IN THE CASE OF: BOARD DATE: 7 May 2020 DOCKET NUMBER: AR20170015362 APPLICANT REQUESTS: in effect processing through the Integrated Disability Evaluation System (IDES) for determination of entitlement to medical separation or retirement for service-connected medical conditions incurred while on active duty. APPLICANT'S SUPPORTING DOCUMENTS CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record) * Applicant’s Civilian Medical Records – Neurology dated 16 February 2016, 28 October 2016 and 2 December 2016 * Applicant’s Military Service Treatment Records for Neurology and Psychology – 20 pages * DA Forms 3349 (Physical Profile Record) dated multiple dates * Department of Veterans Affairs (DVA) Initial Post-Traumatic Stress Disorders (PTSD) Disability Benefits Questionnaire dated 23 January 2017 * DVA Headaches (Including Migraine Headaches) Disability Benefits Questionnaire dated 4 February 2017 * DVA Separation Health Assessment – Disability Benefits Questionnaire dated 4 February 2017 * Memorandum to Hospital Commander, Weed Army Community Hospital, Fort Irwin, California dated 20 June 2017, subject: Request "MRDP" Review [Applicant] * DD Form 214 (Certificate of Release or Discharge from Active Duty) for the period ending 22 June 2017 * DVA Benefits Notification Memorandum dated 20 July 2017 * Applicant’s Military Service Treatment Records miscellaneous dates – 50 pages FACTS: 1. The applicant states his medical providers recommended a medical evaluation board (MEB) on 14 June 2017 for his condition of migraine (headaches) with aura, intractable under the provisions of Army Regulation 40-501 (Standards of Medical Fitness), paragraph 3-30. He states Fort Irwin medical treatment facility personnel denied him entry into the IDES. 2. The applicant enlisted in the Regular Army on 3 February 2013 in the rank of specialist/pay grade E-4. His DD Form 4 (Enlistment/Reenlistment Document Armed Forces of the United States) shows he contracted for 3 years and 20 weeks active duty service obligation with his remaining military service obligation in the Reserve Component. 3. He completed his initial entry training and was awarded military occupational specialty 09L (Translator Specialist). His first permanent duty post was at Fort Irwin, California. A review of his Enlisted Record Brief shows he deployed to Iraq from 13 February 2015 to 30 December 2015, an estimated period of 11 months. 4. On 17 August 2016 he was reduced to private/pay grade E-2. The facts and circumstances of his reduction are not filed in his official military personnel file. 5. On 18 February 2017, Fort Irwin personnel specialists issued Orders 047-0028 releasing the applicant from active duty, not by reason of physical disability on 22 June 2017 and assigned him, effective 23 June 2017, to the U.S. Army Reserve Control Group (Reinforcement). These orders state his terminal date of Reserve obligation is 3 November 2021. 6. On 22 June 2014 he was discharged accordingly and issued a DD Form 214 documenting his service. His DD Form 214 contains the following pertinent information: * Block 12f (Record of Service – Foreign Service) – 10 months and 18 days * Block 18 (Remarks) – no entry showing he served in Iraq * Block 23 (Type of Separation) – release from active duty * Block 24 (Character of Service) – honorable * Block 25 (Separation Authority) – Army Regulation 635-200 (Active Duty (Enlisted Administrative Separations), chapter 4 * Block 26 (Separation Code) – "LBK" * Block 28 (Narrative Reason for Separation) – completion of required active service 7. The applicant provided the following pertinent evidence in support of his application. a. He saw the same civilian neurologist multiple times in 2016 and 2017 as referrals from his servicing medical treatment facility. The neurologist notes show the applicant had a background of intermittent headaches when he was younger, with associated photophobia and phonophobia, predominantly occurring with loss of sleep. During his deployment to Iraq he saw battlefield action and was exposed many times to loud explosions. He self-reported no head injuries, but does report tinnitus. Based on his battlefield exposures, the frequency of his headaches with associated photophobia and phonophobia increased almost to an everyday occurrence. He states his headaches do wake him up at night. The neurologist’s impression was a progressing migraine with analgesia-rebound cephalgia for which he treated him with medications. The neurologist also recommended an evaluation for PTSD because the applicant showed a heightened level of anxiety. b. He provided numerous physical profile records showing he had profiles for the following medical conditions: * shaving profile, ingrown facial hair (permanent 2 for overall physical stamina factor as of 24 August 2016)) * sleep apnea with positive airway pressure machine (permanent 2 for overall physical stamina factor as of 1 May 2017)) * lower back injury/pain – temporary * migraine (bilateral) – temporary * moderate knee injury – temporary c. On 23 January 2017 he underwent a DVA psychological examination wherein the DVA psychologist completed a DVA assessment titled "Initial PTSD Disability Benefits Questionnaire." After conducting her examination she confirmed the applicant’s diagnosis