BOARD DATE: 17 July 2018 DOCKET NUMBER: AR20160003447 BOARD VOTE: _________ _______ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ____x____ ____x____ ____x____ DENY APPLICATION 2 Enclosures 1. Board Determination/Recommendation 2. Evidence and Consideration BOARD DATE: 17 July 2018 DOCKET NUMBER: AR20160003447 BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. _____________x____________ CHAIRPERSON I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. BOARD DATE: 17 July 2018 DOCKET NUMBER: AR20160003447 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documents provided, if any). 2. Military Personnel Records and advisory opinions (if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests, in effect: * amendment of Warrior Transition Unit (WTU) Orders A-05-013770 to show active service from 12 April 2011 to 16 March 2014 * entitlement to all back pay and allowances * referral to the Physical Disability Evaluation System (PDES) * void sanctuary orders * a personal appearance before the Board 2. The applicant and her son, who is serving as her caregiver, state: a. She was denied the opportunity to continue in an active duty (AD) status to complete 20 years of service and a medical board due to her medical condition. She believes the WTU order should be amended to show an end date of 31 May 2015 to cover the service that was effected by the Army’s error at the time of her discharge on 11 April 2011. She also requests the sanctuary order be voided. b. She requests assistance in amending WTU orders A-05-013770 along with the voidance of the sanctuary orders as a result of the amendment of the WTU orders and an AD Army medical board. She has served in the Reserve and Regular Army (RA) for over 29 years. c. The applicant received sanctuary orders on 17 March 2014 to complete AD service for retirement. The applicant has time that is not accounted for as a result of the erroneous separation. d. The governing Army regulation (AR) states a Soldier who is in the retirement process or status cannot receive a medical board. The sanctuary orders dated 12 March 2014 precluded the applicant from a medical board. The doctor stated the applicant would not receive a medical board based on regulations concerning sanctuary orders for retirement purposes. The applicant believes she should receive a medical board due to the fact that she was not on sanctuary orders when her conditions and injuries occurred and she was diagnosed and evaluated. The applicant's permanent profile reflects the status she should have been in while serving in the WTU, when she had the same medical conditions. This again was addressed in all the grievances made with different divisions, offices (chain-of-command), the medical command, and the Inspector General (IG). e. The applicant was released from AD erroneously as her medical conditions were rated at 100 percent permanent by the Department of Veteran Affairs (VA) as of 12 April 2011. She also had over 19 years of federal active service. At the time of her release on 11 April 2011, her medical conditions were not curable and she was not able to meet Army standards. Her son became her caregiver in approximately in 2007. f. The applicant’s 1 May 2014 and 28 August 2012 permanent profiles list the same conditions with physical capacity/stamina, upper body, lower body, hearing, eyes, and psychiatric (PULHES) of 333113 and 333112. The applicant’s 1 May 2014 profile states the applicant’s medical conditions prevented her from working at Army standards and she could not complete the required physical fitness tests without chronic pain or issues. The applicant was not issued a permanent profile for the same conditions she had while assigned to the WTU. g. Dr. O____ failed to acknowledge the severity of the applicant’s medical conditions while she was assigned to the WTU. He intervened in the write-up of the profile, which resulted in a PULHES of 222112, dated 27 November 2012. This action and other actions by Dr. O____ contributed to the applicant being released from AD without proper care from the United States Army and failure to remedy the problems. After being released from AD on 12 April 2011, she continued to have chronic medical issues until 16 March 2014. As of today, her medical conditions remain in a permanent chronic state. h. The applicant received permission to undergo a medical board on 29 August 2012. However, she was told the board was to be a Reserve board for non-duty related (NDR) physical evaluations. Again, all injuries occurred while on AD. When she told the members of the committee this, she was told that the board was cancelled. Please note this is the same board she later learned was sent to Dr. O____. The areas of concern were listed as irritable bowel syndrome, pelvic pain, traumatic brain injury, knee pain, back pain, depression, and hand pain. The applicant has agreed with these areas of medical board concern and the items are listed under her VA ratings. i. The applicant retired on 31 May 2015 under the Sanctuary