IN THE CASE OF: BOARD DATE: 19 September 2023 DOCKET NUMBER: AR20230001716 APPLICANT REQUESTS: in effect, correction of his records to show he was separated due to a medical disability vice being discharged from the Army National Guard at the end of his service obligation APPLICANT'S SUPPORTING DOCUMENT(S) CONSIDERED BY THE BOARD: • DD Form 149 (Application for Correction of Military Record) (2 applications) • DD Form 214 (Certificate of Release or Discharge from Active Duty) for the period 5 August 2015 to 22 March 2016 • DA Form 7652 (Disability Evaluation System (DES) Commander's Performance and Functional Statement), 8 October 2019 • DA Form 2823 (Sworn Statement), 30 October 2019 • Standard Form 600 (Chronological Record of Medical Care) • DA Form 2173 (Statement of Medical Examination and Duty Status) (incomplete- unsigned) and allied documents • Army National Guard (ARNG) discharge orders • Department of Veterans Affairs (VA) Form 21-4138 (Statement in Support of Claim), dated 7 December 2022 • U.S. Army Reserve (USAR) discharge orders • Honorable Discharge Certificate • letter from the VA Medical Center (VAMC), Decatur, GA, date 1 May 2023 • thrombocytopenia information paper FACTS: 1. The applicant states his National Guard Bureau (NGB) Form 22 (Report of Separation and Record of Service) does not show he was separated for medical reasons. His line of duty packet and also "eCase" notes show that the error was created by non-compliance by his cancer physicians. 2. The applicant enlisted in the ARNG on 23 January 2015 for a period of six years. His DD Form 214 shows he attended initial active duty for training from 5 August 2015 to 22 March 2016. 3. On 8 October 2019, the applicant's commander provided a DA Form 7652 and stated the following: a. The applicant was not able to attend drill for up to a year. He came to drill on 5 October 2019 to meet with 171 medical staff and was cleared by Major (MAJ) K to resume normal duties based on his assessment of the Soldier, the doctor's notes, and the Soldiers apparent willingness and desire to resume duties. The Soldier stated several times to him, Staff Sergeant C, and MAJ K that he wanted to come back to the formation and drills. Once he was given a go by medical, he was reassigned to a squad and issued a new set of "OCP's", boots, and any other equipment supply had received for him during his absence since he had no serviceable uniforms and was in civilian attire. b. The applicant was at the final formation and told when first formation was the next morning. On the morning of 6 October 2019, he was not at first formation. After several phone calls, they were able to finally get in contact with him. He stated he had changed his mind and felt it was best for him to pursue a medical discharge course of action in order to get better. He was instructed to return within the next 3 days to report directly to the medical team to begin the paperwork and finalize the process of getting him out. 4. The commander also stated the applicant was unable to drill because he is a high risk for contagious disease and/or sickness due to a compromised immune system. The applicant was excused from duties during times of sickness such as the flu season or when sicknesses were spreading through the formation. 5. The applicant provided a sworn statement, dated 30 October 2019, and stated the following: While on duty, I began to experience several symptoms that have been defined by all of the physicians of my care to be grave and life threatening. I notified my chain of command of the symptoms that I was experiencing, and was immediately administered laboratory analysis on base. After completion of the lab analysis ordered by [First Sergeant A] and [Captain B] at the moment, I was admitted to emergency hospital care following the severe findings of my screening. All laboratory tests and analysis administered by my fellow comrades and also civilian hospital care have all displayed life threatening severities due to my prognosis. 6. Orders issued on 21 January 2021 directed the applicant's separation from the ARNG and his transfer to the USAR Control Group (Individual Ready Reserve), effective 22 January 2021, by reason of completion of 6-year Ready Reserve obligation. 7. The applicant's NGB Form 22 shows he was discharge from the ARNG and transferred to the USAR Control Group (Reinforcement) on 23 January 2021 by reason of expiration of active status commitment in the Selected Reserve. The NGB Form 22 also shows he was assigned a reenlistment eligibility (RE) code of 1 (eligible for reenlistment). The form further shows his transfer to the USAR was for the purpose of completion of 2 years of statutory service obligation. 8. On 12 July 2022, the applicant's former commander provided a VA Form 21-4138 and stated the following: [The applicant] was a Soldier under my leadership from April 2019 to May 2020 while I was the Officer in Charge of the Rear Detachment of the unit while they were deployed to Kosovo. [The applicant] had been diagnosed with a type of blood cancer, Aplastic Anemia, prior to my arrival at the unit. His condition prevented him from attending drill periods due to his compromised immune system and risk of sickness. Once the unit deployed, his case came into my care to initiate a Fit For Duty (FFD) determination. I completed a Commander's Performance and Functional Statement and determined that [the applicant] was unable to perform his duties because of his condition. The Fit For Duty was initiated on 8 October 2019 and I have attached the DA Form 7652 and request for FFD fully detailing my assessment of [the applicant's] condition and its effect on his ability to perform. After I submitted this FFD packet, I was re-assigned to another unit and duty and the results of [the applicant's] case were outside of my need-to-know. 9. Orders issued by the U.S. Army Human Resources Command on 6 June 2023 directed the applicant's discharge from the USAR effective 6 June 2023. His Honorable Discharge Certificate shows he was discharged from the Army on 24 January 2023. 