IN THE CASE OF: BOARD DATE: 14 December 2022 DOCKET NUMBER: AR20220004917 APPLICANT REQUESTS: * reconsideration of his prior requests for physical disability retirement in lieu of physical disability separation with severance pay * clarification of his official disability discharge vice disability retirement status APPLICANT'S SUPPORTING DOCUMENT(S) CONSIDERED BY THE BOARD: * self-authored letter * Standard Form 600 (Chronological Record of Medical Care), 18 June 2009 * partial Department of Veterans Affairs (VA)/DOD Joint Disability Evaluation (DES) Board Claim, 12 August 2009 * partial VA Form 21-4183 (Statement in Support of Claim), 18 August 2009 * Narrative Summary (NARSUM), 30 November 2009 * DA Form 3947 (Medical Evaluation Board (MEB) Proceedings, 7 December 2009 * memorandum titled “Impartial Medical Review”, 18 December 2009 * DA Form 199 (Physical Evaluation Board (PEB) Proceedings, 8 January 2010 * U.S. Army Garrison Walter Reed Orders 084-0136, 25 March 2010 * U.S. Army Garrison Walter Reed Orders 089-0135, 30 March 2010 * DD Form 214 (Certificate of Release or Discharge from Active Duty) covering the period ending 27 May 2010 * multiple Standard Forms 600 dated between 1 April – 27 October 2010 * self-authored Excel Spreadsheet * excerpt from Diagnostic and Statistical Manual Form Mental Disorders, Fifth Edition (DSM-5) * partial VA Rating Decision, 6 April 2021 * VA Rating Decision, 14 May 2021 * VA Disability Ratings printout, 17 June 2021 FACTS: 1. Incorporated herein by reference are military records which were summarized in the previous consideration of the applicant's case by the Army Board for Correction of Military Records (ABCMR) in Docket Number AR20130021731 on 22 January 2014 and Docket Number AR20170011008 on 31 January 2020. 2. The applicant states: a. He is requesting reevaluation of his PEB, as U.S. Code authorized members to have their PEB reevaluated if there is reason to believe that a medical condition of the member considered by the PEB during the evaluation renders the member unsuitable for continued military service. b. He also states he is confused. He has documents showing differing statuses, some show he was medically separated and others shows he was medically retired and placed on the Permanent Disability Retired List (PDRL). Multiple Standard Forms 600 show his patent category as U.S. Army PDRL. c. A PEB was convened at Walter Reed Army Medical Center resulting in a 20 percent disability rating for only one of the unfitting diagnoses listed on his MEB documentation. According to records he was medically separated on 27 May 2010, as opposed to being medically retired in accordance with procedures for service personnel with a 30 percent or greater disability rating. The disparity between these documents, the Standard Forms 600 showing PDRL placement and his PEB documents along with his discharge orders showing medical separation. d. He additionally believes that all of his potentially medically disabling and unfitting conditions were not considered by the DES process during the MEB and PEB. He believes that he would have received a greater disability rating than 30 percent had all of his diagnoses been rated by the PEB. U.S. Code and Army regulations require that all medical conditions be considered during the IDES process. e. He provided a self-authored Excel spreadsheet wherein he lists all the conditions he believes warrant consideration for unfitness by the PEB, as follows: * adjustment disorder with predominant anxiety and depressed mood * migraine headaches * hypertension * hearing loss * sleep apnea * asthma * presbyopia * rhinosinusitis * swelling in hands, fingers, and wrists * chronic bilateral lower extremity pain/myalgia * lumbar spine multilevel degenerative spondylopathy * hammer/mallet toes, bilateral feet * lung condition (latex allergy) * depression * allodynia * post-traumatic stress disorder (PTSD) f. He believes many of his disabling conditions were either not considered during his DES process or were dismissed as being not physically disabling, yet they seem to meet the unfitting criteria and some of them are rated as service-connected disabilities by the VA. He believes these conditions warrant reconsideration by the PEB. g. Furthermore, he requests formal confirmation that if is a U.S. Army Retired PDRL Officer, he be provided with corresponding retirement orders and an increased disability rating through amendment of his DA From 199. 3. After 8 years, 7 months, and 12 days of prior honorable active enlisted service in the U.S. Navy from 21 September 1994 through 2 May 2003, the applicant was appointed as a Medical Corps Officer in the Regular Army on 3 January 2007 and ordered to active duty to fulfill his active Army requirement on 19 March 2007. 4. A Standard Form 600, dated 18 June 2009, shows the applicant was diagnosed with chronic limb pain which was found to be medically unacceptable under the provisions of Army Regulation 40-501 (Standards of Medical Fitness), chapter 3. 5. A partial VA/DOD Joint DES Board Claim, dated 12 August 2009, shows chronic bilateral lower extremity pain/myalgia is listed as the medical conditions to be considered as the basis of a fitness for duty evaluation. 