IN THE CASE OF: 

		BOARD DATE: 20 January 2023

		DOCKET NUMBER: AR20220005146


APPLICANT REQUESTS: In effect, the voiding of his medical separation and his return 
to duty.

APPLICANT'S SUPPORTING DOCUMENT(S) CONSIDERED BY THE BOARD:

*	Online DD Form 149 (Application for Correction of Military Record), dated 5 April 
2022
*	Two letters of support
*	DA Form 199-1 (Formal Physical Evaluation Board (PEB) Proceedings)
*	DA Form 3349 (Physical Profile Record)
*	Civilian physician's evaluation


FACTS:

1.  The applicant states, in 2009, while a member of the Pennsylvania Army National 
Guard (PAARNG) and during a routine annual health assessment, the examining 
physician diagnosed a condition called, "Immune Thrombocytopenia." Essentially, this 
means the applicant's blood platelet count is lower than normal; (the applicant's platelet 
count was 55, and the average person's count is 142). 

	a. Because the applicant showed no symptoms, and the condition was not affecting 
his physical or mental performance, the PAARNG allowed him to continue his service. 
The applicant points out that, in 2014, he deployed to Afghanistan, and, while deployed, 
he experienced no limitations; he adds that he is a Taekwondo Martial Artist, and, 
because it is a contact sport, he frequently spars.

	b. In 2018, while the applicant was stationed in, the Army conducted another health 
assessment prior to the applicant attending airborne training; he states, "I was reminded 
of the condition of the platelet count in my blood and after submitting to all the test that 
the military physician request and providing a testament from my own civilian doctor, I 
was allowed continue my service."

	c. In 2020, during an assignment at Fort Bliss, TX, and as part of his preparation for 
Warrant Officer school, the applicant underwent another health assessment; however, 
this time the doctor referred him to a military blood specialist. Despite not finding any 
deficiencies in the functioning of the applicant's spleen, the blood doctor recommended 
its removal, via a splenectomy. After reviewing the facts and considering his overall 
health, the applicant elected not to have the procedure performed; in response, the 
blood doctor said a level "3" would be entered into the applicant's medical record, and a 
medical evaluation board would have to decide whether the applicant should remain on 
active duty. 

	d. The applicant declares his firm disagreement with the blood doctor's profile, and 
he maintains there is no evidence to support it; for the past 15 years, he has been living 
with this condition and participating in activities that he must now stop because of the 
profile. He argues he has valid complaints, and he asserts the Fort Bliss doctors are 
simply trying to cover for each other; "the only reason they didn't commit malpractice 
was because I refused to go through with the operation that they recommended. I wish 
I had received a fair shake from the Army, and I am disappointed with the result."

2.  The applicant provides two letters of support from his Noncommissioned-Officer-In 
Charge (NCOIC) and his Officer-In-Charge (OIC). Additionally, the applicant includes 
his DA Form 3349; the DA Form 199-1, showing the results of his formal PEB; and 
medical evaluation conducted by his civilian doctor.

	a.  Both the applicant's NCOIC and OIC affirm the applicant is a capable NCO who 
serves in the vital position; the applicant's military occupational specialty (MOS) 
is 25B (Information Technology), and he is the Division Artillery's Primary Key 
Management Infrastructure Operating Account Manager (KOAM) for the unit's 
Communications Security Vault. Currently, there is an Army-wide shortage of 
25B KOAMs, and the applicant's loss would have a negative impact. 

	b. The applicant provides a copy of his civilian physician's evaluation, conducted on 
16 January 2019; the applicant's doctor specializes in Hematology and Oncology.

		(1)  In describing the applicant's medical history, the doctor notes, "[The 
applicant] was recently placed on reserve because he was noted to have a low platelet 
count in routine wellness blood work. The patient has never had any history of abnormal 
bruising or bleeding. He has no history of bleeding gums or abnormal bleeding with 
dental procedures. He has been able to partake in all rigorous training and activities 
during his service as a soldier in the United States Army without incident."