10. The applicant provided a DA Form 2173 and allied documents, however, the DA Form 2173 only shows his social security number and rank. 11. The applicant also provided a letter from the VAMC, Decatur, GA, date 1 May 2023, addressed to the VA Benefits Office and written by the Chief of Medical Oncology/Director of Research, stating, in part, the applicant's medical records indicate he was diagnosed with aplastic anemia soon after deployment to the Persian Gulf and there is no evidence any pre-existing condition. It is the physicians professional opinion that the applicant's aplastic anemia is directly related to their exposure to various environmental toxins during deployment to the Persian Gulf War. The complete VAMC letter was provided to the Board for their review and consideration. 12. 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, her previous ABCMR denial (AR20160018395, 17 May 2019), 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 the Interactive Personnel Electronic Records Management System (iPERMS). The ARBA Medical Advisor made the following findings and recommendations: b. The applicant is applying to the ABCMR in essence requesting a referral to the Disability Evaluation System (DES). He states: “Current NG 22 [National Guard Report of Separation and Record of Service (NGB Form 22)] does not annotate the characterization of my medical separation provided by Major K.” c. The Record of Proceedings outlines the applicant’s military service and the circumstances of the case. His National Guard Report of Separation and Record of Service (NGB Form 22) shows he entered the Army National Guard on 23 January 2015 and was honorably discharged from the Georgia Army National Guard (GAARNG) on 23 January 2021 under provisions in paragraph 6-36n of NGR 600-200, Enlisted Personnel Management (25 March 2021): Expiration of active status commitment in the Selected Reserve. d. The former drilling Army National Guard Soldier was placed on a total duty limiting temporary profile for “profound low WBC (white blood cell) and platelet count” on 12 October 2018. Further evaluation showed the applicant had aplastic anemia. From the National Heart, Lung, and Blood Institute’s website: “Despite its name, aplastic anemia, or bone marrow failure, is more than anemia. Aplastic anemia is a rare but serious blood condition that occurs when your bone marrow cannot make enough new blood cells for your body to work normally. It can develop quickly or slowly, and it can be mild or serious. At this time, there is no way to prevent aplastic anemia. Aplastic anemia is caused by damage to stem cells inside your bone marrow, which is the sponge-like tissue within your bones. Many diseases and conditions can damage the stem cells in bone marrow. As a result, the bone marrow makes fewer red blood cells, white blood cells, and platelets. The most common cause of bone marrow damage is from your immune system attacking and destroying the stem cells in your bone marrow. This is a type of autoimmune illness, a disease that makes your body attack itself. Other causes of aplastic anemia include some medicines, such as those used in chemotherapy, and exposure to toxins or chemicals in the environment. Treatments for aplastic anemia may include the following: • Blood and bone marrow transplants, which may cure aplastic anemia in some people • Blood transfusions • Medicines to stop your immune system from destroying the stem cells in your bone marrow • Medicines to help your body make new blood cells • Removing or staying away from toxins in your environment Aplastic anemia can raise the risk of complications such as bleeding, leukemia, or other serious blood conditions. Without treatment, aplastic anemia can lead to serious medical conditions such as an irregular heartbeat and heart failure. e. A 2019 Disability Evaluation System (DES) Commander’s Performance and Functional Statement (DA form 7652) shows the applicant desired to remain in the ARNG. His case was reviewed by GAARNG medical providers and he was authorized to remain in the ARNG. However, on the morning of 6 October 2019: “He stated he had changed his mind and felt it was best for him to pursue a medical discharge course of action in order to get better. He was instructed to return within the next 3 days to report directly to the medical team to begin the paperwork and finalized the process of him getting out.” f. Case management notes show the battalion medical readiness NCO (MRNCO) and his case social worker worked on a “FFD [fit for duty] packet from November 2019 thru 21 October 2021 at which time the social worker wrote: “SM [Service Member] is AWOL [absent without leave] and medically noncompliant, unit has not provided FFD packet after several requests, case will be closed.” g. The applicant was honorably discharged from the GAARNG two months later at the completion of his six-year obligation (23 January 2021). h. No medical documentation was submitted with this application. i. The circumstances of his case make him ineligible for referral to the DES. In addition to the applicant’s being discharged at the end of his service obligation and not for a disqualifying medical condition, there is no probative evidence this condition was incurred during or permanently aggravated by his military service, i.e., in the line of duty. j. Review of his records in JLV shows he has been awarded several 10% VA service-connected disability ratings, none of which is related to his hematologic condition. k. 