6. Multiple pages of a VA Form 21-4183 (Statement in Support of Claim), dated 18 August 2009, shows the applicant claimed the following additional conditions other than shoes referred for the fitness for duty determination, that he felt were caused by or aggravated by his active military service: * lung condition (latex allergy * migraine headaches * swelling in hands, fingers, and wrists * nasal cavity polyps * presbyopia (gradual loss of eyes’ ability to focus on nearby objects) * hammer toe/mallet toe, bilateral feet * depression * hypertension 7. A NARSUM, dated 30 November 2009, shows the following: a. The applicant’s chief complaints (per his VA Claim Sheet) were as follows: * chronic bilateral lower extremity pain/myalgia * latex allergy * migraines * swelling of hands, fingers, and wrists * presbyopia * hammer/mallet toes of bilateral feet * depression * hypertension b. The psychiatric summary shows on 2 September 2009, the applicant had his Compensation and Pension (C&P) examination at the VA, where he reported a history of sexual assault while in the U.S. Navy in 1995 and began experiencing anxiety and depression in 2006. According to the C&P exam, he meets the criteria for adjustment disorder with predominant anxiety. He describes only mild impairment in his occupational functioning, attributable primarily to his chronic pain and not his psychiatric symptoms. He has nor received psychiatric services while at Walter Reed Army Medical Center. c. The applicant was known to suffer other medical conditions, all of which are medically acceptable. He suffers from migraine headaches, which are responsive to medications and are non-disabling. He takes anti-hypertensives for his hypertension and is well-controlled. He suffers from bilateral foot pain due to calluses and also has bilateral hammer/mallet toes, which are also considered medically acceptable. He has some hearing loss; however, it is not an unfitting condition. He complains of severe snoring and apnea-like symptoms, but has not been seen or worked-up for it. d. His medical diagnoses were as follows: * chronic bilateral lower extremity pain/myalgia; medically unacceptable * adjustment disorder with anxiety; medically acceptable * migraine headaches; medically acceptable * hypertension; medically acceptable * foot pain due to calluses, bilateral; medically acceptable * hammer/mallet toes, bilateral; medically acceptable * latex allergy; medically acceptable * hearing loss; medically acceptable e. The applicant’s restrictions and limitations related to military duty may be found on the accompanying DA Form 3349 (Physical Profile). 8. The applicant’s DA Form 3349 detailing the duty restrictions and limitations associated with his physical profile for his chronic bilateral lower extremity pain/myalgia is not in his available records for review. 9. A DA Form 3947 shows the following: a. An MEB convened on 7 December 2009, where the applicant was found to have chronic bilateral lower extremity pain/myalgia, which was medically unacceptable per Army Regulation 40-501, chapter 3. b. The following conditions were considered and found to be medically acceptable: * adjustment disorder with anxiety * migraine headaches * hypertension * foot pain due to calluses, bilateral * hammer/mallet toes, bilateral * latex allergy * hearing loss c. The MEB recommended the applicant’s referral to a PEB and on 18 December 2009, the applicant signed the form indicating he agreed with the board’s findings and recommendations. 10. A memorandum titled “Impartial Medical Review”, shows the applicant signed the memorandum on 18 December 2009, indicating he reviewed the contents of the MEB packet, read the DA Form 3947, NARSUM and DA Form 3349 and marking on the form that he did not request an impartial medical review of his MEB to ensure it adequately reflected the complete spectrum of his injuries and/or illnesses. 11. A DA Form 199, shows a PEB convened on 8 January 2010, showing the following: a. The applicant’s chronic bilateral lower extremity pain/myalgia (MEB diagnosis (DX) 1) was found unfitting because his physical profile limited him from lifting and carrying greater than 30 pounds due to this condition, which prevents him from performing his job as a nurse. The recommended rating is not listed on the form, as it was at the time pending the VA Proposed Rating Decision. b. His adjustment disorder with anxiety (MEB DX 2), was not a physical disability and was not ratable. c. The applicant’s MEB DXs 3-8 meet medical retention standards, are not listed on his physical profile as limiting any of his functional activities, are not commented upon by the commander as hindering the applicant’s performance, and the case file contains no evidence that these DXs independently or combined render him unfit for his assigned duties. 