IN THE CASE OF: 

		BOARD DATE: 19 October 2023

		DOCKET NUMBER: AR20230003773


APPLICANT REQUESTS:  the narrative reason for separation to reflect “disability.”

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)
*	Memorandum For Record (MFR), Subject Medical Disqualification (MOD 13)
*	Memorandum, Subject: Individual Early Redeployment (IER)
*	DA Form 2173 (Statement of Medical Examination and Duty Status)
*	NGB Form 22 (National Guard Report of Separation and Record of Service)
*	Veterans Affairs (VA) Summary of Benefits


FACTS:

1.  The applicant did not file within the 3-year time frame provided in Title 10, U.S. 
Code, section 1552(b); however, the Army Board for Correction of Military Records 
(ABCMR) conducted a substantive review of this case and determined it is in the 
interest of justice to excuse the applicant's failure to timely file.

2.  The applicant states, in effect:

   a.	Narrative reason should reflect discharge due to disability. The orders separating 
him from active duty, while deployed, as a result of a condition that he was suffering 
from. The condition required medical treatment only accessible stateside. As a result, 
he was discharged prior to his unit's required active service.
   
   b.	As it stands, early separation after nine months does not allow him to qualify for 
full education benefits under chapter 33. This correction would allow him to qualify for 
the full education benefits he is entitled to as a result of early discharge due to a service 
connected condition.

3.  The applicant provides:

   a.	DD Form 214 reflects he was honorably released from active duty and released 
back to his command in Gastonia, NC on 14 July 2018, under the provisions of Army 
Regulation (AR) 635-200 (Active Duty Enlisted Administrative Separation), chapter 4, 
completion of required active service. He served 9 months and 6 days of net active 
service this period. Item 18 (Remarks) shows he had service in the following areas:

*	Kuwait, 29 November 2017 – 13 March 2018
*	Jordan, 13 March 2018 – 1 June 2018 
*	Kuwait, 1 June 2018 - 9 June 2018

   b.	MFR, dated 2 June 2018, Subject Medical Disqualification (MOD 13), authored 
by the battalion physician assistant, which states the following:

      1)	[The applicant] has been determined to have New Onset Diabetes Mellitus 
Type I (E10.9), Long Term Insulin Use (Z79.4), and Abnormal Weight Loss (R63.4). He 
was first seen 26 May 2018 with evidence of glucose levels greater than 1000mg/dl, 
large amounts of ketones in urine, and evidence of diabetic ketoacidosis. He was 
started on short acting insulin. Since that time his glucose level has improved but not 
considered at goal and continues to fluctuate. [The applicant] needs to be transferred to 
CONUS for further treatment and management. The above statements are my expert 
medical opinion within a reasonable degree of medical certainty.
      
      2)	The aforementioned condition cannot be fully treated in theater and is 
considered a MOD13 disqualifying condition under the USCENTCOM Modification 
Thirteen Individual Protection and Individual-Unit Deployment Policy, PPG- Tab A, 
Section 7.A. The command team has been notified and is in agreement with this 
treatment plan.
      
      3)	The patient can depart theater via routine flight coordinated through the unit 
and Gateway. Please work within the Standard Operating Procedures (SOP) of 
ARCENT to transfer the service member to CONUS status.

   c.	Memorandum, dated 4 June 2018, Subject: Individual Early Redeployment (IER), 
authored by the company commander, states:

      1)	It is recommended that [the applicant] be authorized released from theater 
due to a MOD 13 disqualifying condition.
      
      2)	It is requested that [the applicant] depart theater before his date eligible for 
return from overseas in order to treat a medical condition that is not treatable here at 
Camp Arifjan. According to CPT 's (battalion physician assistant) review of his medical 
records, as well as multiple interviews and examinations of [the applicant], it has been 
determined he has newly onset Diabetes Mellitus (Type 1), long term insulin use, and 
abnormal weight loss. His condition cannot fully be evaluated or treated within theater 
and it is considered a MOD 13 disqualifying condition. It is requested he be transferred 
stateside for further evaluation and treatment as needed.