Program, which validated her earlier complaint and grievance for erroneous release from AD under the Federal AD service rule of 18 years or more. She received a permanent profile for the same injuries that she obtained while on AD prior to her erroneous release from AD on 11 April 2011. A permanent profile was issued concerning the medical conditions of pelvic pain, allergies, abdominal pain, head injury, hand pain, back pain, knee pain, and depression with a PULHES of 333112. j. The applicant was given documents to support that she should have been medically boarded. However, without her knowledge the medical board proceeded. The medical board packet was sent to the same doctor that denied her medical care and treatment while she was assigned to the WTU. The applicant brought this issue to the attention of her command, the commanding general in charge, IG, and the medical command, but again to no avail. Still, as a result, the applicant was able to obtain the document that shows and demonstrates she should have been medically boarded. 3. The applicant provides copies of: * self-authored statement from her son (her caregiver) * DD Forms 214 * sanctuary orders * VA ratings, dated 18 December 2012 and 7 October 2015 * fit for duty packet * medical board packets write-up * medical board recommendations * personal write-up * caregiver packet CONSIDERATION OF EVIDENCE: 1. The applicant enlisted in the RA on 6 February 1986. With the exception of a brief break in service in 2000, she continuously served in the United States Army Reserve (USAR) and the RA in various positions. She held military occupational specialty (MOS) 42A (Human Resources Specialist). 2. A noncommissioned officer evaluation report (NCOER) covering the period 1 April 2009 to 16 February 2010 shows the applicant received ratings of excellence, success, and among the best. It also shows she was successfully performing the duties of her office, grade, rank, and rating. 3. On 17 February 2010, the U.S. Army Human Resources Command (HRC) issued Orders A-02-005153 retaining the applicant on AD for a period of 60 days to participate in the Reserve Component (RC) Warriors in Transition Medical Retention Processing Program (MRPP) for completion of medical care and treatment. 4. On 29 March 2010, HRC issued Orders A-02-005153A02, amending Orders A-02-005153 to retain the applicant in an AD status for 90 days, with an end date of 17 May 2010. 5. On 6 May 2010, HRC issued Orders A-05-013770, retaining the applicant in an AD status for period of 90 days to participate in the RC MRPP for completion of medical care and treatment with an end date of 3 August 2010. 6. On 30 July 2010, she was issued a temporary physical profile for menorrhagia and irritable bowel syndrome (IBS) that shows a PULHES of 322111 and an expiration date of 28 October 2010. 7. Headquarters, U.S. Army Medical Department Activity, Fort Belvoir, VA, memorandum, dated 29 September 2010, subject: Request Release to AD, Meets Retention Standards in Accordance with (IAW) AR 40-501 (Standards of Medical Fitness) and AR 40-400 (Patient Administration), shows a medical evaluation resulted in a fit for duty determination for the applicant. She was cleared to be released from AD to rejoin her Reserve unit. It further shows this memorandum was signed by her primary care manager and commander. 8. On 3 February 2011, she was issued another temporary physical profile for IBS, with PULHES 211111, which was to expire on 1 May 2011. 9. Orders 105-0003, issued by United States Army Garrison, Fort Belvoir, VA, dated 15 April 2011, shows the applicant was released from AD (REFRAD) effective 11 April 2011 and transferred to the United States Army Reserve (USAR). 10. She was honorably REFRAD on 11 April 2011 due to completion of required active service. Her DD Form 214 shows she completed 4 years and 11 days of net active service this period. It further shows she completed 14 years, 11 months, and 21 days total prior active service (for a total of 19 years and 12 days). 11. A review of the applicant’s record failed to reveal a Sanctuary Request Checklist that was submitted to the Commander, HRC, requesting to remain on AD per Title 10, United States Code (USC), section 1286a. There is no record of an HRC approval or disapproval prior to her REFRAD. Reserve Soldiers on AD who have attained 18 years or more (but less than 20 years) of active service must forward a notice of sanctuary status to the Commander, HRC, through his or her chain of command. The notice must include all the documents on the Sanctuary Request Checklist to substantiate the Soldier's eligibility for sanctuary. The notice must be received by HRC 120 days prior to the end date of the Soldier's orders. 12. On 28 August 2012, the applicant was issued a permanent physical profile with PULHES of 333113. The profile further shows: * no Army Physical Fitness Test (APFT) events * IBS * pelvic pain * traumatic brain injury (headaches) * hand pain * knee pain * back pain * depression * allergies She did not meet retention standards IAW chapter 3, AR 40-501, and was recommended to be considered for a Reserve non-duty related physical evaluation board, under the provisions of AR 40-501, chapters 9 (Army Reserve Medical Examinations) and 10 (Army National Guard). 