12. A second DA Form 199, dated 12 February 2010, shows the following: a. The applicant’s chronic bilateral lower extremity pain/myalgia (MEB DX 1) was found unfitting because his physical profile limited him from lifting and carrying greater than 30 pounds due to this condition, which prevents him from performing his job as a nurse. The recommended rating was 0 percent, based on the 25 January 2010 VA Proposed Rating Decision. [Of note to the Board, this 25 January 2010 VA Proposed Rating Decision is not in the applicant’s available records for review.] b. His adjustment disorder with anxiety (MEB DX 2), was not a physical disability and was not ratable. c. The applicant’s MEB DXs 3-8 meet medical retention standards, are not listed on his physical profile as limiting any of his functional activities, are not commented upon by the commander as hindering the applicant’s performance, and the case file contains no evidence that these DXs independently or combined render him unfit for his assigned duties. d. The PEB found the applicant was physically unfit and recommended a combined rating of 0 percent and that his disposition be separation with severance pay if otherwise qualified. e. On 19 February 2010, the applicant signed the form indicating he concurred with the PEB findings. He waived his right to a formal hearing of his case and did not request reconsideration of his VA Ratings. 13. U.S. Army Garrison Walter Reed Orders 084-0136, dated 25 March 2010, honorably discharged the applicant effective 27 May 2010 due to physical disability with a rating of 0 percent and that he was entitled to separation pay based on 3 years, 2 months, and 9 days of service. 14. U.S. Army Garrison Walter Reed Orders 089-0135, dated 30 March 2010, amended the above-referenced Orders 084-0136, dated 25 March 2010 to show he was honorably discharged due to physical disability with a rating of 20 percent and that he was entitled to separation pay based on 11 years, 9 months, and 21 days of service. 15. The applicant’s second DD Form 214 shows he was honorably discharged on 27 May 2010 due to non-combat disability with severance pay. He was credited with 3 years, 2 months, and 9 days of net active service this period, 8 years, 7 months, and 12 days of total prior active service, and awarded severance pay in the amount of $105,055.28. 16. The applicant provided 6 copies of Standard Forms 600 dated between 1 April – 27 October 2010, detailing his chronological record of medical care at Walter Reed Army Medical Center. All of these forms list the applicant’s patient category (PAT CAT) as “USA RET PDRL OFFICER” (U.S. Army Retired PDRL Officer). There is no evidence of record indicating this patient category listing is anything more than a typographical error, erroneously entered and carried forward on subsequent forms from 1 April through 27 October 2010. All available evidence, aside from that erroneous entry on these Standard Forms 600, reflects the applicant was honorably separated from the Army with severance pay due to non-combat disability and that he was not placed on the PDRL. 17. On 12 May 2013, the applicant applied to Army Review Boards Agency requesting a review of his mental health diagnoses through a Physical Disability Board of Review (PDBR) Special Review Board (SRB). 18. A PDBR, SRP memorandum, dated 10 December 2013, provided a mental health disability review and has been provided in full to the Board for review. It shows in pertinent part, the following: a. The applicant requested a review of the military disability evaluation of his mental health condition. In accordance with Secretary of Defense directive for a comprehensive review of service members who were referred to DES process between 11 September 2001 and 30 April 2012 and whose mental health diagnoses were changed or eliminated during that process, the applicant’s case file was reviewed regarding diagnosis change, fitness determination, and rating of unfitting mental health diagnoses in accordance with the VA Schedule for Rating Disabilities. Only his mental health conditions were addressed by this review and any other conditions or requests were outside the SRP scope. b. The applicant was separated for a non-mental health condition. He developed symptoms diagnosed as anxiety and depression in 2006 and had a physical profile rating of “1” in factor P (Psychiatric). The MEB NARSUM listed adjustment disorder with anxiety as medically acceptable, with the MEB forwarding the same diagnosis to the PEB as medically acceptable. The PEB adjudicated the adjustment disorder with anxiety as not a physical disability and not ratable. His mental health diagnosis was not changed t during the DES process. c. His mental health condition was reviewed int eh medical record and considered by the SRP. The commander’s statement, dated 9 September 2009, noted the applicant was performing his duties, had effective work relationships, and was limited by being unable to life patients or take falls risk patients and limited mobility in fast-paced environments, unable to deploy, and limited duty status. The physical profile did not impose psychiatric limitations and there was no evidence of medical treatment for the mental health condition in the record. d. After due deliberation in consideration of the preponderance of the evidence, the SRP concluded there was insufficient cause to recommend a change I the PEB determination for the mental health condition and, therefore no disability ratings were recommended. The SRP recommended there be no change to the applicant’s disability and separation determination. 