		(2)  Under "Review of Systems," the doctor affirms the applicant has "No history 
of abnormal bruising or bleeding." For "Assessment and Plan," the doctor wrote the 
applicant had, "no significant active medical problem requiring intervention with a history 
of mild thrombocytopenia dating back to at least 2009. The patient has no history of 
abnormal bruising or bleeding. He has no other clinical consequence of platelet 
dysfunction or thrombocytopenia. The patient likely has mild immune thrombocytopenic 
purpura (ITP)."

	c.  The applicant's DA Form 3349, dated in March 2021, reflects that, for Immune 
Thrombocytopenia (Bilateral), the medical authority issued a permanent level "3" profile 
(significant functional or activity limitations) under the "P" functional area (Physical 
Capacity or Stamina).

		(1)  In Section 4 (Functional Activities), the profile shows the applicant cannot 
perform 4 out of 6 listed activities. 

		(2)  Section 5 (Medical Instructions to Unit Commander) states, "Soldier was 
diagnosed with Immune Thrombocytopenia in encounter dated 21 SEP 2020. Soldier 
was instructed by that he must undergo a Splenectomy if he desired to stay in Active 
duty. Soldier reported to General Surgery and informed them he is refusing surgery. I 
called the SM today and verified with him again that he does not desire surgery at this 
time. I am writing this profile per the recommendation of in note dated 21 Sep 2020, "If 
he opts against splenectomy, a P3 profile will be needed," as this condition may 
compromise or aggravate the Soldier's health or well-being if they were to remain in the 
military service."

	d. The DA Form 199-1 shows that, on 16 February 2022, a Formal PEB (FPEB) 
convened via telephone and/or other information technology means, due to COVID-19; 
the applicant appeared with counsel before the FPEB. 

		(1)  After reviewing evidence and hearing the applicant's testimony, the FPEB 
determined the applicant was physically unfit for continued military service; the FPEB 
recommended the applicant's separation with severance pay and a disability rating of 
0 percent. 

		(2)  On 4 March 2022, the applicant recorded his non-concurrence with the 
FPEB's findings and recommendations, and he indicated his intent to file a written 
appeal; (the applicant did not include a copy of his appeal). 

		(3)  On 5 April 2022, the U.S. Army Physical Disability Agency (USAPDA) 
approved the applicant's FPEB on behalf of the Secretary of the Army.

3.  a review of the applicant's service records show:

	a.  On 14 May 2007, the applicant enlisted into the PAARNG for 8 years; on 8 June 
2007, the applicant entered active duty for initial active duty for training, and, upon 
completion of initial entry training and the award of MOS 92A (Automated Logistical 
Specialist), orders released the applicant from active duty and returned him to the 
PAARNG.

	b. The applicant extended his enlistment twice for a total of 2 years and 2 months; 
(respectively, on 18 October 2012 and 17 November 2013). On 3 April 2014, orders 
mobilized the applicant in support of Operation Enduring Freedom, and, on 31 May 
2014, he deployed to Afghanistan. On 19 September 2014, Permanent Orders awarded 
the applicant the Army Commendation Medal based on his exceptionally meritorious 
service during his deployment; on 23 November 2014, he redeployed, and, 
on 9 January 2015, orders honorably released him from active duty and returned him to 
the PAARNG. 

	c. On 13 July 2015, the PAARNG honorably discharged the applicant because he 
had reached his expiration term of service. 

	d.  On 13 November 2015, he enlisted into the U.S. Army Reserve (USAR) for a 6-
year term. 

	e.  On 20 September 2018, the applicant submitted a DD Form 368 (Request for 
Conditional Release), asking the USAR to release him so he could enter the Regular 
Army; on 8 July 2019, following his request's approval, the applicant enlisted into the 
Regular Army for 3 years. 

