IN THE CASE OF: BOARD DATE: 14 December 2022 DOCKET NUMBER: AR20220003370 APPLICANT REQUESTS: in effect, reversal of his Combat Related Special Compensation (CRSC) claim denial for combat related post-traumatic stress disorder (PTSD). APPLICANT'S SUPPORTING DOCUMENT(S) CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record), 2 February 2022 * U.S. Army Human Resources Command (HRC) Memorandum, Subject: Army CRSC Decision letter, 22 February 2021 * Medical documents * HRC Memorandum, Subject: Army CRSC Decision letter, 16 December 2021 * Department of Veterans Affairs (VA) eBenefits ratings decision document (no name) FACTS: 1. The applicant states: a. At the time of the Medical Evaluation Board (MEB), the Physical Evaluation Board Liaison Officer (PEBLO) asked him about adding additional contentions, besides the contentions listed for the MEB. He asked the PEBLO if he was able to add his combat PTSD, Veteran Affairs Schedule for Rating Disabilities (VARSD) Code 9411 to it, and the PEBLO indicated the VA had already rated him 100 percent since January 2019, therefore not necessary to add it. b. After being denied three times for CRSC for his combat PTSD, HRC has now given him a "final disapproval; no new medical evidence provided to show related event caused condition-CRSC program must independently adjudicate the disability as combat criteria caused." Why else would the VA have him rated at 100 percent, prescribe him 6 different prescriptions for depression, anxiety, nightmares, and insomnia, and have him attend mental health sessions during active duty and after. His mental health records at Luke Air Force Base and the VA indicate his PTSD was caused from combat criteria. He simply wants to be able to provide for his wife and 2- year-old daughter and receive what he is entitled to. 2. Having had prior service, DD Form 214 (Certificate of Release or Discharge from Active Duty) shows the applicant entered active duty this period on 3 March 2012. He served in Iraq from 15 June 2008 to 21 October 2009. 3. On 14 September 2020, DA Form 199 (Informal Physical Evaluation Board (PEB) Proceedings) shows a PEB convened and found the applicant was physically unfit and recommended a combined total rating of 50 percent and that his disposition be "permanent disability retirement." In pertinent part, the PEB determined the medical condition PTSD was NOT unfitting. The applicant was fit for PTSD. a. On 17 September 2020, the PEBLO informed the applicant of the findings and recommendations of the PEB and explained to the applicant the result of the findings and recommendations and his legal rights pertaining thereto. The applicant concurred and waived a formal hearing of his case. He did not request reconsideration of his VA ratings. b. On 7 October 2020, the PEB findings and recommendations were approved by the U.S. Army Physical Disability Agency. 4. On 5 January 2021, the applicant was retired by reason of permanent disability. DD Form 214 shows he completed 6 years, 5 months, and 21 days of net active service this period with 6 years, 10 months, and 15 days of total prior active service. 5. On 4 February 2021, the applicant applied for CRSC through HRC, Fort Knox, KY, for the conditions of tinnitus and PTSD. 6. On 22 February 2021, HRC denied the applicant's request for PTSD stating the condition did not meet the criteria for CRSC. HRC was unable to verify as combat- related disability. Specifically, HRC commented "no documentation in claim that establishes disability in accordance with CRSC guidelines. 7. The applicant submitted a request for reconsideration of his PTSD CRSC claim to HRC. On 12 May 2021, HRC again denied his claim for PTSD (9411) and stated, unfortunately, the documentation submitted by the applicant made no mention of a combat-related event in relationship to his PTSD (9411) disability. 8. On 16 December 2021, HRC again denied the applicant's claim for PTSD stating the condition did not meet the criteria for CRSC. HRC was unable to verify as a combat- related disability. Specifically, HRC commented "final disapproval; no new medical evidence provided to show combat-related event caused condition." HRC also stated, the evidence within the new documentation that the applicant submitted still does not establish a link between requested conditions and a combat-related event. To award a condition as combat-related the applicant must provide HRC with official documentation that shows how each condition is combat related as defined by CRSC program guidance. Official documentation includes medical documentation from the time each injury occurred, wartime chain of command endorsements which confirms exposure to armed conflict, copies of combat decorations (certificates, combat badges, and DA Forms 638 (Recommendation for Award), and evaluation reports which support exposure to armed conflict. 9. The applicant provides: a. Medical documents with various dates that show his PTSD diagnosis, clinical impression/summary with justification for diagnosis, and treatment plan. b. VA ratings decision (eBenefits extract) with no name that shows a combined disability rating of 100 percent. PTSD is listed as a condition with 100 percent service connection. 