of PTSD conforming to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria for PTSD. Additionally, he was diagnosed with major depressive disorder, recurrent and severe with some psychotic features. She noted his occupational and social impairment showed deficiencies in most areas including work, school, family relations, judgment, thinking or mood. d. On 4 February 2017 he underwent a DVA physical examination for migraine headaches with the health care provider completing DVA questionnaire titled, "Headaches (Including Migraines Headaches) Disability Benefits Questionnaire." The applicant stated the onset of his migraine symptoms started in October 2015 when he was in Iraq after a rollover motor vehicle accident. He also stated he had back pain, neck pain, bilateral ankle pain, bilateral shoulder pain, and bilateral hip pain. e. A review of his service treatment records shows he was consistently seen for migraine headaches with aura, intractable. He self-reported to his medical providers that while deployed to Iraq he was in a military motor vehicle accident when it rolled over resulting in a low back injury. His headaches started in late 2015 and he was treated in the theater of operations. It is noted he reported having headaches 17 days of the month. On 14 June 2017, a medical provided noted his Migraine Disability Assessment Test was 104 with a score greater than 20 considered a severe disability. The medical doctor stated because the applicant has migraine headaches with aura (intractable, without status migrainosus) that failed multiple attempts to control systems he fails the retention criteria of Army Regulation 40-501, paragraph 3-30. He recommended a permanent profile indicating no helmet use, no 24-hour duty, permission to wear sunglasses as needed, all physical training at his own pace and distance, and permission to lie down in a dark, quiet room whenever migraine occurs. He further recommended referral to an MEB to determine further disposition. f. Medical notes dated 18 May 2017 show he was diagnosed with the following by a psychiatrist at a civilian practice: * Post-trauma syndrome * Severe major depression with psychotic features * PTSD, chronic * Sequela of traumatic brain injury g. Reviewing the 18 May 2017 psychiatric medical notes the applicant stated he was not prepared for his tour of duty in Iraq. He was attached to an airborne unit providing translator services to U.S. Armed Forces and foreign military units. He worked on the front lines with the Iraqi Army. He assisted in translating during onsite interviews, meetings, and document reviews. He frequently was exposed to simultaneous rocket attacks and mortar blasts. He stated he was in close proximity to a suicide bomber and recalls flying several feet into the air. He quickly recovered from his fall and started administering first aide to the Iraqi civilians including children who were seriously injured by the suicide bomber. He also witnessed (Iraqi) soldiers who were severely tortured by enemy forces. He also served as an interpreter for a medical team informing Iraqi civilians of the status of their family members including their deceased members. He was in a rollover accident in a motor vehicle suffering a concussion in 2015. He informed the psychiatrist he was demoted to private/pay grade E-2 because he did not return from visiting family in Turkey when required due to air restrictions. h. On 12 June 2017 a physical profile record (DA Form 3349) shows in the past 12 months he had temporary profiles for 319 days and during the past 24 months he had temporary profiles for 375 days. His temporary profiles were for lower back injury/pain and migraine headaches (bilateral) limiting his ability to wear his helmet, body armor, and load bearing equipment. He also could not lift and carry 40 pounds while wearing his protective gear up to 100 yards. For his sleep apnea which was permanent (P2), he required the use of a positive airway pressure (PAP) machine requiring a power source or battery. If unable to use a PAP machine and he shows signs of sleepiness then he should not fire a weapon, drive vehicles, operate dangerous equipment, stand guard or perform duties that are dangerous or require sustained attention. He also had a permanent profile of P2 for ingrown facial hair (shaving profile). i. On 20 June 2017 the applicant’s attorney-advisor from the Office of Soldier’s Counsel Western and Pacific Region at Joint Base Lewis-McChord, Washington prepared a memorandum through the Deputy Commander for Clinical Services at the Weed Army Community Hospital, National Training Center, Fort Irwin, California to its Hospital Commander. The attorney-advisor requested on behalf of the applicant a medical retention determination point review. The two requests for an explanation as to the reason why he was not referred to an MEB and why his migraine and back condition are not considered failing U.S. Army retention standards in accordance with Army Regulation 40-501, paragraphs 3-30g, 3-39h, and/or 3-41e (1, 2, and 3). The attorney- counselor explains in detail the applicant’s medical history and the actions of his company commander to separate him under the provisions of Army Regulation 635- 200, paragraph 5-17 (Other designated physical or