	f. At some point prior to February 2022, medical authority referred the applicant into 
the Army's Disability Evaluation System (DES). 

	g.  On 16 February 2022, following a formal PEB (FPEB) hearing in which the 
applicant appeared with counsel, an FPEB determined the applicant was physically unfit 
for military service and recommended his separation with severance pay; the FPEB 
additionally indicated the applicant should receive a 0 percent disability rating. On 4 
March 2022, the applicant non-concurred with the FPEB's findings and 
recommendations and indicated he would file an appeal; (the applicant's available 
service record does include the appeal). On 5 April 2022, the USAPDA approved the 
FPEB's findings and recommendations on behalf of the Secretary of the Army.

	h. On 4 July 2022, orders honorably discharged the applicant, citing paragraph 
4-27c (3) (Final Disposition by USAPDA – Separation with Disability Severance Pay), 
Army Regulation (AR) 635-40 (Disability Evaluation for Retention, Retirement, or 
Separation). 

		(1)  The applicant's DD Form 214 (Certificate of Release or Discharge from 
Active Duty) shows he completed 2 years, 11 months, and 27 days of his 3-year 
enlistment contract, with 1 year, 9 months, and 17 days of prior service and 10 years 
and 2 months of prior inactive service; (a total of 14 years, 11 months, and 14 days of 
combined ARNG, USAR, and Regular Army service). 

		(2)  The report shows the following additional information:

		(a)  Item 13 (Decorations, Medals, Badges, Citations, and Campaign Ribbons 
Awarded or Authorized):

*	Army Commendation Medal
*	Joint Service Achievement Medal
*	Army Good Conduct Medal (1st Award)
*	National Defense Service Medal
*	Global War on Terrorism Expeditionary Medal
*	Global War on Terrorism Service Medal
*	Afghanistan Campaign Medal with one bronze service star
*	NCO Professional Development Ribbon with Numeral "2"
*	Army Service Ribbon
*	Overseas Service Ribbon
*	Armed Forces Reserve Medal with Bronze Hourglass
*	North Atlantic Treaty Organization Medal
*	Driver and Mechanic Badge with Operator-S (Special Mechanical 
Equipment) Component Bar

		(b)  Item 18 (Remarks) lists the amount of the applicant's severance pay.

4.  AR 40-501 (Standards of Medical Fitness), currently in effect, prescribes policies and 
procedures for identifying and referring for DES processing those Soldiers who fail the 
medical retention standards; chapter 3 (Medical Fitness Standards for Retention and 
Separation, including Retirement) lists the various disqualifying medical conditions 
and/or physical defects requiring DES referral. 

	a. Paragraph 3-1 (General) states any medical conditions that have met the clinical 
or administrative medical retention decision point (MRDP) and meet the below-listed 
criteria should be referred. (According to AR 40-502 (Medical Readiness), currently in 
effect, a Soldier's MRDP is reached when the medical condition has either stabilized or 
cannot be stabilized in a reasonable period of time for up to twelve months and impacts 
the Soldier's successful performance of duty. Successful performance of duty is defined 
as the ability to perform basic Soldiering skills required by all military personnel and to 
carry MOS specific duties).  

		(1)  "Significantly limit or interfere with the Soldier’s performance of their duties 
(either basic Soldier skills or MOS specific) as substantiated by the Soldier’s 
commander or supervisor."

		(2)  "Require medication for control that requires frequent monitoring by a 
physician due to debilitating or serious side effects, medical care, or hospitalization with 
such frequency as to interfere with the satisfactory performance of duty."

		(3)  "Restrict performance of any of the profile functional activities listed in 
Section 4 of DA Form 3349 (Physical Profile); prevent the performance of all aerobic 
events of the APFT; have met a clinical MRDP; or have been temporarily profiled for 
more than 365 days, meeting the administrative MRDP."