14. On 29 August 2012, an email from the Surgeon’s Office, HRC, Fort Knox, KY, indicated the applicant was found not to meet medical retention standards, and that office would be mailing her an option letter where she could make retirement, discharge, or medical evaluation option choice. 15. On 2 September 2012, a memorandum for disposition election for medical disqualification shows the applicant elected a medical evaluation board (MEB). 16. On 5 November 2012, a memorandum for disposition of failure to meet medical retention standards of AR 40-501, showed that a recent review of available medical records revealed one or more medical condition(s) that did not meet retention standards in the U.S. Army Reserve. The condition under consideration with associated retention standard was pelvic pain (3-17h). 17. The available records do not show the results of an associated MEB. 18. On 27 November 2012, the applicant was issued a permanent physical profile with PULHES of 222112. Item 8 (Functional Limitations and Capabilities and Other Comments) show “Soldier's assessment on FCC507 indicated she was unable to perform a single Soldier skill or APFT event which appears to be overly restrictive and exaggerated. As a matter of history, all of her issues were chronic and all were addressed. Numerous medical appointments were made for her (some of which she did not attend) prior to her release from WTU 18 months ago. Per Dr. D____ (MEB Clinical Supervisor at Ft Belvoir), the applicant did not meet criteria for MEB.” 19. A VA Rating decision letter dated 18 December 2012, shows that effective 12 April 2011 the applicant was assigned ratings for: * traumatic brain injury with headaches, dizziness/vertigo and memory loss (claimed as head injury) at 40 percent * sleep apnea at 50 percent * depression at 50 percent * mixed stress and urgency incontinence at 40 percent * uterine fibroids status post hysterectomy at 30 percent * degenerative joint disease lumbar spine at 10 percent * degenerative joint disease cervical spine at 10 percent * iron deficiency anemia at 10 percent * alopecia with dermatitis/eczema, left knee degenerative joint disease, right knee degenerative joint disease, irritable bowel syndrome, and allergies with upper respiratory infections at zero percent 20. On 12 March 2014, HRC issued Orders A-03-402344 ordering the applicant to AD in to obtain 20 years of active federal service in accordance with Title 10, USC, section 12686 (commonly known as the sanctuary program). She was ordered to report on 17 March 2014 to serve on AD until 31 May 2015. 21. Orders 020-0001, issued by Joint Base Myer-Henderson Hall, Arlington, VA, dated 20 January 2015, show the applicant was retired effective 31 May 2015 and placed on the retired list on 1 June 2015. 22. The applicant’s DD Form 214 shows she retired on 31 May 2015. She completed 1 year, 2 months, and 14 days of net active service this period. It further shows she completed 18 years, 10 months, and 14 days of total prior active service. 23. In the processing of this case, an advisory opinion was obtained from the Army Review Boards Agency (ARBA) Senior Medical Advisor. a. The ARBA Senior Medical Advisor noted that a review of the applicant's electronic medical record (AHLTA) revealed clinical encounters from June 2006 through February 2015. Clinical notes were reviewed from January 2004 through June 2014. Radiology reports were reviewed from September 2003 through September 2014. Laboratory results were reviewed from October 2002 through May 2014. The applicant's Interactive Personnel Electronic Records Management System records were also reviewed. b. A review of these systems and databases showed the most recent APFT the applicant passed was in October 2005. c. The ARBA Senior Medical Advisor noted the applicant’s NCOER covering the period 1 April 2009 through 16 February 2010 (11 months) shows she was on a profile with a date of 20 October 2009. It also showed the applicant’s rater gave her three excellent and two successful ratings. Her senior rater rated her among the best and gave the applicant two number 1 ratings out of 5. d. The review also revealed a physical profile (DA Form 3349), dated 4 March 2010, for heavy menstrual periods and chronic diarrhea. It showed a temporary PULHES of 411111 that expired on 4 May 2010; it further showed the applicant was on medical retention processing evaluation orders to complete a medical evaluation. A physical profile dated 3 May 2010 for menorrhagia and IBS with a temporary PULHES of 311111 expired on 1 August 2010. e. The Senior Medical Advisor’s review revealed a physical profile dated 30 July 2010 for menorrhagia and IBS with temporary PULHES of 323111 that expired 28 October 2010. It further showed a memorandum dated 