mental conditions). After objections by the applicant’s trail defense attorney, the administrative separation action was terminated. There is no evidence a response was provided to the applicant or his attorney-advisor. j. On 6 July 2017 the DVA issued him a rating decision showing his overall or combined rating was 100 percent. It contained the following issues or contentions and their respective percentage. The effective date for all issues or contentions was 23 June 2017, the date after his honorable discharge date of 22 June 2017. His conditions are listed below in the order of sequence outlined in the DVA Rating Decision. * Right lateral collateral ligament sprain (claimed as ankle pain/laxity rating 10 percent * Left lateral collateral ligament sprain (claimed as ankle pain/laxity) rating 10 percent * Iliopsoas tendinitis right hip with impairment of the thigh (claimed as hip pain) rating 10 percent * Left lower extremity radiculopathy rating 20 percent * Tinnitus rating 10 percent * Iliopsoas tendinitis right hip with limited flexion rating 0 percent * Right lower extremity radiculopathy rating 10 percent * Right shoulder impingement syndrome (claimed as shoulder pain) rating 20 percent * PTSD and major depressive disorder, recurrent, with some psychotic features (claimed as depression, anxiety, adjustment disorder, and disturbance of emotions) rating 70 percent * Iliopsoas tendinitis left hip with impairment of the thigh (claimed as hip pain) rating 10 percent * Iliopsoas tendonitis right hip with limited extension rating 0 percent * Left upper extremity radiculopathy rating 20 percent * Cervical strain (claimed as cervicalgia/neck) rating 10 percent * Migraine headaches rating 50 percent (emphasis added) * Right upper extremity radiculopathy rating 20 percent * Bilateral pinguecula rating 0 percent * Left knee patellofemoral pain syndrome rating 10 percent * Iliopsoas tendinitis left hip with limited extension rating 0 percent * Left should impingement syndrome (claimed as shoulder pain) rating 20 percent * Iliopsoas tendinitis left hip with limited flexion rating 0 percent * Lumbosacral strain (claimed as low back pain/lumbago) rating 40 percent * Right knee patellofemoral pain syndrome rating 10 percent k. On 20 July 2017 the DVA issued him a letter informing him he was enrolled in the DVA Priority Group 1 effective 6 July 2017 based on his 100 percent disabling rating for service-connected medical conditions. His rating was total disability permanent in nature based on his active service in Southwest Asia. 8. In the processing of this case, the Army Review Boards Agency (ARBA) medical advisor provided an advisory wherein based on the evidence of record the applicant should have been referred to an MEB as recommended by his neurologist and for PTSD as documented by a psychiatrist. The advisor opined the applicant’s medical including psychological health conditions were not appropriately managed while he was on active duty. The evidence is clear the onset of his migraine headaches occurred after a service-connected injury during a motor vehicle accident while serving in combat. He opines the applicant’s medical records provide sufficient detail to show the extent of the medical treatments that were tried and failed in the treatment of his migraine headaches. He concludes by stating in effect the applicant should be referred to the IDES for full consideration of a medical retirement. 9. On 15 April 2020 the staff of ARBA sent the applicant a copy of the medical advisory for his review and comment. 10. On 27 April 2020 the applicant responded to the medical advisory submitting new evidence for the Board’s consideration noted below: * Email from Applicant’s Defense Counsel dated 27 April 2017 * DA Form 3349 (Physical Profile Record) dated 1 May 2017 * Report of Polysomnography dated 22 May 2017 * Excerpt from Applicant’s service treatment record dated 6 June 2017 * DVA Benefits Decision Letter dated 6 July 2017 (duplicate) * DVA Rating Decision dated 27 October 2017 * DVA Benefits Decision Letter dated 31 October 2017 * DVA Rating Decision dated 8 June 2018 * DVA Benefits Decision Letter 13 June 2018 11. His new evidence provides the following information: a. On 27 April 2017, his military defense counsel sent an email to members of the applicant’s chain of command stating he represents the applicant who at the time was pending an administrative separation under the provisions of Army Regulation 635-200, paragraph 5-17 for the condition of lower back pain which prevents him from performing military duties. Counsel identified this medical condition falls under the provisions of Army Regulation 40-501, chapter 3. Therefore, his administrative separation action should be stopped and he should be referred to the MEB. He continues explaining the requirements of Army Regulation 40-501 identifying paragraph 3-41 (General and Miscellaneous conditions) and subparagraph 3-41e as the most appropriate paragraph requiring the applicant’s referral to an MEB. He concludes stating he will coordinate with appropriate personnel to initiate an MEB. b. On or about 1 May 2017 he received a permanent profile showing his shaving profile (P2) (ingrown facial hair, razor bumps) was initiated on 24 August 2016, migraine with aura (P3) (chronic, bilateral) on 28 April 2017 and sleep apnea (P2) on 1 May 2017. His temporary profile of 257 days remained for his lower back injury/pain. The prescribing medical provider stated per Army Regulation 40-501, chapter 3 the applicant should be referred to an MEB. c. On 6 June 2017 he had a medical appointment in neurology at the Naval Medical Center San Diego, California. He had been referred from his Army medical provider. The neurologist restated his involvement in a rollover vehicle accident in Iraq wherein he sustained a concussion. He experienced mild headaches, low back pain, knee pain and ankle pain. Within a year he developed debilitating headaches several times a week. He was seen by a civilian neurologist near his installation who recommended Botox injections. The neurologist described his symptoms in detail. She also pointed out he went to the emergency room multiple times a week for headaches (duration of headaches 3 to 4 hours), he was not aware of a headache abortive regime, and he has been experiencing headaches for 2 years with limited relief. She prescribed (headache) abortive medication and recommended consultations with psychiatry and pain management for management of his back pain and PTSD. She concluded, "Under no circumstance is the patient to drive or handle other dangerous equipment when sedated from medication or significantly affected by a severe headache." d. He submitted multiple DVA rating decisions including the decision dated 6 July 2017 which is dated less than three weeks after his date of discharge of 22 June 2017. The rating decision of 6 July 2017 was previously discussed in detail within this record of proceedings. The new DVA rating decisions rendered in October 2017 and June 2018 confirmed their previous decision of 6 July 2017. That decision stated the applicant’s PTSD rating was 70 percent disabling and his migraine headaches rating was 50 percent. BOARD DISCUSSION: 1. The Board carefully considered the applicant’s request, supporting documents and evidence in the records. The Board considered the applicant’s statement, his record of service, his service medical records and record of profiles, a record showing a recommendation for an MEB, his VA ratings and the date and reason for his separation. The Board considered the review and conclusions of the medical advising official ad agreed with the advisors recommendation. Based on a preponderance of evidence, the Board determined that the applicant’s conditions should be reviewed to determine if he failed to meet medical retention standards at the time of his separation. The Board concurs with the corrections stated in the Administrative Note(s) below. 2. After reviewing the application and all supporting documents, the Board found that partial relief was warranted. BOARD VOTE: Mbr 1 Mbr 2 Mbr 3 :XXX :XXX :XX GRANT FULL RELIEF : : : GRANT PARTIAL RELIEF : : : GRANT FORMAL HEARING : : : DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The Board determined the evidence presented is sufficient to warrant a recommendation for relief. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by referring his records to the Office of The Surgeon General for review as follows: a. If a review by the Office of The Surgeon General determines the evidence supports it, the individual concerned will be afforded due process through the Disability Evaluation System for consideration of any diagnoses identified as having not met retention standards prior to his discharge. b. In the event that a formal PEB becomes necessary, the individual concerned will be issued invitational travel orders to prepare for and participate in consideration of his case by a formal PEB. All required reviews and approvals will be made subsequent to completion of the formal PEB. c. Should a determination be made that the applicant should be separated or retired for disability, these proceedings serve as the authority to issue him the appropriate separation retroactive to his original separation date, with entitlement to all back pay and allowances and/or retired pay, less any entitlements already received. I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. ADMINISTRATIVE NOTE(S): The applicant’s DD Form 214, Block 18 (Remarks), does not contain the period of his deployment to Iraq as required by Army Regulation 635-8 (Separation Processing and Documents). His Enlisted Record Brief shows his dates of deployment were from 13 February 2015 to 30 December 2015. Therefore, administratively correct his 22 June 2017 DD Form 214 by adding this statement, "Service in Iraq from 20150213- 20151230," to Block 18. REFERENCES: 1. Title 10, U.S. Code, chapter 61, provides the Secretaries of the Military Departments with authority to retire or discharge a member if they find the member unfit to perform military duties because of physical disability. a. Soldiers are referred to the disability system when they no longer meet medical retention standards in accordance with Army Regulation 40-501 (Standards of Medical Fitness), chapter 3, as stipulated in a medical evaluation board; when they receive a permanent medical profile rating of 3 or 4 in any physiological or psychological factor and are referred by an Military Occupation Specialty Medical Retention Board; and/or they are command-referred for a fitness-for-duty medical examination. b. The mere presence of a medical impairment does not in and of itself justify a finding of unfitness. In each case, it is necessary to compare the nature and degree of physical disability present with the requirements of the duties the Soldier may reasonably be expected to perform because of his or her office, grade, rank, or rating. Reasonable performance of the preponderance of duties will invariably result in a finding of fitness for continued duty. A Soldier is physically unfit when a medical impairment prevents reasonable performance of the duties required of the Soldier's office, grade, rank, or rating. 