10. MEDICAL REVIEW: a. The applicant is applying to the ABCMR requesting, in effect, reversal of his Combat Related Special Compensation (CRSC) claim denial for combat related post- traumatic stress disorder (PTSD). The applicant contends he is 100 percent service- connected for PTSD by the VA and the diagnosis is directly related to combat exposure. b. The specific facts and circumstances of the case can be found in the ABCMR Record of Proceedings (ROP). Pertinent to this advisory are the following: 1) The applicant enlisted into Regular Army on 3 March 2012; 2) He served in Iraq 15 June 2008 to 21 October 2009; 3) On 14 September 2020 a PEB convened and found the applicant was physically unfit and recommended a combined total rating of 50 percent and that his disposition be "permanent disability retirement." In pertinent part, the PEB determined the medical condition PTSD was NOT unfitting; 4) On 17 September 2020 the applicant concurred and waived a formal hearing of his case. He did not request reconsideration of his VA ratings; 5) On 5 January 2021, the applicant was retired by reason of permanent disability. c. The military electronic medical record (AHLTA), VA electronic medical record (JLV), and ROP were reviewed. A review of AHLTA showed the applicant first engaged in BH-related services at the 56th Medical Group, Glendale AZ on 20 July, where he was diagnosed with Partner Relational Problems. The encounter note is void of any other details. He was referred to the Family Advocacy Program on 9 August 2010 secondary to allegations of family maltreatment. He attended routine counseling through 23 February 2011. He next encountered BH on 24 April 2018 with complaints of depressed mood and anxiety related to his deployment and a 2017 vehicle incident that resulted in multiple injuries to lower body. He reported chronic pain, sleep disturbances, depressed mood associated with his limited physical abilities subsequent the accident, anxiety associated with feeling like a handicap and being judged by others, combat related nightmares he couldn’t recall, and hypervigilance. He was diagnosed with Adjustment Disorder with Anxiety and Depressed mood and scheduled for routine outpatient treatment. During a session on 9 May 2018 the applicant shared an incident that reportedly happened while he served at a detention center in Iraq. He reportedly witnessed a visiting family member of a detainee murder a service-member by stabbing him in the neck. The applicant reportedly blamed himself for the loss of life because he should have been able to stop it. The provider annotated a rule out of Other Trauma and Stress Related. On 15 May the applicant’s problem list was amended to include a diagnosis of Other Trauma and Stress Related. d. Records suggest the applicant did not engage in any BH-related care between 16 May 2018 through 1 November 2018 due to being bedridden following surgery. On 2 November 2018, after reengaging in treatment, the provider diagnosed the applicant with PTSD, citing he now endorsed all required criteria. He was referred for trauma specific therapy and attended intermittently from 30 November 2018 to 13 January 2019. The applicant next visit BH on 1 September 2020 after being referred by his PCM after complaining of increased frequency in nightmare secondary to a recent suicide of a friend. Approximately two weeks later (14 September 2020) the PEB convened and found the applicant unfit for continued service. Of note, his PTSD diagnosis was not found to be unfitting. e. A review of JLV showed the applicant has a 100 percent service-connected diagnosis of PTSD related to his time in service. A VA C&P Examination dated 6 April 2019 showed the examiner diagnosed the applicant with PTSD related to his deployment and a non-deployment related incident that was determined LOD yes. The applicant reported that during deployment he was exposed to small arms fire, rocket attacks, multiple IED explosions, and was in a constant state fear. He also recounted losing two buddies to suicide while in theatre and at least four total. The applicant did not include his previous report of witnessing a fellow soldier stabbed in the neck by a visiting family member at the detention center. The non-deployment trauma involved an incident whereby someone attempted to rob the applicant of his shoes and during the attempted robbery, the assailant used his car to run over the applicant, shattering his pelvis. f. The applicant’s first VA BH-related engagement, post service, appears to have occurred at the , VA, on 25 March 2021. Records show he sought treatment for depressed mood and increased PTSD related symptoms secondary to the loss of another friend to suicide. The applicant was scheduled for outpatient treatment via talk therapy and medication management and engaged in treatment intermittently between 25 March 2021 and August 2021. g. Although the VA later determined the applicant 100 percent service-connected with PTSD, the determination does not meet CRSC criteria for combat-related, which is defined in 10 U.S.C. § 1413a(e) as follows: A disability that is "attributable to an injury for which the member was awarded the Purple Heart" or was incurred "as a direct result of armed conflict," ''through an instrumentality of war," "while engaged in hazardous service," or "in the performance of duty under conditions simulating war." h. Block J of DD Form 2860 Combat-Related