29 September 2010 requesting release from AD because the applicant met retention standards in accordance with AR 40-501 and AR 40-400. A medical evaluation of the applicant resulted in a finding of fit for duty and she was to be released from AD to rejoin her unit. f. The applicant’s medical records also contained a temporary physical profile dated 28 October 2010 for menorrhagia and IBS with a temporary PULHES of 111111 that expired 28 January 2011 and a temporary physical profile dated 3 February 2011 for IBS with a PULHES of 211111 that expired 1 May 2011. g. The applicant received continuous AD extension orders that provided for her participation in the MRPP beginning on 17 February 2010. She was under medical evaluation and care from 17 February 2010 through 11 April 2011, at which time she was honorably REFRAD and transferred to the Individual Ready Reserve. h. A physical profile dated 28 August 2012 for several conditions showed a permanent PULHES of 333113 and no APFT events. It further showed the applicant did not meet retention standards of Chapter 3, AR 40-501, and referred the applicant to Chapter 9 (Army Reserve Medical Examinations) and Chapter 10 (Army National Guard). i. The record includes a physical profile dated 27 November 2012 for pelvic pain, allergies, abdominal pain, head injury, hand pain, back pain, knee pain, and depression, with permanent PULHES of 222112, no regular APFT, and “YES” for alternate APFT aerobic events. The applicant’s assessment on FCC507 showed she was unable to perform a single Soldier skill or APFT event, which appeared to be overly restrictive and exaggerated. As a matter of history, all her issues are chronic and all were addressed. Numerous medical appointments were made for her (some of which she did not attend) prior to her release from the WTU. Per Dr. O____ (MEB Clinical Supervisor at Fort Belvoir) the applicant did not meet the criteria for an MEB. j. A VA rating decision letter dated 18 December 2012 with an effective date of 12 April 2011 shows: * sleep apnea at 50 percent * depression as secondary at 50 percent * traumatic brain injury with headaches, dizziness/vertigo and memory loss (claimed as head injury) at 40 percent * mixed stress and urgency incontinence at 40 percent * uterine fibroids status post hysterectomy at 30 percent * degenerative joint disease lumbar spine at 10 percent * degenerative joint disease cervical spine at 10 percent * iron deficiency anemia at 10 percent * alopecia with dermatitis/eczema, left knee degenerative joint disease, right knee degenerative joint disease, irritable bowel syndrome, and allergies with upper respiratory infections at zero percent * no disease or injury in service for scar on right foot * no current diagnosed disability for bilateral carpal tunnel syndrome * deferred decision for frostbite of feet, frostbite of hands, mild peripheral retinal degeneration, and endocrine disorder k. On 12 March 2014, HRC issued Orders A-03-402344 ordering the applicant to AD to obtain 20 years of active federal service. She was ordered to serve on AD from 17 March 2014 to 31 May 2015. l. A physical profile dated 1 May 2014 (only one signature, T____C____, Nurse Practitioner) for pelvic pain, allergies, abdominal pain, head injury, hand pain, back pain, knee pain, and depression shows a permanent PULHES of 333112. The profile further showed functional limitations of being unable to perform an APFT event. All her issues were chronic and all had treatment ongoing. She was assessed as 100 percent disabled by the VA. Her retirement date was in March 2015. It was recommended she perform light office work for the remainder of her service. The senior medical advisor noted it was unclear how the profile could be a permanent P3 profile with only one signature. Single-signature P3 profiles are not valid; profiles must have two signatures and one must be at least a physician. m. A VA rating letter dated 7 October 2015 reinstated compensation that was discontinued effective 17 March 2014 due to her return to AD. Affected were mixed stress and urgency incontinence at 40 percent (increased to 60 percent), IBS from 0 to 30 percent, and depression at 50 percent. A combined VA rating from 100 percent to 0 percent was effective 1 June 2015. n. A limited review of VA records through the Joint Legacy Viewer showed 59 problems listed (13 VA-entered) including depression, IBS, sleep apnea, allergic rhinitis, mild cognitive impairment, polyarthralgia, low back pain, and late effect of intracranial injury. The applicant is currently VA service connected at 100%. o. The ARBA senior medical advisor found that the available record reasonably supported a boardable condition of depression; however, this condition did not fail to meet medical retention standards IAW AR 40-501 and thus did not warrant a separation through medical channels. The applicant met medical retention standards of Chapter 3, AR 40-501, and following the provisions set forth in AR 635-40 that were applicable to the applicant's era of service. The applicant's medical conditions were 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 discharge in this case. 24. On 1 May 2017, the applicant was provided a copy of the ARBA medical advisory opinion to allow her 30 days to submit comments or a rebuttal. A response was not received from the applicant or her caregiver (son). REFERENCES: 1. AR 635-200 prescribes the release of Soldiers from AD upon termination of enlistment and other periods of AD or AD for training. Personnel released from AD and transferred to the USAR upon completion of the term of service for which ordered into active Federal service, or released to their RC upon completion of AD. These Soldiers will not be discharged until completion of their reserve obligation. 