      3)	[The applicant] began Title X orders on 12 October 2017 and deployed to 
Camp Arifjan on 29 November 2017. [The applicant] has accrued 20 days of leave and 
has not taken any during this mobilization. No replacement will be requested.

      4)	[The applicant] served in Jordan for 77 days while on Title X orders.

      5)	[The applicant] is expected to leave on or about 16 June 2018 and return to 
Fort Bliss, TX for demobilization and be mission complete.

      6)	An evaluation for [the applicant] is currently being processed through his 
rating chain. An end of tour award is being processed through the chain of command 
and will be mailed to his home of record as soon as complete.

   d.	DA Form 2173, dated 4 June 2018, reflects the applicant was examined on  
2 June 2018. Item 30 (Details of accident - Remarks) states, “Symptoms began May 
9,2018 while OCONUS in Jordan. Glucose was over 1000 on initial visit with JTC BAS. 
Currently the BGL stays on average 200s. SM has excessive thirst and urination 
w/blurred vision, exhaustion, and dehydration. [The applicant] has been diagnosed with 
Type I Diabetes Mellitus, long term insulin use, and abnormal weight loss. It has been 
determined that he will need to be transferred CONUS for further treatment and 
management.”

   e.	NGB Form 22 reflects the applicant was honorably discharged on 10 May 2019, 
under the provisions of NGR 600-200, paragraph 6-35L(8), medical, physical or mental 
condition retention (MG). He served 2 years, 11 months, and 18 days of net service this 
period.

   f.	VA Summary of Benefits, dated 10 November 2022, reflects the applicant has 
one or more service-connected disabilities and was awarded a combined service-
connected evaluation of 60 percent.

4.  A review of the applicant’s service record shows:

   a.	He enlisted in the Army National Guard on 23 May 2016.
   
   b.	As previously stated in paragraph 3e, the applicant was honorably discharged on 
10 May 2019, under the provisions of NGR 600-200, paragraph 6-35L(8), medical, 
physical or mental condition retention (MG).  

5.  Army Regulation (AR) 635-5 (Personnel Separations - Separation Documents), 
prescribes the separation documents prepared for Soldiers upon retirement, discharge, 
or release from active military service or control of the Army. It established standardized 
policy for preparation of the DD Form 214. The DD Form 214 is a synopsis of the 
Soldier's most recent period of continuous active duty. It provides a brief, clear-cut 
record of active Army service at the time of release from active duty, retirement, or 
discharge. 

6.  NGR 600-200 (Enlisted Personnel Management) prescribes the criteria, policies, 
processes, procedures and responsibilities to classify; assign; utilize; transfer within and 
between states; provides Special Duty Assignment Pay; separate, and appoint to and 
from Command Sergeant Major, Army National Guard (ARNG) and Army National 
Guard of the United States (ARNGUS) enlisted Soldiers.

