IN THE CASE OF: BOARD DATE: 11 April 2023 DOCKET NUMBER: AR20220004956 APPLICANT REQUESTS: * reconsideration of his previous request for physical disability retirement in lieu of separation with severance pay * personal appearance before the Board APPLICANT'S SUPPORTING DOCUMENT(S) CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record) * DD Form 214 (Certificate of Release or Discharge from Active Duty) * Summary of benefits letter, 30 May 2022 * MRI Cervical Spine (my HealtheVet) * Cervical Spine (Duplicate) * Digital Image (My HealtheVet) * Veterans Affairs (VA) Medical Records 2021 * Appeal Cervical Spine - Status (printout) * Appeal - Issues (printout) * VA Appeal - Details (printout) * VA Disability (eBenefits printout) 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 AR20200000039 on 29 July 2021. 2. The applicant states he was diagnosed with post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) with Cervical Spine injury for which he received a Purple Heart Medal. Ongoing medical care from that time to his time of discharge in 2016 reflects that his pain prevented him from service. Pain continued in late 2016 after discharge into 2017 which is supported by VA documentation for cervical spine issues. Which is also reflected in rating increase for cervical spine in 2017. Although surgery was performed, pain continues with degenerative disc issues and narrowing of disc above and below surgical sight. VA records confirm the same as he is now 100% Permanent and Total (P&T) service connected; and continue a medical regiment to make pain manageable. The pain continues to persist making it increasingly difficult to maintain employment because both difficulty sitting and standing, migraines from neck pain. He continues to exhaust all means of treatment per the VA as neck issues may lead to another surgery. In addition, not being medically discharged excludes him from obtaining maximum care through both Tricare via Brooke Army Medical Center, excludes him from Purple Heart benefits, which he has earned, and most of all without the record being corrected to reflect: Officer-Retirement-Permanent, it fails to recognize what the VA has placed in the record via his status first as 100% granted in 2020, then with the final designation of P&T granted in 2021. Medical records reflect ongoing medical treatment for this issue since 2017, even as the VA Disability Board recognized the error in not recognizing PTSD and TBI. The step of correcting his military record will be the final correction needed to properly reflect his service, extent of injuring and need for further treatment. 3. The applicant served in the U.S. Navy from 23 March 2005 to 2 January 2008. 4. He was appointed as a commissioned officer and entered active duty on 6 January 2008. He completed the Chaplain Basic Officer Leader Course on 4 April 2008. He served in a variety of assignments including Hawaii and Iraq. 5. On 8 April 2016, he underwent a Compensation and Pension (C&P) evaluation at the VA, after having been referred to the Integrated Disability Evaluation System (IDES) for cervical fusion and cervical spondylosis. 6. On 9 May 2016, a medical evaluation board (MEB) convened and after consideration of clinical records, laboratory findings, and physical examinations, the MEB found that the applicant had the medically unacceptable condition of Cervical spondylosis and cervical fusion; in accordance with Army Regulation (AR) 40-501 (Standards of Medical Fitness), paragraph 3-39h - does not meet medical. He also had the following medically acceptable conditions that met retention standards: * Right Trichiasis without entropion * Dry eye syndrome, status post PRK (Not a VA diagnosis) * Bilateral Conjunctivitis, Chronic allergic * H/O (unknown) Tinnitus * Chronic post-traumatic headache * Lumbar spondylosis * Scoliosis. (Not a VA diagnosis) * Vitamin D deficiency (Not a VA diagnosis) * OSA (obstructive sleep apnea) * Bilateral pes planus * GERD (Gastroesophageal reflux disease) (and esophageal spasm (associated with GERD) (VA diagnosis) * TBI * Hyperlipidemia (Not a VA diagnosis) * Mild Right carpal tunnel syndrome * Right TMJ (temporomandibular joint) * Latrogenic infertility status post vasectomy and vasovasostomy * Right ankle sprain * Right Unequal Leg Length * Allergic rhinitis (Not a VA diagnosis) * Left ulnar neuropathy * Vertigo attributable to TBI * Bilateral calcaneus bursitis 7. The MEB recommended referral to a physical evaluation board (PEB). The applicant was counseled but did not agree with the MEB’s findings and recommendation. He submitted a rebuttal. a. In his rebuttal, he disagreed that the following conditions met retention standards: Diagnosis #7 Lumbar spondylosis; Diagnosis #11 bilateral pes planus, and Diagnosis #15 and 21 are mild right carpal tunnel syndrome and left ulnar neuropathy. He also indicated that the MEB/Narrative Summary did not address the left knee issues causes by the leg length discrepancy created by his scoliosis. b. The MEB reviewed his submission and after a review, the MEB found the preponderance of the evidence did not support a change in the assessment of those conditions that met retention standards or to the alleged knee condition. 