Special Compensation (CSRC) claim form is where the applicant is directed to describe, in their own words. the events surrounding the disability and how it meets the guidelines of combat related. The applicant submitted the following: “At CAMP BUCCA detention facility OIF 2008-2009, I engaged in detainee rioting the compound every other week for nearly a year. Detainees would always complaint about living conditions, food and being falsely detained. Detainees would burn tents, mattresses, and clothing. I had to gear up in full battle rattle, baton and shield, to push the detainees to the rear of the compound, having to be spit on, feces thrown (cocktails), hit with rocks and metal pieces, physical fights with detainees. One occasion I was relieving a soldier from post, and he shot a detainee with a 12-gauge shotgun in the chest, for running towards us with a knife” i. Paragraph 631001A of Department of Defense Financial Management Regulation 7000.14-R Volume 7B Chapter 63 “Combat-Related Special Compensation (CRSC)” defines the basis for determining combat related for the purposes of awarding CRSC: Determinations of whether a disability is combat-related will be based on the preponderance of available documentary information where quality of information is more important than quantity. All relevant documentary information is to be weighed in relation to known facts and circumstances, and determinations will be made on the basis of credible, objective documentary information in the records as distinguished from personal opinion, speculation, or conjecture. j. To award CRSC for PTSD, the claimant must submit official documentation that shows how the condition is combat related as defined by CRSC program guidance. Official documentation includes wartime chain of command endorsements which confirms exposure to armed conflict (Wartime chain of command must be First Sergeant and/or Company Commander or higher), copies of combat decorations (certificates, combat badges, and DA Form 638s), and/or evaluation reports which support exposure to armed conflict. k. The applicant is not in receipt of a Purple Heart, Combat Action Badge, and no corroborating documentation was found. A note in paragraph 630502 of DoD FMR 7000.14-R Volume 7B Chapter 63 CRSC notes the requirement for documentation, stating in part: An uncorroborated statement in a record that a disability is combat-related will not, by itself, be considered determinative for purposes of meeting the combat- related standards for CRSC prescribed herein. CRSC determinations must be made based on the program criteria. l. It is the opinion of the ARBA Medical Advisor there is insufficient probative evidence upon which to reverse the United States Army Human Resources Command’s previous non-combat related determinations. BOARD DISCUSSION: 1. After reviewing the application, all supporting documents, and the evidence found within the military record, the Board found that relief was not warranted. The Board carefully considered counsel’s statement, the applicant's record of service, documents submitted in support of the petition and executed a comprehensive and standard review based on law, policy and regulation. The governing regulation provides that an uncorroborated statement in a record that a disability is combat-related will not, by itself, be considered determinative for purposes of meeting the combat-related standards for CRSC prescribed herein. Upon review of the applicant’s petition, available military records, Human Resources Command (HRC) CRSC branch and the medical review the Board, concurred with the advisory official finding there is insufficient probative evidence upon which to reverse the United States Army Human Resources Command’s previous non-combat related determinations. 2. Evidence in the record show the applicant’s record lacked sufficient details to show a casual event. During deliberation the Board agreed with the CRSC, HRC finding that they were unable to verify as combat-related disability. Specifically, HRC commented "no documentation in claim that establishes disability in accordance with CRSC guidelines. Based on the preponderance of evidence the Board determined there was insufficient evidence for reversal of the U.S. Army Human Resources Command decision to deny him combat related special compensation (CRSC) for his post- traumatic stress disorder (PTSD). BOARD VOTE: Mbr 1 Mbr 2 Mbr 3 : : : GRANT FULL RELIEF : : : GRANT PARTIAL RELIEF : : : GRANT FORMAL HEARING X X X DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. 