		(4)  "May compromise or aggravate the Soldier’s health or well-being if they were 
to remain in the military service. This may involve dependence on certain medications, 
appliances, severe dietary restrictions, frequent special treatments, or a requirement for 
frequent clinical monitoring."

		(5)  "May compromise the health or well-being of other Soldiers (for example, a 
carrier of communicable disease who poses a health threat to others)."

		(6)  "May prejudice the best interests of the U.S. Government if the individual 
were to remain in the military service."

	b. Paragraph 3-25 (Blood and Blood-Forming Tissues) lists causes for referral into 
DES; while Immune Thrombocytopenia is not specifically identified in this or any other 
paragraph in chapter 3, the paragraph names splenectomy as a disqualifying medical 
condition.

5.  AR 635-40 (Disability Evaluation for Retention, Retirement, or Separation), currently 
in effect, prescribes policies and procedures for the Army's implementation of the 
Disability Evaluation System (DES). Federal law defines the DES as a DOD process for 
evaluating the nature and extent of disabilities affecting members of the Armed Forces; 
its objectives are to maintain an effective and fit military force, provide benefits for 
Soldiers whose service was terminated due to a disability incurred in the line of duty, 
and to provide prompt processing of disabled Soldiers while ensuring the Soldiers' rights 
and the interests of both the government and Soldiers are protected.  

	a. PEBs can be either informal or formal. The informal PEB consists of two military 
or civilian members and makes the Soldier's initial fitness determination. In cases where 
the Soldier does not concur with the informal PEB's findings and recommendations, 
he/she can request a formal PEB, during which the Soldier can appear, with counsel, to 
present matters for the PEB's consideration. PEBs determine a Soldier's fitness for 
continued military service by applying the standard of "preponderance of evidence." 

	b. Unless reserved for higher authority, USAPDA approves disability cases for the 
Secretary of the Army and issues the disposition instructions to the Transition Center for 
Soldiers separated or retired for physical disability from an active duty status. 
Separation with disability severance pay applies to Soldiers determined to be physically 
unfit, but who have less than 20 years of service and a combined disability rating of less 
than 30 percent (including a 0 percent rating).

6.  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 is applying to the ABCMR requesting reversal of the United States 
Army Physical Disability Agency’s finding that his immune thrombocytopenia is an 
unfitting medical condition for continued military service.  He states in part: “After 
reviewing the facts and my current physical and mental health, I elected not to undergo 
the splenectomy procedure.  At that point the blood specialist recommended that a P3 
profile be place on my medical record for a Medical Evaluation Board to decide whether 
or not I was going to be retain for duty. Sir, I am disputing the P3 code being place on 
my record because there is no evidence supporting the medical provider and the 
regulation that he is citing.  I am disputing the way that my record was handle by the 
military physician as to jeopardize my military career with not regard to the regulation, 
which in fact and sited in the same regulation, splenectomy is one reason for 
recommendation to a MEB, and using inaccurate restrictions I was made to look like 
less than a Soldier.”

    b.  The Record of Proceedings details the applicant’s service and the circumstances 
of the case.  His DD 214 for the period of Service under consideration shows he entered 
the Regular Army on 26 March 2019 and was honorably discharged with $51,580.80 of 
disability severance pay on 4 July 2022 under provisions provided in paragraph 4-
27c(3) of AR 635-40, Physical Evaluation for Retention, Retirement, or Separation (19 
January 2017).  
    c.  On 30 August 2021, the applicant’s informal PEB found his immune 
thrombocytopenia to be the sole unfitting for continued military service.  