2. Army Regulation 40-501 (Standards of Medical Fitness) effective 19 January 2017 provides information on medical fitness standards for induction, enlistment, appointment, retention, retirement and related policies and procedures. Chapter 3 describes the various medical conditions and physical defects which may render a Soldier unfit for further military services. These medical conditions and physical defects, individually or in combination, are those that significantly limit or interfere with the Soldier’s performance of duty; may compromise or aggravate the Soldier’s health or well-being, if they were to remain in the military Service such as frequent clinical monitoring; may compromise the health or well-being of other Soldiers; and may prejudice the best interest of the Government if the individual were to remain in the military Service. Soldiers who do not meet the required medical standards will be evaluated by a medical evaluation board. a. Paragraph 3-30 refers to neurological disorders requiring referral to an MEB with paragraph 3-30g stating migraine, tension, or cluster headaches, when manifested by frequent incapacitating attacks will be referred to a neurologist who will ascertain the cause of the headaches. If the neurologist feels a trial of prophylactic medicine is warranted, a 3-month trial of therapy can be initiated. If the headaches are not adequately controlled at the end of 3 months, the Soldier will undergo an MEB referral to a physical evaluation board (PEB). If a neurologist determines the Soldier is unlikely to respond to therapy, the Soldier can be directly referred to an MEB. b. Paragraph 3-39 refers to the spine, scapulae, ribs and sacroiliac joints with paragraph 3-39h stating nonradicular pain involving the cervical, thoracic, lumbosacral, or coccygeal spine, whether idiopathic or secondary to degenerative disc or joint disease, that fails to respond to adequate conservative treatment and necessitates significant limitation of physical activity should be referred to an MEB. Range of motion (ROM) measurements should be obtained using a goniometer. Use the DVA’s instructions for completion of spine and joint evaluations including the six measurements shown on VASRD Plate V ROM of cervical and thoracolumbar spine. c. Paragraph 3-41 refers to general and miscellaneous conditions and defects with paragraph 3-41h specifically addressing miscellaneous conditions and defects not mentioned elsewhere in chapter 3 which are causes for referral to an MEB. (1) The conditions (individually or in combination) result in interference with satisfactory performance of duty as substantiated by the individual’s commander or supervisor. Any medical condition, injury or defect (individually or in combination) that prevents the Soldier from performing any of the functional activities listed under item number 5 on DA Form 3349 (Physical Profile). (2) The individual’s health or well-being would be compromised if they were to remain in the military service. (3) In view of the Soldier’s condition, their retention in the military service would prejudice the best interests of the Government. Questionable cases including those involving latent impairment, will be referred to PEBs. 3. Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) published on 19 January 2017 prescribes the Army Disability Evaluation System 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 office, grade, rank, or rating. It implements the requirements of Title 10, U.S. Code, chapter 61; Department of Defense Instructions (DoDI) 1332.18 (Disability Evaluation System (DES)); DoD Manuel 1332.18 (DES Volumes 1 through 3) and Army Directive 2012-22 (Changes to Integrated Disability Evaluation System Procedures) as modified by DoDI 1332.18. a. The objectives are to maintain an effective and fit military organization with maximum use of available manpower; provide benefits to eligible Soldiers whose military service is terminated because of a service-connected disability; provide prompt disability evaluation processing ensuring the rights and interests of the Government and Soldier are protected; and, establish the Military Occupational Specialty Administrative Retention Review (MAR2) as an Army pre-DES evaluation process for Soldiers who require a P3 or P4 (permanent profile) for a medical condition that meets the medical retention standards of Army Regulation 40-501. b. Public Law 110-181 defines the term, physical DES, as a system or process of the DoD for evaluating the nature and extent of disabilities affecting members of the Armed Forces that is operated