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. REFERENCES: 1. Department of Defense Financial Management Regulation, Volume 7B: a. Section 630301 states a member may not be paid CRSC unless he or she has applied for and elected to receive compensation under the CRSC program by filing an application on DD Form 2860 (Claim for CRSC), with the Military Department from which he or she retired. A member may submit an application for CRSC at any time and, if otherwise qualified for CRSC, compensation will be paid for any month after May 2003 for which all conditions of eligibility were met. b. Section 630502 states a combat-related disability is a disability with an assigned medical diagnosis code from the VA Schedule Rating of Disabilities (VASRD). The Military Departments will determine whether a disability is combat-related based on the following criteria: * as a direct result of armed conflict * while engaged in hazardous service * in the performance of duty under conditions simulating war, or * through an instrumentality of war c. The Department will record for each disability determined to be combat-related which of the circumstances provided qualifies the disability as combat-related. A determination of combat-relatedness (see section 6306) will be made with respect to each separate disability with an assigned medical diagnosis code from the VASRD. A retiree may have disabilities that are not combat-related. Such disabilities will not be considered in determining eligibility for CRSC or the amount of CRSC payable. An uncorroborated statement in a record that a disability is combat-related will not, by itself, be considered determinative for purposes of meeting the combat-related standards for CRSC prescribed herein. CRSC determinations must be made on the basis of the program criteria. d. Section 6306 (Determinations of Combat Relatedness) (1) Direct Result of Armed Conflict: a. The disability is a disease or injury incurred in the line of duty as a direct result of armed conflict. To support a combat-related determination, it is not sufficient to only state the fact that a member incurred the disability during a period of war, in an area of armed conflict, or while participating in combat operations. There must be a definite causal relationship between the armed conflict and the resulting disability. b. Armed conflict includes a war, expedition, occupation of an area or territory, battle, skirmish, raid, invasion, rebellion, insurrection, guerilla action, riot, or any other action in which Service members are engaged with a hostile or belligerent nation, faction, force, or with terrorists. c. Armed conflict may also include such situations as incidents involving a member while interned as a prisoner of war or while detained against his or her will in custody of a hostile or belligerent force, or while escaping or attempting to escape from such confinement, prisoner of war, or detained status. (2) While Engaged in Hazardous Service. Hazardous service is service that includes, but is not limited to, aerial flight, parachute duty, demolition duty, experimental stress duty, and diving duty. A finding that a disability is the result of such hazardous service requires that the injury or disease be the direct result of actions taken in the performance of such service. Travel to and from such service, or actions incidental to a normal duty status not considered hazardous, are not included. (3) In the Performance of Duty Under Conditions Simulating War. In general, performance of duty under conditions simulating war covers disabilities resulting from military training, such as war games, practice alerts, tactical exercises, airborne operations, leadership reaction courses, grenade and live fire weapon practice, bayonet training, hand-to-hand combat training, repelling, and negotiation of combat confidence and obstacle courses. It does not include physical training activities such as calisthenics, jogging, formation running, or supervised sport activities. (4) Instrumentality of War: a. There must be a direct causal relationship between the instrumentality of war and the disability. It is not required that a member's disability be incurred during an actual period of war. The disability must be incurred incident to a hazard or risk of the service. b. An instrumentality of war is a vehicle, vessel, or device designed primarily for Military Service and intended for use in such Service at the time of the occurrence or injury. It may also include such instrumentality not designed primarily for Military Service if use of or occurrence involving such instrumentality subjects the individual to a hazard peculiar to Military Service. Such use or occurrence differs from the use or occurrence under similar circumstances in civilian pursuits. c. A determination that a disability is the result of an instrumentality of war may be made if the disability was incurred in any period of service as a result of such diverse causes as wounds caused by a military weapon, accidents involving a military combat vehicle, injury or sickness caused by fumes, gases, or explosion of military ordnance, vehicles, or materiel. d. For example, if a member is on a field exercise, and is engaged in a sporting activity and falls and strikes an armored vehicle, then the injury will not be considered to result from the instrumentality of war (armored vehicle) because it was the sporting activity that was the cause of the injury, not the vehicle. On the other hand, if the individual was engaged in the same sporting activity and the armored vehicle struck the member, then the injury would be considered the result of an instrumentality of war. 2. 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 Army Board for Correction of Military Records (ABCMR). In pertinent part, it states 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. The ABCMR will decide cases based on the evidence of record. It is not an investigative agency. //NOTHING FOLLOWS// ABCMR Record of Proceedings (cont) AR20220003370 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1