8. On 22 April 2016, the applicant was issued a physical profile (permanent) for chronic neck pain, chronic mid-low back pain, and sleep problems. 9. On 9 June 2016, an informal PEB convened and found the applicant's condition (Cervical spondylosis and cervical fusion) unfitting. The PEB accepted the VA proposed rating of 10% for this unfitting condition, and recommended his disposition be separation with entitlement to severance pay if otherwise qualified. The PEB noted that: a. The applicant reported onset of condition in 2009 as a result of a motor vehicle accident while on temporary duty to Virginia. The condition worsened when a mortar/rocket detonation blew him from his chair while stationed in Iraq in 2011. He has been awarded the Purple Heart and the Combat Action Badge. Reasonable performance in his area of concentration requires him to perform certain activities. He is unfit because this condition prevents him from being able to perform required activities that includes walking for distances up to a mile and standing/crouching for prolonged periods in completion of his assigned AOC (56A, Chaplain). b. The PEB considered his other conditions. The PEB noted he is fit for the following conditions MEB Dx 2-23 (right trichiasis without entropion; dry eye syndrome, status post PRK; bilateral conjunctivitis, chronic allergic; history of tinnitus; chronic posttraumatic headache; lumbar spondylosis; scoliosis; vitamin D deficiency; obstructive sleep apnea; bilateral pes planus; GERD and esophageal spasm; traumatic brain injury; hyperlipidemia; mild right carpal tunnel syndrome; right TMJ; iatrogenic infertility status post vasectomy and vasovasostomy; right ankle sprain; right unequal leg length; allergic rhinitis; left ulnar neuropathy; vertigo attributable to traumatic brain injury; and bilateral calcaneus bursitis). In full consideration of DODI 1332.18, Enc. 3, App. 2, to include combined, overall effect, the conditions are not unfitting because the MEB indicates these conditions meet retention standards; does not indicate that any of these conditions cause profile limitations (functional activities a-h); and does not indicate that performance issues, if any, are due to these conditions. c. This case was adjudicated as part of the Integrated Disability Evaluation System (IDES). As documented in the Department of Veterans Affairs (DVA) memorandum dated 2 June 2016, the DVA determined the specific VASRD code(s) to describe the Soldier's condition(s). The PEB determined the disposition recommendation based on the proposed DVA disability rating(s) and in accord with applicable statutes and regulations. d. It is noted that the officer's disability rating is less than 30%. Soldiers with a disability rating of less than 30%, and with less than 20 years of service as computed under 10 USC 1208 (active plus RC equivalent service), require separation from service with disability severance pay. Disability severance pay, as changed by the National Defense Authorization Act of Fiscal Year 2008, is computed by multiplying monthly basic pay for two months by the number of combined years (but not over 19) of active service and inactive duty points (to include membership points). The number of years for purposes of the calculation is not less than 6 years if the disability was determined to have been incurred in the line of duty in a combat zone or incurred during the performance of duty in combat-related operations, and no less than 3 years for all other Soldiers. e. The applicant was counseled and concurred with the PEB's finding and recommendation and waived his right to formal hearing of his case. He also indicated that he did not want a reconsideration of his VA rating. 10. The applicant was honorably discharged from active duty on 19 September 2016. His DD Form 214 shows he was discharged in accordance with chapter 4 of AR 635-40 (Physical Evaluation for Retention, Retirement, or Separation), with entitlement to severance pay ($96,840.90). Block 27 (Separation Code) shows JEA and Block 28 (Narrative Reason for Separation) of his DD Form 214 shows the entry "Disability, Severance Pay, Combat Related (Enhanced)." 11. In his previous request (AR20200000039) on 29 July 2021, after reviewing the application and all supporting documents, the Board determined relief was not warranted. Based upon the available documentation and the findings of the medical advisor, the Board concluded there was insufficient evidence of an error or injustice which would warrant a change to the applicant’s narrative reason for separation. 