19. The Record of Proceedings in Docket Number AR20130021731 shows after due deliberation in consideration of the preponderance of the evidence, the SRP concluded there was insufficient cause to recommend a change in the applicant’s PEB determination for his mental health condition, and on 22 January 2014, the Board voted to accept the SRP’s assessment and deny the applicant’s request for a change to his mental health condition’s disability rating. 20. A VA letter, dated 29 September 2014, shows the applicant was granted the service-connected disability ratings for the following conditions: * migraine headaches, 10 percent effective 28 May 2010, increased to 30 percent effective 10 October 2013 * chronic bilateral lower extremity pain/myalgia, 0 percent continued * bilateral calluses (claimed as hammer toe/mallet toe bilateral feet), 0 percent continued 21. The applicant again applied to the ABCMR in 2017, requesting correction of his records to show physical disability retirement in lieu of physical disability discharge with severance pay. After reviewing the application and all supporting documents, including the evidence found within his military record the Board determined on 31 January 2020 that the requested relief was not warranted and denied his request. 22. A partial VA Rating Decision, dated 6 April 2021, shows the applicant’s previous denial of service-connection for asthma was confirmed and continued and that his previous denial of service-connection for asthma as secondary to obstructive sleep apnea was confirmed and continued. 23. A VA Rating Decision, dated 14 May 2021, shows the applicant’s evaluation of obstructive sleep apnea, which was then currently rated as 50 percent disabling, was continued. 24. A VA Disability Ratings printout, dated 17 June 2021, presumably pertaining to the applicant although his name does not appear on the document, shows the following: a. The applicant had a combined VA disability rating of 90 percent for the following service-connected conditions: * adjustment disorder with mixed anxiety and depressed mood, chronic, 50 percent (claimed as PTSD due to personal trauma), effective 31 December 2014 * chronic bilateral lower extremity pain, myalgia, 0 percent effective 28 May 2010 * chronic rhinosinusitis (claimed as nasal cavity polyps), 30 percent effective 28 May 2010 * migraine headaches, 30 percent effective 10 October 2013 * bilateral calluses (claimed as hammer toe mallet toe, bilateral feet), 0 percent effective 28 May 2010 * obstructive sleep apnea, 50 percent, effective 10 October 2013 b. The following conditions were deemed not service-connected: * hypertension * swelling in hands, fingers, and wrists * anaphylactic latex allergy * low back pain * asthma * ansometropic hyperopic presbyopia 25. The Army rates only conditions determined to be physically unfitting at the time of discharge, which disqualify the Soldier from further military service. The Army disability rating is to compensate the individual for the loss of a military career. The VA does not have authority or responsibility for determining physical fitness for military service. The VA may compensate the individual for loss of civilian employability. 26. 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 rating does not establish an error or injustice on the part of the Army. 27. Title 38, CFR, Part IV is the VA’s schedule for rating disabilities. The VA awards disability ratings to veterans for service-connected conditions, including those conditions detected after discharge. As a result, the VA, operating under different policies, may award a disability rating where the Army did not find the member to be unfit to perform his duties. 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. 28. MEDICAL REVIEW: The Army Review Boards Agency (ARBA) Medical Advisor was asked to review this case. Documentation reviewed included the applicant’s ABCMR application and accompanying documentation, the military electronic medical record (AHLTA), the VA electronic medical record (JLV), the electronic Physical Evaluation Board (ePEB), the Medical Electronic Data Care History and Readiness Tracking (MEDCHART) application, and/or the Interactive Personnel Electronic Records Management System (iPERMS). The ARBA Medical Advisor made the following findings and recommendations: a. The applicant has again applied to the ABCMR requesting additional medica conditions be found unfitting for continued military service with a corresponding increase in his military disability rating and a subsequent change in his current disability separation disposition from separated with disability severance pay to permanent retirement for physical disability. He states: “I believe that many disabling unfitting conditions were not considered during my IDES medical board process. AND On the DA FORM 199 {Physical Evaluation Board (PEB) Proceedings}, many disabling conditions were dismissed as " ... not a physical disability ... " e.g., Dx2 {dx = diagnosis} and Dx3-Dx8. Yet they seem