    d.  “Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder 
characterized by abnormally low levels of blood cells called platelets, a situation 
referred to as thrombocytopenia.  Platelets are specialized blood cells that help maintain 
the integrity of the walls of blood vessels and help prevent and stop bleeding by 
accelerating clotting where it is needed.  A normal platelet count ranges from 
approximately 150,000 to 400,000 per microliter (µL) of blood depending on the 
laboratory.  However substantial bleeding does not usually occur until the platelet count 
is less than 50,000 or even 30,000/µl.” (https://rarediseases.org/rare-diseases/immune-
thrombocytopenia/?filter=ovr-ds-resources) 

    e.  First line treatment is corticosteroids.  Second line treatments include several 
biologic medications.  Another second line treatment is splenectomy, usually performed 
laparoscopically:  “The spleen plays a major role in destroying antibody-covered 
platelets and contributes to making antiplatelet antibodies. Splenectomy improves 
platelet counts in approximately 80% of patients initially and can induce a long-term 
remission in 60%. The high long-term success rate must be weighed against the small 
but real increased risk of thrombosis and serious infection, which necessitates 
appropriate vaccinations and urgent evaluation for serious febrile illnesses. Recent 
guidelines recommend deferral of splenectomy for at least a year from diagnosis to 
determine if a patient will go into remission. However, splenectomy remains an option in 
patients who fail other forms of treatment or in resource challenged areas where more 
expensive alternatives which require repeated administration are not available. As 
mentioned, combinations of agents are often used to increase response and lessen 
toxicity.” (https://rarediseases.org/rare-diseases/immune-thrombocytopenia/?filter=ovr-
ds-resources) 

    f.  The PEB found the four remaining medical conditions not unfitting for continued 
service.  They applied the Veterans Benefits Administration (VBA) derived rating of 0% 
and recommended the applicant be separated with disability severance pay.  On 31 
August 2021, after being counseled by his PEB Liaison Officer (PEBLO) on the PEB’s 
findings and recommendations, the applicant non-concurred with the PEB’s findings and 
demanded a formal hearing with the assistance of regularly appointed counsel but did 
not request a VA reconsideration of the ratings (VARR). 

    g.  The applicant was present for and represented by regularly appointed counsel at 
his formal hearing on 16 February 2022.  He contended that because he had had the 
condition for so long it should not be found unfitting.  The formal PEB confirmed the 
informal PEB’s findings:  

		(1)  “The Soldier testified that he was initially made aware of a low platelet count 
in 2009 after receiving a routine blood draw in conjunction with his periodic health 
assessment.  He noted that even though his condition had been monitored, it became 
an issue when he tried to apply for Airborne and Warrant Officer Candidate School.  He 
stated a prior MEB (P3 issued 06DEC2018) previously reviewed this condition which 
resulted in assigning a permanent P2 profile (04FEB2019) for low platelet count. The 
FPEB does not have any visibility of the Soldier's previous records. 

		(2)  The Soldier continued to testify that he is in physically top shape and holds a 
black belt in martial arts (Taekwondo) and reports having no symptoms or bleeding with 
this condition to date.  While the PEB acknowledges that he is a high achieving Soldier 
with 14 years of service, his current platelet count does not meet criteria for continued 
service.  This is due to his increased risk of a fatal injury from bleeding due to a 
decreased platelet count from major trauma that could be sustained with training or 
combat operations.  

		(3)  To remain on active duty, the Soldier has been offered splenectomy as the 
only treatment option; however, he respectfully declined because medical personnel 
were unable to identify any specific pathology with his spleen.  There are no other 
medical options available to remedy this condition. 

		(4)  The Soldier was placed on a P3 profile for this condition on 04MAR2021.  
IAW AR 635-40, this Soldier is unfit because the DA Form 3349, Physical Profile 
Record, Section 4, functional activity limitations associated with this condition make this 
Soldier unable to reasonably perform required duties. 

