he was treated for insomnia with medication. A neuropsychological assessment on 14 April 2011 again shows anxiety disorder NOS j. During his post-deployment mental health assessment on 2 May 2011, the applicant expressed feeling guilty over the death of another Soldier in an IED attack. He received a TBI evaluation on 9 May 2011 (Vilseck, Germany) with assessment of headaches, irritability, memory issues, anxiety and an imbalance. He received a speech-language pathology evaluation on 18 May 2011 with assessment of mild cognitive-communication deficits characterized by decreased auditory/visual attention and semantic fluency. k. He underwent a psychiatry evaluation on 27 May 2011 with impressions of insomnia and post-concussion syndrome with predominating headaches. He was followed up by neurology on 26 July 2011 and speech-language pathology on 28 July 2011. He was seen on 1 August 2011 in neurology, psychology, and reintegration. He had numerous visits for mild TBI (mTBI) (neurology, psychology, psychiatry) in August through October 2011. He was found to be compliant with medication management and his sleep had improved. There was no evidence to suggest bipolar disorder, no thought disorder, no personality disorder, no substance abuse disorder, no PTSD, no obsessive-compulsive disorder, suicidal ideation was low risk, with no homicidal ideation and no depression. Judgement and insight were intact. No entries for medical treatment were noted from November 2011 to February 2012. l. On 22 March 2012 he was seen in the Neurology clinic (last seen on 2 August 2011) with an impression of tension-type headache, chronic – compliant with headache preventive medications, but not with Behavioral Heath follow-up or recommendations. He expressed his frustrations with the Army by stating he was "fed up with the Army." A psychiatry follow-up on 22 March 2012 noted amitriptyline [tricyclic antidepressants] once in a while (not nightly as prescribed, no refills since September 2011); the applicant voiced plans to leave the Army after his enlistment was up. m. He was reassigned to Korea. He received a medical in-processing evaluation on 25 April 2012 and a psychiatric evaluation on 11 June 2012. The impressions were insomnia, anxiety disorder NOS, with PTSD ruled out. His treatment plan included medications for insomnia and nightmares. He had several more visits for management of intermittent headaches, sleep, and behavioral health symptoms. He was seen at the TBI clinic on 13 February 2012. He reported sleeping well with medication and his headaches were also controlled with medication. There were no other issues identified. n. He underwent a physical examination visits for separation on 11 March 2013. He completed a DD Form 2807-1 (Report of Medical History) and the medical evaluator completed DD Form 2808 (Report of Medical Examination). The examiner determined his physical profile was "PULHES 1-1-1-2-1-1" and he was qualified for service. His diagnoses were: * hearing loss * TBI * insomnia * left heel pain (chronic) * sleep apnea * headaches o. The applicant met medical retention standards in accordance with chapter 3, AR 40-501, and following the provisions set forth in AR 635-40 (Physical Evaluation for Retention, Retirement, or Separation) that were applicable to the applicant's era of service. The applicant's medical conditions were duly considered during medical separation processing. A review of the available documentation found no evidence of a medical disability or condition which would support a change to the reason for the discharge in this case. 7. The applicant was provided with a copy of this advisory opinion to give him an opportunity to submit a rebuttal and/or comments. He did not respond. REFERENCES: 1. AR 635-200 provides for the administrative separation of enlisted personnel. Paragraph 5-16 provides for the early separation of a Soldier to further their education. Soldiers may be discharged or released from active duty for the convenience of the Government up to 90 days before the expiration of their term of service in order to attend a specific term at college, university, vocational school, or technical schools. 2. AR 635-40 establishes the Army Physical Disability Evaluation System and sets forth policies, responsibility, and procedures that apply in determining whether a member is unfit because of physical disability to perform the duties of his office, grade, rank, or rating. a. The medical treatment facility commander with the primary care responsibility evaluates those referred to him and, if it appears as though the member is not medically qualified to perform duty or fails to meet retention criteria, refer the member to a MEB. Those members who do not meet medical retention standards are referred to a physical evaluation board (PEB) for a determination of whether they are able to perform the duties of their grade and military specialty with the medically-disqualifying condition. b. Paragraph 3-2b(1) states that when a member is being separated by reasons other than physical disability, his or her continued performance of assigned duty commensurate with his or her rank or grade until he or she is scheduled for separation or retirement creates a presumption that he or she is fit. This presumption may be overcome only by clear and convincing evidence that he or she is unable to perform his or her duties for a period of time or that acute grave illness or injury or other deterioration of physical condition, occurring immediately prior to or coincident with separation, renders the member unfit. 3. Title 38, United States Code, permits the VA to award compensation for a medical condition which was incurred in or aggravated by active military service. The VA, however, is not required by law to determine medical unfitness for further military service. The VA, in accordance with its own policies and regulations, awards compensation solely on the basis that a medical condition exists and that said medical condition reduces or impairs the social or industrial adaptability of the individual concerned. Consequently, due to the two concepts involved, an individual's medical condition, although not considered medically unfitting for military service at the time of processing for separation, discharge or retirement, may be sufficient to qualify the individual for VA benefits based on an evaluation by that agency. The VA can evaluate a veteran throughout his or her lifetime, adjusting the percentage of disability based upon that agency’s examinations and findings. DISCUSSION: 1. The available evidence shows the applicant requested voluntary separation from active duty to attend civilian school. As he requested, he was honorably discharged from active duty on 10 July 2013 prior to his expiration of his term of service. 2. He contends he should have been separated by reason of physical disability but does not specify the medical condition(s) that affected his duty performance in his military specialty. He appears to believe that because the VA awarded him service-connected disability compensation for various conditions, the Army should have done the same. 3. A key element of the Army's disability system is the Soldier's condition at the time of separation. It is not intended to be a prediction of his future medical condition(s). Additionally, an award of service-connected disability compensation by another agency (the VA) does not establish error by the Army. Operating under different laws and their own policies the VA does not have the authority or the responsibility for determining medical unfitness for military service. The VA may award ratings because of a medical condition related to service (service-connected) affecting the individual's civilian employability. 4. Military 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. Here, the applicant voluntarily requested separation to pursue his education; it was not interrupted by any medical condition. 5. A review by the ARBA Senior Medical Officer, a medical doctor, determined the applicant was found fit for duty or voluntary separation by appropriate medical personnel. As the applicant did not have a limiting physical profile or unfitting condition, it appears there was no basis for referring him to the Disability Evaluation System at the time of his separation. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20150011726 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20150011726 7 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2