to meet the unfitting criteria discussed above in the references listed in paragraph III A. Additionally, some disabilities stated, recorded, and documented by the Department of Veterans Affairs (the VA) that are potentially UNFITTING were. not considered. Many of these disabilities warrant evaluation for a military PEB disability rating.” b. The Record of Proceedings details the applicant’s service and the circumstances of the case. The DD 214 for the period of Service under consideration shows he entered the regular Army on 19 March 2007 and was separated with $105,055.28.00 of disability severance pay on 27 May 2010 under provisions provided in chapter 4 of AR 635-40, Physical Evaluation for Retention, Retirement, or Separation (8 February 2006). c. The applicant’s previous request for review of his military disability evaluation pertaining to his mental health condition was denied in full on 24 January 2014 (AR20130021731). For that request, the ABCMR requested a review of his mental health condition from the Physical Disability Board of Review (PDBR) Special Review Panel (SRP). The SRP recommended “that there be no change of the applicant's disability and separation determination.” DoD PDBR decisions are final and the issues considered by the PDBR cannot afterward be considered by the Army Board for Correction of Military Records. Hence, this review will only address his non-mental health conditions. d. A Soldier is referred to the IDES when they have one or more conditions which appear to fail medical retention standards as documented on a duty liming permanent physical profile. At the start of their IDES processing, a physician lists the Soldier’s referred medical conditions in section I the VA/DOD Joint Disability Evaluation Board Claim (VA Form 21-0819). The Soldier, with the assistance of the VA military service coordinator, lists all conditions they believe to be service-connected disabilities in block 8 of section II or a separate Statement in Support of Claim (VA form 21-4138). e. Soldiers then receive one set of VA C&P examinations covering all their referred and claimed conditions. These examinations, which are the examinations of record for the IDES, serve as the basis for both their military and VA disability processing. All conditions are then rated by the VA prior to the Soldier’s discharge. The physical evaluation board (PEB), after adjudicating the case sent them by the medical evaluation board (MEB), applies the applicable VA derived ratings to the Soldier’s unfitting condition(s), thereby determining their final combined rating and disposition. Upon discharge, the Veteran immediately begins receiving the full disability benefits to which they are entitled from both their Service and the VA. f. The applicant’s Medical Evaluation Board Proceedings (DA Form 3947) show that on 7 December 2009 a medical evaluation board (MEB) determined his “Chronic bilateral lower extremity pain/myalgia” was the sole condition which failed the medical retention standards of AR 40-501, Standards of Medical Fitness. The narrative summary states that despite an extensive evaluation of his leg pains, no pathological cause was identified. “SM {service member} lower extremity become noticeable in 2005 but was not incapacitating. Sometime in 2008, while running during an APFT, SM collapsed because of severe leg pains. SM was seen in the ER and was diagnosed with cramps and anxiety. Since then, his symptoms persisted. He has been evaluated by different medical specialties to include Internal Medicine, Orthopedics, Rheumatology, Oncology, and Physical Medicine. The working diagnosis has been limb pain. SM has undergone extensive serologic workup which failed to yield a diagnosis. MRI of lumbar spine revealed multilevel degenerative spondylopathy. NCS {nerve conduction studies} testing was normal. In spite of the interdisciplinary management approach, there was no specific diagnosis established. However, the general consensus amongst the specialist was a Chronic Limb Pain with an obscure etiology.” g. His mental health condition along with six additional medical conditions were determined to meet medical retention standards; migraine headaches, hypertension, foot pain du to calluses, hammer/mallet toes, latex allergy, and hearing loss. On 18 December 2009, the applicant agreed with the board’s findings and recommendation and his case was forwarded to a physical evaluation board (PEB) for adjudication. h. On 8 January 2010, the applicant’s informal PEB found his “Chronic bilateral lower extremity pain/myalgia” to be the sole unfitting medical condition for continued service. The PEB applied the VBA derived rating of 0% to this condition. From the VA’s 25 January 2010 rating decision: “For Disability Evaluation System purposes, a 0 percent evaluation is proposed for chronic bilateral lower extremity pain/myalgia ... A non-compensable evaluation is assigned for your chronic bilateral lower extremity pain/myalgia because the evidence does not show loss of sensation or motor strength in your lower extremities.” i. As his combined military disability rating was less than 30%, the PEB recommended the applicant be