by the Secretaries of the military departments and is composed of medical evaluation boards, physical evaluation boards, counseling of Soldiers, and mechanisms for the final disposition of disability evaluations by appropriate personnel. c. The DES begins for a Soldier when either of the events below occurs: (1) The Soldier is issued a permanent profile approved in accordance with the provisions of Army Regulation 40–501 and the profile contains a numerical designator of P3/P4 in any of the serial profile factors for a condition that appears not to meet medical retention standards in accordance with AR 40–501. Within (but not later than) 1 year of diagnosis, the Soldier must be assigned a P3/P4 profile to refer the Soldier to the DES. (2) The Soldier is referred to the DES as the outcome of MAR2 evaluation. d. A medical evaluation board is convened to determine whether a Soldier’s medical condition(s) meets medical retention standards per Army Regulation 40-501. This board may determine a Soldier’s condition(s) meet medical retention standards and recommend the Soldier be returned to duty. This board must not provide conclusions or recommendations regarding fitness determinations. e. The physical evaluation board determines fitness for purposes of Soldiers retention, separation or retirement for disability under Title 10, U.S. Code, chapter 61, or separation for disability without entitlement to disability benefits under other than Title 10, U.S. Code, chapter 61. The physical evaluation board also makes certain administrative determinations that may benefit implications under other provisions of law. f. Unless reserved for higher authority, the U.S. Army Physical Disability Agency approves disability cases for the Secretary of the Army and issues disposition instructions for Soldiers separated or retired for physical disability 4. Directive-Type Memorandum (DTM) 11-015 (IDES) published in 2013, explains the IDES. a. The IDES is the joint Department of Defense (DoD) – DVA process by which DoD determines whether wounded, ill, or injured Service members are fit for continued military service and by which the DoD and the DVA 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 DVA 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 promulgated in DoD Directive 1332.18 (Disability Evaluation System (DES)) 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. c. IDES medical examinations will include a general medical examination and any other applicable medical examinations performed to DVA 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 DVA 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. For example, a veteran appeals the VA’s disability rating of an unfitting condition based on a portion of his or her service treatment record that was missing during the IDES process. If the VA changes the disability rating for the unfitting condition based on a portion of his or her service treatment record that was missing during the IDES process and the change to the disability rating may result in a different disposition, the Service member may request correction of his or her military records through his or her respective Military Department BCMR. e. If, after separation from service and attaining veteran status, the former Service member (or his or her designated representative) desires to appeal a determination from the rating decision, the veteran (or his or her designated representative) has 1 year from the date of mailing of notice of the VA decision to submit a written notice of disagreement with the decision to the VA regional office of jurisdiction. f. The Secretaries of the Military Departments shall establish procedures within their respective Military Departments to ensure the proposed DVA disability ratings for each of the military unfitting conditions are used to determine the individual and combined DoD disability rating for all military unfitting conditions. Military Departments will follow applicable guidance and applicable DoD policy memorandums regarding application of the VA Schedule for Ratings Disabilities (VASRD). It is DoD policy to ensure Service members requiring disability evaluations are referred, processed, and counseled. Service members will be referred to the IDES in accordance with this DTM which states in consultation with a Service member’s commander an on approval by the MEB convening authority, a military medical provider refers a Service member to the IDES and provides the referral to a military treatment facility patient administrator for further processing within the standards of this DTM. 5. 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 rating of at least 30 percent. Title 10, U.S. Code, section 1203, provides for the physical disability separation of a member who has less than 20 years of service and a disability rating of less than 30 percent. 6. Army Regulation 15-185 (Army Board for Correction of Military Records (ABCMR)) prescribes the policies and procedures for correction of military records by the Secretary of the Army, acting through the ABCMR. The regulation provides that 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. //NOTHING FOLLOWS// ABCMR Record of Proceedings (cont) AR20170015362 14 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1