12. The applicant provides: a. Summary of benefits letter, 30 May 2022, which shows he is P&T 100% combined service-connected disabled effective 1 December 2021. b. MRI Cervical Spine (my HealtheVet) documents in support of his claim. c. Digital Image (My HealtheVet) documents in support of his claim. d. VA Medical Records 2021 (54 pages) in support of his claim with highlighted sections related to his history of cervical fusion and back pain. e. Appeal Cervical Spine - Status (printout) which shows his VA claim decision was made on 30 September 2017. He submitted a notice of disagreement on 21 March 2017. He opted into the rapid appeals modernization program on 8 August 2018. f. Appeal - Issues (printout) which shows withdrawn due to increased rating, degenerative arthritis of the spine. g. VA Appeal - Details (printout) he claimed cervical spondylosis with cervical fusion (claimed as cervical disc disease) (Increase) received 30 July 2018. h. VA Disability (eBenefits printout) which shows his disabilities and percentages. 13. 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. 14. Title 38, U.S. Code, 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. 15. Title 38, CFR, Part IV is the VA’s schedule for rating disabilities. The DVA awards disability ratings to veterans for service-connected conditions, including those conditions detected after discharge. As a result, the DVA, 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 DVA can evaluate a veteran throughout his or her lifetime, adjusting the percentage of disability based upon that agency's examinations and findings. 16. In reaching its determination, the Board can consider the applicant’s petition and his service record in accordance with the published equity, injustice, or clemency determination guidance. 17. MEDICAL REVIEW: a. 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: b. The applicant has applied to the ABCMR requesting a reconsideration of their previous denial of his request to have additional medical conditions be determined unfitting for continued military service with a subsequent increase in his military disability rating and change in his current disability separation disposition from separated with disability severance pay to permanent retirement for physical disability. The applicant states in part: “I was diagnosed with PTSD and TBI w/Cervical Spine injury for which I received a Purple Heart Medal. Ongoing medical care from that time to my time of discharge in 2016 reflects that my pain prevented me from service. Pain continued in late 2016 after discharge in to 2017 which is supported by VA documentation for cervical spine issues. Which is also reflected in rating increase for cervical spine in 2017. Although surgery was performed, pain continues with degenerative disc issues and narrowing of disc above and below surgical sight. VA records confirm the same as I am now 100% P&T {permanent and total} Service Connected; and continue a medical regiment to make pain manageable.” c. 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 6 January 2008 and was separated with $96,840.90 of disability severance pay on 19 September 2016 under provisions provided in Chapter 4 of AR 635-40, Physical Evaluation for Retention, Retirement, or Separation (20 March 2012). d. This request was previously denied in full on 29 July 2021 (AR20200000039). Rather than repeat their findings here, the board is referred to the record of proceedings and medical advisory opinion for that case. This review will concentrate on the new evidence submitted by the applicant. e. Additional documentation in this case consists of recent VA documentation showing there has been progression of his cervical spine pain/condition; the applicant’s combined service-connected disability rating is 100%; and that his rating is unchanged from 31 May 2019. f. The applicant notes his TBI and PTSD in his request. Review of his AHLTA encounters show he was treated for TBI in 2011. From the initial neurology encounter: “35-year-old USA Chaplain encountered a blast less than 10 meters from his CHU on 22 Jan 2011. Was knocked out of his chair & reports slight memory loss of couple minutes after blast ... Pt reporting continued symptoms, frontal headaches w/ photophobia, intermittent vertigo, occasional vertigo, and decreased energy. g. The applicant was treated for his TBI by optometry, speech therapy, and physical therapy. He was released without restrictions and the Brain Injury Center closed his case on 14 June 2012. There are no additional TBI related encounters. h. The TBI was addressed by the medical evaluation board and the physical evaluation board, with their findings of meets medical retention standards and not unfitting for service respectively. i. As for his PTSD, this was diagnosed by the VA after his discharge from the Army. j. AHLTA shows the applicant was seen at the theater clinic on four occasions between 24 December 2010 and 29 January 2011 after self-referring for stress. At the first visit, the provider diagnosed him occupational problem, opining: Pt {patient} presents with symptoms of stress related to occupational demands. Pt admitted to difficulties in