2. AR 40-501 provides information on medical fitness standards for induction, enlistment, appointment, retention, and related policies and procedures. Chapter 3 describes the various medical conditions and physical defects which may render a Soldier unfit for further military service and which fall below the standards required for Soldiers in the active Army. a. Paragraph 3-1 (General) shows these medical conditions and physical defects, individually or in combination, are those that: (1) significantly limit or interfere with the Soldier's performance of his or her duties; (2) may compromise or aggravate the Soldier's health or well-being if he or she were to remain in the military. This may involve dependence on certain medications, appliances, severe dietary restrictions, or frequent special treatments, or a requirement for frequent clinical monitoring; (3) may compromise the health or well-being of other Soldiers; and/or (4) may prejudice the best interests of the Government if the individual were to remain in the military service. b. Paragraph 3-4 (General policy) shows that possession of one or more of the conditions listed in this chapter does not mean automatic retirement or separation from the service. 3. AR 635-40 sets forth policies, responsibilities, and procedures 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. Chapter 1 (Introduction) provides that, 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 his or her office, grade, rank, or rating in such a way as to reasonably fulfill the purposes of his/her employment on AD. b. Chapter 3 (Policies) 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 his or her office, rank, grade or rating in such a way as to reasonably fulfill the purposes of his/her employment on AD. When a member is being separated by reason other than physical disability, his/her continued performance of duty creates a presumption of fitness which can be overcome only by clear and convincing evidence that he/she was unable to perform his/her duties or that acute grave illness or injury or other deterioration of physical condition occurring immediately prior to or coincident with separation rendered the member unfit. 4. Title 10, USC, chapter 61, provides disability retirement or separation for a member who is physically unfit to perform the duties of his office, rank, grade or rating because of disability incurred while entitled to basic pay. 5. Title 10, USC, section 1201, provides for the physical disability retirement of a member who has a disability rated at least 30 percent. 6. Title 38, USC, sections 1110 and 1131, permit the VA to award compensation for disabilities which were incurred in or aggravated by active military service. However, an award of a VA (or other government agency) disability rating does not establish error or injustice on the part of the Army. 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. Accordingly, it is not unusual for the two agencies of the Government, operating under different policies, to arrive at different disability ratings based on the same impairments. Furthermore, unlike the Army, the VA can evaluate a veteran throughout his or her lifetime, adjusting the percentage of disability based upon that agency's examinations and findings. The Army rates only conditions determined to be physically unfitting at the time of discharge, thus compensating the individual for loss of a career; while the VA (and some other government agencies) may rate any service connected impairment, including those that are detected after discharge, in order to compensate the individual for loss of civilian employability. 7. AR 40-501 (Standards of Medical Fitness), paragraph 7–8 (Profiling reviews and approvals) states permanent "3" or "4" profiles require the signatures of 2 profiling officers, one of which is a physician approving authority. (Permanent profiles of "3" or "4" for the Individual Ready Reserve are valid with only one signature if signed by the AHRC Surgeon or his/her designee.) Temporary or permanent profiles of "1" or "2" require the signature of one profiling officer. 