		(5)  The Soldier's condition prevents him from performing functional activities 
24a, 24b, 24c and 24f which corresponds to being physically and mentally able to carry 
and fire an individual assigned weapon; riding in a military vehicle while wearing usual 
protective gear without worsening the condition; wearing a helmet, body armor, and 
load bearing equipment (LBE) without worsening the condition; and live and function 
without restrictions in any geographic or climactic area without worsening the condition.”

    h.  The applicant appealed these findings to the United States Army Physical 
Disability Agency.  His counsel notes that the recommended splenectomy fails medical 
retention standards, and while true, so did the applicant’s current condition (paragraphs 
3-25i and 3-25 respectively of AR 40-501, Standards of Medical Fitness (27 June 2019).  
Counsel goes on to impugn the Soldier’s treating specialists with: “The fact that military 
providers would suggest this course of action for SSG {Applicant} raises serious doubts 
about their familiarity with regulations applicable to the care of Soldiers.” 

    i.  While health care providers are well aware of the Army regulations, their primary 
mission is to care for the Soldier.  A physician would neither recommend nor provide 
substandard care to satisfy a regulation: When a leg must be amputated for the 
wellbeing of a Soldier, it should be amputated even though this will fail medical retention 
standards.

    j.  The United States Army Physical Disability Agency confirmed the formal PEB’s 
findings in their 5 April 2022 memorandum to Soldier’s counsel:

		(1)  “The Soldier was offered splenectomy, but he declined this procedure. 
Hematology-Oncology notes that the goal of other methods of treatment, primarily high-
dose steroids, is improvement of the platelet count, not normalization.  Further, 
remissions induced by other treatment modalities are typically short-lived, and relapse is 
expected.  Other therapies, including rituximab and growth factor, also were not 
considered to be optimal treatment options in the military setting by Hematology-
Oncology ...  

		(2)  Consequently, the FPEB found the Soldier unfit for continued military service 
due to the increased risk of fatal bleeding from traumatic injury that might result from 
military training or combat operations.  

		(3)  Regarding the issue of splenectomy, this procedure would not automatically 
disqualify the Soldier from continued military service. AR 40-501, paragraph 3-25i, 
would have required assignment of a permanent P-3 profile and subsequent Integrated 
Disability Evaluation System evaluation to determine whether the Soldier is fit for 
continued military service or not, just as occurred without splenectomy.”

    k.  Review of his PEB case file in ePEB along AHLTA records identified no material 
inaccuracies or discrepancies.  

    l.  Given no evidence of error or injustice, it is the opinion of the ARBA Medical 
Advisor that a reversal of the Untied States Army Physical Disability Agency’s finding 
the applicant’s immune thrombocytopenia is an unfitting condition for continued military 
service in not warranted.  


BOARD DISCUSSION:

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.

	a.  The Board noted that on 16 February 2022, a formal PEB in which the applicant 
appeared with counsel, determined the applicant was physically unfit for military service 
(Immune thrombocytopenia, an autoimmune bleeding disorder characterized by 
abnormally low levels of blood cells called platelets, a situation referred to as 
thrombocytopenia) and recommended his separation with severance pay. On 5 April 
2022, the USAPDA approved the formal PEB’s findings and recommendations on 
behalf of the Secretary of the Army.

	b.  The Board reviewed and agreed with the medical reviewer’s finding that the 
applicant was offered splenectomy, to improve platelet count, but he declined this 
procedure. Consequently, the formal PEB found him unfit for continued military service 
due to the increased risk of fatal bleeding. As for the splenectomy, this procedure would 
not automatically disqualify a Soldier from continued military service but would have 
required assignment of a permanent profile and subsequent Integrated Disability 
Evaluation System evaluation to determine whether the Soldier is fit for continued 
military service or not, just as occurred without splenectomy.

	c.  The Board agreed that the applicant’s PEB contains no errors, inaccuracies, or 
discrepancies, and given the absence of evidence of error or injustice, the Board 
determined that a reversal of the USAPDA’s finding the applicant’s immune 
thrombocytopenia as an unfitting condition for continued military service in not 
warranted.  
?
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.  AR 40-501 (Standards of Medical Fitness), currently in effect, prescribes policies and 
procedures for identifying and referring for DES processing those Soldiers who fail the 
medical retention standards; chapter 3 (Medical Fitness Standards for Retention and 
Separation, including Retirement) lists the various disqualifying medical conditions 
and/or physical defects requiring DES referral. 