7.  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, his previous ABCMR denial, 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) for his new-onset insulin dependent diabetes 
incurred while he was in theater.  He states:
“Narrative reason should reflect discharge due to disability . Please see the 
attached orders separating me from active duty while deployed as a result of a 
condition that I was actively suffering from that required medical treatment only 
accessible stateside.  As a result, I was discharged prior to my unit's required 
active service. 
As it stands, early separation after nine months does not allow me to qualify for 
full education benefits under Ch. 33.  This correction would allow me to qualify for 
the full education benefits I am entitled to as a result of early discharge due to a 
service-connected condition as the evidence reflects.”
    c.  The Record of Proceedings outlines the circumstances of the case.  His DD 214 
for the period of Service under consideration shows he entered active duty for 9 
October 2017 and was honorably discharged on 14 July 2018 under provisions provided 
in chapter 4 of AR 635-200 (19 December 2016) after having completed his required 
active service.  It shows he was deployed in Southwest Asia (Kuwait and Jordan) from 
29 November 2017 thru 1 June 2018.
    d.  On 30 May 2018, the applicant was evaluated in a theater clinic for a three-week 
history of blurry vision, exhaustion, excessive thirst, nausea, and dehydration.  His 
blood glucose was 1,000 (normal is 70 – 100).  He was diagnosed with and started on 
treatment for Type 1 insulin dependent diabetes mellitus.
    e.  This condition failed to meet the medical retention standard in paragraph 3-11d of 
AR 40-501, Standards of Medical Fitness (14 June 2017).  This paragraph states 
diabetes does not fail retention standards only when “hemoglobin A1c can be 
maintained at <(less than) 7% using only lifestyle modifications (diet, exercise).”
    f.  The applicant was placed on a permanent duty limiting physical profile for diabetes 
on 2 June 2018.  At this point, the Soldier was de facto referred to the IDES for this 
illness which had been incurred in the line of duty to his country: The issuance a 
permanent duty limiting physical profile is the first step in the Army’s DES process, and 
the date of approval on the profile is also the date of referral into the DES.
    g.  Paragraphs 7b1 and 7b2 of appendix 3 to enclosure 3 of Department of Defense 
Instruction 1332.18, SUBJECT: Disability Evaluation System (DES) (5 August 2014) 
show his condition was incurred in the line of duty:

7b.  Presumption of Sound Condition for Members on Continuous Orders to 
Active Duty Specifying a Period of More Than 30 Days 

(1) The Secretaries of the Military Departments will presume Service 
members, including RC members and recalled retirees, on continuous orders 
to active duty specifying a period of more than 30 days entered their current 
period of military service in sound condition when the disability was not noted 
at the time of the Service member’s entrance to the current period of active 
duty.

(2) The Secretaries of the Military Departments may overcome this 
presumption if clear and unmistakable evidence demonstrates that the 
disability existed before the Service member’s entrance on their current 
period of active duty and was not aggravated by their current period of military 
service. Absent such clear and unmistakable evidence, the Secretary of the 
Military Department concerned will conclude that the disability was incurred or 
aggravated during their current period of military service.” 