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 a referral of his case to the DES 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. The evidence of record shows the applicant served in the ARNG for 6 years from 23 January 2015 to 22 January 2021. He was separated by reason of completion of his 6-year obligation. The Board reviewed and concurred with the medical reviewer’s dining the circumstances of his case make him ineligible for referral to the Disability Evaluation System (DES). In addition to the applicant’s being discharged at the end of his service obligation and not for a disqualifying medical condition, there is no probative evidence this condition was incurred during or permanently aggravated by his military service, i.e., in the line of duty. Based on the preponderance of the evidence, the Board determined a referral of his case to the DES in not warranted. BOARD VOTE: Mbr 1 Mbr 2 Mbr 3 : : : GRANT FULL RELIEF : : : GRANT PARTIAL RELIEF : : : GRANT FORMAL HEARING :XX :XX :XX 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. 9/19/2023 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 40-501 (Standards of Medical Fitness) provides that for an individual to be found unfit by reason of physical disability, he or she must be unable to perform the duties of his or her office, grade, rank or rating. Performance of duty despite impairment would be considered presumptive evidence of physical fitness. 2. Army Regulation 635-40 (Disability Evaluation for Retention, Retirement, or Separation), dated 19 January 2017, prescribes the Army DES and sets forth policies, responsibilities, and procedures that apply in determining whether a Soldier is unfit because of physical disability to reasonably perform the duties of his office, grade, rank, or rating. It implements the requirements of Title 10, U.S. Code, chapter 61; Department of Defense Instructions (DoDI) 1332.18 (Disability Evaluation System); DoD Manual 1332.18 (DES Volumes 1 through 3) and Army Directive 2012-22 (Changes to Integrated Disability Evaluation System Procedures) as modified by DoDI 1332.18. a. The objectives are to maintain an effective and fit military organization with maximum use of available manpower; provide benefits to eligible Soldiers whose military service is terminated because of a service-connected disability; provide prompt disability evaluation processing ensuring the rights and interests of the Government and Soldier are protected; and, establish the Military Occupational Specialty Administrative Retention Review (MAR2) as an Army pre-DES evaluation process for Soldiers who require a P3 or P4 (permanent profile) for a medical condition. b. Public Law 110-181 defines the term, physical DES, as a system or process of the DoD for evaluating the nature and extent of disabilities affecting members of the Armed Forces that is operated by the Secretaries of the military departments and is composed of medical evaluation boards (MEB), physical evaluation boards (PEB), counseling of Soldiers, and mechanisms for the final disposition of disability evaluations by appropriate personnel. c. The DES begins for a Soldier when either of the events below occurs: (1) The Soldier is issued a permanent profile approved in accordance with the provisions of Army Regulation 40–501 and the profile contains a numerical designator of P3/P4 in any of the serial profile factors for a condition that appears not to meet medical retention standards in accordance with AR 40–501. Within (but not later than) 1 year of diagnosis, the Soldier must be assigned a P3/P4 profile to refer the Soldier to the DES. (2) The Soldier is referred to the DES as the outcome of MAR2 evaluation. d. An MEB is convened to determine whether a Soldier’s medical condition(s) meets medical retention standards per Army Regulation 40-501. This board may determine a Soldier’s condition(s) meet medical retention standards and recommend the Soldier be returned to duty. This board must not provide conclusions or recommendations regarding fitness determinations. e. The PEB determines fitness for purposes of Soldiers’ retention, separation or retirement for disability under Title 10, U.S. Code, chapter 61, or separation for disability without entitlement to disability benefits under other than Title 10, U.S. Code, chapter 61. The PEB also makes certain administrative determinations that may benefit implications under other provisions of law. f. Unless reserved for higher authority, the U.S. Army Physical Disability Agency approves disability cases for the Secretary of the Army and issues disposition instructions for Soldiers separated or retired for physical disability. g. Unit commanders will ensure medical profiles containing a P3/P4 or temporary (T) 3/T4 in one of the serial profile factors are reviewed according to the standards of Army Regulation 40-501. Among the duties required, a unit commander will provide a non-medical assessment by completing DA Form 7652 (DES Commander’s Performance and Functional Statement). 3. Section 1556 of Title 10, U.S. Code, requires the Secretary of the Army to ensure that an applicant seeking corrective action by 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//