	a. Paragraph 3-1 (General) states any medical conditions that have met the clinical 
or administrative medical retention decision point (MRDP) and meet the below-listed 
criteria should be referred. (According to AR 40-502 (Medical Readiness), currently in 
effect, a Soldier's MRDP is reached when the medical condition has either stabilized or 
cannot be stabilized in a reasonable period of time for up to twelve months and impacts 
the Soldier's successful performance of duty. Successful performance of duty is defined 
as the ability to perform basic Soldiering skills required by all military personnel and to 
carry MOS specific duties).  

		(1)  "Significantly limit or interfere with the Soldier’s performance of their duties 
(either basic Soldier skills or MOS specific) as substantiated by the Soldier’s 
commander or supervisor."

		(2)  "Require medication for control that requires frequent monitoring by a 
physician due to debilitating or serious side effects, medical care, or hospitalization with 
such frequency as to interfere with the satisfactory performance of duty."

		(3)  "Restrict performance of any of the profile functional activities listed in 
Section 4 of DA Form 3349 (Physical Profile); prevent the performance of all aerobic 
events of the APFT; have met a clinical MRDP; or have been temporarily profiled for 
more than 365 days, meeting the administrative MRDP."

		(4)  "May compromise or aggravate the Soldier’s health or well-being if they were 
to remain in the military service. This may involve dependence on certain medications, 
appliances, severe dietary restrictions, frequent special treatments, or a requirement for 
frequent clinical monitoring."

		(5)  "May compromise the health or well-being of other Soldiers (for example, a 
carrier of communicable disease who poses a health threat to others)."

		(6)  "May prejudice the best interests of the U.S. Government if the individual 
were to remain in the military service."

	b. Paragraph 3-25 (Blood and Blood-Forming Tissues) lists causes for referral into 
DES; Immune Thrombocytopenia is not specifically identified. Subparagraph i shows 
"Splenectomy" as disqualifying.

2.  AR 635-40 (Disability Evaluation for Retention, Retirement, or Separation), currently 
in effect, prescribes policies and procedures for the Army's implementation of the 
Disability Evaluation System (DES). Paragraph 4-1 (Scope of the DES) states Federal 
law defines the DES as a DOD process for evaluating the nature and extent of 
disabilities affecting members of the Armed Forces; its objectives are to maintain an 
effective and fit military force, provide benefits for Soldiers whose service was 
terminated due to a disability incurred in the line of duty, and to provide prompt 
processing of disabled Soldiers while ensuring the Soldiers' rights and the interests of 
both the government and Soldiers are protected.  

	a. Paragraph 4-21 Composition of Informal and Formal PEBs). PEBs are either 
informal or formal. 

	b. Paragraph 4-22 (The Informal PEB Process). The informal PEB consists of two 
military or civilian members and makes the Soldier's initial fitness determination. In 
cases where the Soldier does not concur with the informal PEB's findings and 
recommendations, he/she can request a formal PEB, during which the Soldier and 
appear, with counsel, to present matters for the PEB's consideration.

	c. Paragraph 4-27 states, unless reserved for higher authority, USAPDA approves 
disability cases for the Secretary of the Army and issues the disposition instructions to 
the Transition Center for Soldiers separated or retired for physical disability from an 
active duty status. Separation with disability severance pay applies to Soldiers 
determined to be physically unfit, but who have less than 20 years of service and a 
combined disability rating of less than 30 percent (including a 0 percent rating).

	d. Paragraph 5-7 (Standards for Determining Permanence and Stability for 
Permanent or Temporary Retirement). PEBs determine a Soldier's fitness for continued 
military service by applying the standard of "preponderance of evidence."

//NOTHING FOLLOWS//
ABCMR Record of Proceedings (cont)	AR20220005146


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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

RECORD OF PROCEEDINGS


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