separated with disability severance pay. On 19 February 2010, after being counseled on the informal PEB’s findings by her PEB Liaison Officer (PEBLO), the applicant concurred with the informal PEB’s findings and waived his right to a formal hearing. j. There is no probative evidence the applicant had additional medical conditions which would have failed the medical retention standards of chapter 3, AR 40-501 and thus been subject to a finding of unfitness for continued service and compensable prior to his discharge. Furthermore, there is no evidence an additional medical condition prevented the applicant from being able to reasonably perform the duties of his office, grade, rank, or rating prior to his discharge. k. Review of his records in JLV shows he has been awarded multiple VA service- connected disability ratings, including ratings for chronic adjustment disorder, migraine headaches, and obstructive sleep apnea. However, the DES compensates an individual only for service incurred medical condition(s) which have been determined to disqualify him or her from further military service. The DES has neither the role nor the authority to compensate service members for anticipated future severity or potential complications of conditions which were incurred or permanently aggravated during their military service; or which did not cause or contribute to the termination of their military career. These roles and authorities are granted by Congress to the Department of Veterans Affairs and executed under a different set of laws. l. It is the opinion of the ARBA Medical Advisor that neither an increase in his military disability rating nor a referral of his case back to the Disability Evaluation System is warranted. 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 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. Upon review of the applicant’s petition, available military records and the medical review, the Board concurred with the advisory official finding that neither an increase in his military disability rating nor a referral of his case back to the Disability Evaluation System is warranted. The Board recognized there is no evidence an additional medical condition prevented the applicant from being able to reasonably perform the duties of his office, grade, rank, or rating prior to his discharge. Furthermore, the Board determined applicant had no additional medical conditions which would have failed the medical retention standards and thus been subject to a finding of unfitness for continued service and compensable prior to his discharge. Based on the preponderance of evidence, the Board determined there is insufficient evidence to amend the previous Board’s decision. 2. The Board determined DES compensates an individual only for service incurred condition(s) which have been determined to disqualify him or her from further military service. The DES has neither the role nor the authority to compensate service members for anticipated future severity or potential complications of conditions which were incurred or permanently aggravated during their military service; or which did not cause or contribute to the termination of their military career. 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 Board found the evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined the overall merits of this case are insufficient as a basis to amend the decision of the ABCMR set forth in Docket Number: * AR20130021731 on 22 January 2014 * AR20170011008 on 31 January 2020 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. 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. The U.S. Army Physical Disability Agency is responsible for administering the Army physical disability evaluation system and executes Secretary of the Army decision-making authority as directed by Congress in chapter 61 and in accordance with DOD Directive 1332.18 and Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation). 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 evidenced in an MEB; when they receive a permanent medical profile rating of 3 or 4 in any factor and are referred by an MOS Medical Retention Board; and/or they are command-referred for a fitness-for-duty medical examination. b. The disability evaluation assessment process involves two distinct stages: the MEB and PEB. The purpose of the MEB is to determine whether the service member's injury or illness is severe enough to compromise his/her ability to return to full duty based on the job specialty designation of the branch of service. A PEB is an administrative body possessing the authority to determine whether or not a service member is fit for duty. A designation of "unfit for duty" is required before an individual can be separated from the military because of an injury or medical condition. Service members who are determined to be unfit for duty due to disability either are separated from the military or are permanently retired, depending on the severity of the disability and length of military service. Individuals who are "separated" receive a one-time severance payment, while veterans who retire based upon disability receive monthly military retired pay and have access to all other benefits afforded to military retirees. 2. Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) establishes 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. Only the unfitting conditions or defects and those which contribute to unfitness will be considered in arriving at the rated degree of incapacity warranting retirement or separation for disability. 3. Army Regulation 40-501 (Standards of Medical Fitness) governs medical fitness standards for enlistment, induction, appointment (including officer procurement programs), retention, and separation (including retirement). The Department of Veterans Affairs Schedule for Rating Disabilities (VASRD). VASRD is used by the Army and the VA as part of the process of adjudicating disability claims. It is a guide for evaluating the severity of disabilities resulting from all types of diseases and injuries encountered as a result of or incident to military service. This degree of severity is expressed as a percentage rating which determines the amount of monthly compensation. 4. Department of Defense (DoD) Directive-Type Memorandum (DTM) 11-015 (Disability Evaluation System) explains the Integrated Disability Evaluation System (IDES). The version in effect at the time defined the IDES process and procedures. The guidelines within the DTM were incorporated in the DoD Manual Number 1332.18 (DES Manual: General Information and Legacy DES Time Standards). a. The IDES is the joint DoD-VA process by which DoD determines whether wounded, ill, or injured Service members are fit for continued military service and by which the DOD and the VA determine appropriate benefits for Service members who are separated or retired for a Service-connected disability. The IDES features a single set of disability medical examinations appropriate for fitness determination by the Military Departments and a single set of disability ratings provided by the VA for appropriate use by both departments. Although the IDES includes medical examinations, IDES processes are administrative in nature and are independent of clinical care and treatment. b. Unless otherwise stated in this DTM, DOD will follow the existing policies and procedures 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. Service members whose cases were initiated under the legacy DES process will not enter the IDES. c. IDES medical examinations will include a general medical examination and any other applicable medical examinations performed to VA compensation and pension (C&P) standards. Collectively, the examinations will be sufficient to assess the member’s referred and claimed condition(s) and assist the VA in ratings determinations and assist military departments with unfit determinations. d. Within 15 days of receiving the proposed disability ratings from the Disability Rating Activity Site (D-RAS), the PEB will apply the rating using the diagnostic code(s) provided by the D-RAS to the Service Member’s unfitting conditions and publish the disposition recommendation. For example, if the PEB identifies a condition to the D-RAS as “schizophreniform disorder”, but the D-RAS rates the condition as “psychotic disorder NOS (VASRD 9210), the PEB will apply the rating as “schizophophreniform disorder rated as psychotic disorder NOS (VASRD 9210). e. 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. 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. Title 38, U.S. Code, section 1110 (General – Basic Entitlement) states for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service, during a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation as provided in this subchapter, but no compensation shall be paid if the disability is a result of the veteran's own willful misconduct or abuse of alcohol or drugs. 7. Title 38, U.S. Code, section 1131 (Peacetime Disability Compensation – Basic Entitlement) states for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service, during other than a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation as provided in this subchapter, but no compensation shall be paid if the disability is a result of the veteran's own willful misconduct or abuse of alcohol or drugs. 8. Title 10, U.S. Code, section 1556 requires the Secretary of the Army to ensure that an applicant seeking corrective action by the Army Review Boards Agency (ARBA) be provided with a copy of any correspondence and communications (including summaries of verbal communications) to or from the Agency with anyone outside the Agency that directly pertains to or has material effect on the applicant's case, except as authorized by statute. ARBA medical advisory opinions and reviews are authored by ARBA civilian and military medical and behavioral health professionals and are therefore internal agency work product. Accordingly, ARBA does not routinely provide copies of ARBA Medical Office recommendations, opinions (including advisory opinions), and reviews to Army Board for Correction of Military Records applicants (and/or their counsel) prior to adjudication. //NOTHING FOLLOWS// ABCMR Record of Proceedings (cont) AR20220004917 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1