8. Title 10, USC, section 12686a, states, under regulations to be prescribed by the Secretary concerned, a member of an RC who is on AD (other than for training) and is within 2 years of becoming eligible for retired pay under a purely military retirement system may not be involuntarily REFRAD before he or she becomes eligible for that pay unless the release is approved by the Secretary of the Army or his designee. 9. A memorandum from Assistant Secretary of the Army, Manpower and Reserve Affairs (ASA M&RA), dated 11 August 2008, subject: Management of RC Soldiers Retained on AD for Sanctuary, states a Reserve Soldier on AD who has attained 18 years or more (but less than 20 years) of active service must forward a request/notice of sanctuary status to the Commander, HRC, ATTN: AHRC-PLM-O, through his or her chain of command. The notice must include all the documents on the Sanctuary Request Checklist to substantiate the Soldier's eligibility for sanctuary. The notice must be received by HRC 120 days prior to the end date of the Soldier's orders. When the Commander, HRC, does not support the Soldier's retention on AD for sanctuary, the Soldier's notice must be forwarded to the Army G-1 with HRC justification for REFRAD. An HRC recommendation for REFRAD must be signed by the commander and will be forwarded through the Army G-1 to the ASA M&RA for final approval/disapproval. 10. AR 15-185 (ABCMR) prescribes the policies and procedures for correction of military records by the Secretary of the Army, acting through the ABCMR. Paragraph 2-11 states that applicants do not have a right to a hearing before the ABCMR. The Director of the ABCMR or an ABCMR panel may grant a formal hearing whenever justice requires. DISCUSSION: 1. The applicant and her caregiver (son) request a personal appearance before the Board and contend, in effect, that the applicant's records should be corrected to show she was medically retired based on medical conditions for which the VA granted her service-connected disability ratings, amending REFRAD orders that released her from the WTU, providing her all back pay and allowances, and referral to the PDES. 2. The applicant's request for a personal appearance hearing was carefully considered. By regulation, an applicant is not entitled to a hearing before the Army Board for Correction of military Records (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 are sufficient to render a fair and equitable decision at this time. 3. The applicant was issued orders that retained her on AD on to participate in the RC Warriors in Transition MRPP between 2010 and 2011 for the purpose of medical treatment, medical evaluation, and processing through the PDES, if applicable. The evidence of record shows the applicant's medical conditions were thoroughly documented and evaluated. 4. The WTU chain of command found the applicant fit for duty and unanimously concurred with releasing her back to her USAR unit. HRC approved the applicant's REFRAD with a release date of 11 April 2011. 5. In the absence of evidence indicating her REFRAD in 2011 was improper (i.e., evidence that she should have been retained for ongoing disability evaluation), there is no basis for amending her WTU orders to show she was assigned to the WTU until 31 May 2015. 6. As a part of the sanctuary program, the applicant was ordered to AD from 17 March 2014 to 31 May 2015 to complete 20 years of active service for retirement. She retired on 31 May 2015. 7. The governing regulations state a Soldier will be referred into the PDES when they no longer meet medical retention standards, receive a permanent P3 or P4 profile, or are diagnosed with a medical/mental condition that permanently renders them unfit to perform their military duties. For a Soldier assigned to the WTU, once medical care is complete the WTU commander requests a REFRAD order authorization from HRC, which is what happened in the applicant’s case. 8. The applicant has a P3 profile, dated 1 May 2014, with one signature. IAW with AR 40-501, permanent profiles of "3" or "4" for Individual Ready Reserve Soldiers are valid with only one signature, if signed by the AHRC Surgeon or his/her designee. However, there are not documents indicating the profiling officer was a designated signature authority. It appears this profile is invalid. 9. There is no evidence of record that shows while serving in the MRPP the applicant's medical conditions (individually or in combination) were medically unfitting for retention under the provisions of AR 40-501, thereby requiring referral to an MEB. There is also no evidence that shows she was unable to perform her duties (within any specified temporary physical profile limitations) or that an acute grave illness or injury or other deterioration of physical condition occurred immediately prior to or coincident with her REFRAD that rendered her unfit. The advisory official in this case found no evidence of a disability or medical condition that would support a change to the final outcome in her case. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20160003447 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20160003447 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2