setting boundaries for himself and feels that he is often pulled in many directions. This lack of self-protection is likely contributing to pt’s increased stress and periods of increased heart rate. He does not currently meet criteria for a mood or anxiety disorder. Will continue to explore pt’s symptoms further in upcoming sessions. k. His diagnosis remained “Occupational problem” at his final visit on 29 January 2011 after which the provider opined: “Pt is currently experiencing increased occupational difficulties as a result of his recent involvement in an IDF {indirect fire} attack. Pt is struggling with feelings of anger that he has not been able to adequately express. He does not currently meet criteria for a mood or anxiety disorder.” l. There were no additional mental health encounters. m. The applicant claimed anxiety on of his separate Statement in Support of Claim (VA form 21-4138). After the VA provider completed the applicant’s Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire and examination, he stated the applicant did not have a “mental health disorder.” There is no mental health disorder noted in the MEB narrative summary or the Medical Evaluation Board Proceedings (DA Form 3947). The 2 June 2016 VA ratings decision for his Integrated Disability Evaluation System (IDES) processing states “ANXIETY: Proposed DES Not Service Connected, No Diagnosis.” n. There is no significant probative evidence the applicant had any additional medical condition(s) which would have failed the medical retention standards of chapter 3 of AR 40-501, Standards of Medical Fitness, prior to his discharge; or which prevented the applicant from being able to reasonably perform the duties of his office, grade, rank, or rating prior to his discharge. o. Review of his records in JLV shows there has been no increase in the cervical spine 10% disability rating he received while in the IDES. It also shows he has been awarded multiple VA service-connected disability ratings, including ratings for PTSD, traumatic brain disease, and migraine headaches. However, the DES only compensates an individual 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. 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 DES is warranted. BOARD DISCUSSION: 1. The Board determined the evidence of record was sufficient to render a fair and equitable decision. As a result, a personal appearance hearing is not necessary to serve the interest of equity and justice in this case. 2. After reviewing the application, all supporting documents, and the evidence found within the military record, the Board found that relief was not warranted. The applicant’s contentions, the military record, and regulatory guidance were carefully considered. The evidence of record shows an informal PEB convened and found the applicant's condition (Cervical spondylosis and cervical fusion) unfitting. The PEB accepted the VA proposed rating of 10% for this unfitting condition, and recommended his disposition be separation with entitlement to severance pay. He was counseled and concurred with the PEB's finding and recommendation and waived his right to formal hearing of his case. He also indicated that he did not want a reconsideration of his VA rating. The Board reviewed and agreed with the medical advisor’s finding that there is no significant probative evidence the applicant had any additional medical condition(s) which would have failed the medical retention standards of chapter 3 of AR 40-501, prior to his discharge; or which prevented the applicant from being able to reasonably perform the duties of his office, grade, rank, or rating prior to his discharge. Based on a preponderance of evidence, the Board determined that the disability rating percentage the applicant received upon separation was not in error or unjust. 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 to amend the decision of the ABCMR set forth in Docket Number AR2020000039 on 29 July 2021. 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. Army Regulation 15-185 (Army Board for Correction of Military Records) prescribes the policies and procedures for correction of military records by the Secretary of the Army acting through the ABCMR. Paragraph 2-11 states applicants do not have a right to a formal hearing before the ABCMR. The Director or the ABCMR may grant a formal hearing whenever justice requires. 2. 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 a Medical Evaluation Board (MEB); when they receive a permanent medical profile rating of 3 or 4 in any factor and are referred by an Military Occupational Specialty (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 Physical Evaluation Board (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. c. 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. 3. Army Regulation 635-40 (Physical Evaluation for Retention, Retirements, 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. a. Disability compensation is not an entitlement acquired by reason of service- incurred illness or injury; rather, it is provided to Soldiers whose service is interrupted and who can no longer continue to reasonably perform because of a physical disability incurred or aggravated in military service. b. Soldiers who sustain or aggravate physically-unfitting disabilities must meet the following line-of-duty criteria to be eligible to receive retirement and severance pay benefits: (1) The disability must have been incurred or aggravated while the Soldier was entitled to basic pay or as the proximate cause of performing active duty or inactive duty training. (2) The disability must not have resulted from the Soldier's intentional misconduct or willful neglect and must not have been incurred during a period of unauthorized absence. c. The percentage assigned to a medical defect or condition is the disability rating. A rating is not assigned until the PEB determines the Soldier is physically unfit for duty. Ratings are assigned from the Department of Veterans Affairs (VA) Schedule for Rating Disabilities (VASRD). The fact that a Soldier has a condition listed in the VASRD does not equate to a finding of physical unfitness. An unfitting, or ratable condition, is one which renders the Soldier unable to perform the duties of their office, grade, rank, or rating in such a way as to reasonably fulfill the purpose of their employment on active duty. There is no legal requirement in arriving at the rated degree of incapacity to rate a physical condition which is not in itself considered disqualifying for military service when a Soldier is found unfit because of another condition that is disqualifying. 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. 4. 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. 5. 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. 6. 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. 7. On 3 September 2014, the Secretary of Defense directed the Service Discharge Review Boards (DRBs) and Service Boards for Correction of Military/Naval Records (BCM/NRs) to carefully consider the revised PTSD criteria, detailed medical considerations, and mitigating factors, when taking action on applications from former service members administratively discharged under other than honorable conditions, and who have been diagnosed with PTSD by a competent mental health professional representing a civilian healthcare provider in order to determine if it would be appropriate to upgrade the characterization of the applicant's service. 8. On 25 August 2017, the Office of the Undersecretary of Defense for Personnel and Readiness issued clarifying guidance for the Secretary of Defense Directive to DRBs and BCM/NRs when considering requests by Veterans for modification of their discharges due in whole, or in part, to: mental health conditions, including PTSD; traumatic brain injury; sexual assault; sexual harassment. Boards were directed to give liberal consideration to Veterans petitioning for discharge relief when the application for relief is based in whole or in part on those conditions or experiences. The guidance further describes evidence sources and criteria and requires Boards to consider the conditions or experiences presented in evidence as potential mitigation for that misconduct which led to the discharge. 9. On 25 July 2018, the Under Secretary of Defense for Personnel and Readiness issued guidance to Military Discharge Review Boards and Boards for Correction of Military/Naval Records (BCM/NRs) regarding equity, injustice, or clemency determinations. Clemency generally refers to relief specifically granted from a criminal sentence. BCM/NRs may grant clemency regardless of the type of court-martial. However, the guidance applies to more than clemency from a sentencing in a court- martial; it also applies to other corrections, including changes in a discharge, which may be warranted based on equity or relief from injustice. This guidance does not mandate relief, but rather provides standards and principles to guide Boards in application of their equitable relief authority. In determining whether to grant relief based on equity, injustice, or clemency grounds, BCM/NRs shall consider the prospect for rehabilitation, external evidence, sworn testimony, policy changes, relative severity of misconduct, mental and behavioral health conditions, official governmental acknowledgement that a relevant error or injustice was committed, and uniformity of punishment. Changes to the narrative reason for discharge and/or an upgraded character of service granted solely on equity, injustice, or clemency grounds normally should not result in separation pay, retroactive promotions, and payment of past medical expenses or similar benefits that might have been received if the original discharge had been for the revised reason or had the upgraded service characterization. 10. 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) AR20220004956 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1