    h.  It is clear the presumption of incurred during service is not overcome by evidence:  
There is no medical evidence the applicant’s diabetes existed prior to his entrance onto 
active duty.  Paragraph 5-11a and 5-11b of AR 635-40, Physical Evaluation for 
Retention, Retirement, or Separation (19 January 2017) incorporates the DoDI 1332.18 
standard:  
5–11. Presumption of sound condition for Soldiers on orders to active duty 
specifying a period of more than 30 days
The PEB will presume Soldiers, including RC Soldiers and recalled retirees 
on continuous orders to active duty specifying a period of more than 30 days, 
entered their current period of military Service in sound condition when the 
disability was not noted at the time of the Soldier’s entrance to the current 
period of active duty.
The PEB may overcome this presumption if clear and unmistakable evidence 
demonstrates that the disability existed before the Soldier’s entrance on their 
current period of active duty and was not aggravated by their current period of 
military Service. Absent such clear and unmistakable evidence, the PEB will 
conclude that the disability was incurred or aggravated during their current 
period of military Service.
    i.  The cause(s) of type I diabetes remains unknown.  From the Mayo Clinic’s website:
Different factors, including genetics and some viruses, may contribute to type 1 
diabetes. Although type 1 diabetes usually appears during childhood or 
adolescence, it can develop in adults.   The exact cause of type 1 diabetes is 
unknown.  Usually, the body's own immune system — which normally fights 
harmful bacteria and viruses — mistakenly destroys the insulin-producing (islet, 
or islets of Langerhans) cells in the pancreas. Other possible causes include 
genetics and exposure to viruses and other environmental factors
(https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-
causes/syc-20353011) 
    j.  An autoimmune response against the insulin producing beta cells in the 
pancreases due viral infection is thought to be the most likely cause of type 1 diabetes, 
and the signs and symptoms often appear relatively suddenly as they did in this case.
Finally, paragraph 2-3a(1) of AR 600-8-4, Line of Duty Policy, Procedures, and 
Investigations (15 April 2004) states that the applicant’s diabetes was incurred in the 
line of duty and the disease does NOT require any line of duty determination:
“a. The LD determination is presumed to be "LD YES" without an investigation
(1) In the case of disease, except as described in paragraphs c (1) and (8) 
below.
    k.  Paragraph c(1) is for diseases under strange or doubtful circumstances or 
apparently due to misconduct or willful negligence, and c(8) is for Reserve Component 
Soldiers on orders of 30 days or less.  Neither of these criterions were applicable in this 
case.
    l.  Upon his return to the States, the applicant should have been entered into the 
Integrated Disability Evaluation System.  Paragraph 7-1 of AR 40-400, Patient 
Administration (8 July 2014), states in part: “If the Soldier does not meet retention 
standards, an MEB is mandatory and will be initiated by the physical evaluation board 
liaison officer (PEBLO).”  Note there is no mention of component or duty status.  
    m.  Paragraph 5-17b or AR 635-200, Active Duty Enlisted Administrative Separations 
(19 December 2016) illuminates the error made by his chain of command:
“When a commander determines that a Soldier has a physical or mental 
condition that potentially interferes with assignment to or performance of duty, 
the commander will refer the Soldier for a medical examination and/or mental 
status evaluation in accordance with AR 40–501.”
    n.  Instead of taking the correct action, his command inappropriately released him 
from active duty.   The North Carlina Army National Guard then made the same mistake 
and discharged their Soldier with a service incurred disability on 10 May 2019.
    o.  The applicant developed a career ending disability during his military service in a 
combat theater and then was inappropriately discharged without benefits by the Regular 
Army and the Army National Guard.  
   p.  Paragraph 5-5 of AR 635-40:

“The DES compensates disabilities when they cause or contribute to career 
termination.”

    q.  It is the strong opinion of the ARBA Medical Advisor the applicant should be 
referred to the Disability Evaluation System for his service incurred career ending 
medical condition.   


BOARD DISCUSSION:

1.  The Board carefully considered the applicant's request, supporting documents, 
evidence in the records, a medical review, and published Department of Defense 
guidance for liberal consideration of requests for changes to discharges.

2. The Board concurred with the conclusion of the ARBA Medical Advisor that the 
applicant incurred a condition found to be in the line of duty that required referral to the 
Disability Evaluation System.  The Board determined the applicant should now be 
afforded processing through the Disability Evaluation System to determine if he should 
have been retired or discharged with severance pay due to disability.


BOARD VOTE:

Mbr 1	Mbr 2	Mbr 3

:	:	:	GRANT FULL RELIEF

:X	:X	:X	GRANT PARTIAL RELIEF

:	:	:	GRANT FORMAL HEARING

:	:	:	DENY APPLICATION


?
BOARD DETERMINATION/RECOMMENDATION:

1.  The Board determined the evidence presented is sufficient to warrant a 
recommendation for partial relief.  As a result, the Board recommends that all 
Department of the Army records of the individual concerned be corrected by referring 
his records to the Office of The Surgeon General for processing through the Disability 
Evaluation System.  

     a.  The individual concerned will be afforded due process through the Disability 
Evaluation System for consideration of any diagnoses identified as having not met 
retention standards prior to his discharge. 

     b.  In the event that a formal Physical Evaluation Board (PEB) becomes necessary, 
the individual concerned will be issued invitational travel orders to prepare for and 
participate in consideration of his case by a formal PEB.  All required reviews and 
approvals will be made subsequent to completion of the formal PEB.  

     c.  Should a determination be made that the applicant should be retired or 
discharged for disability, these proceedings serve as the authority to issue him the 
appropriate separation retroactive to his original separation date, with entitlement to all 
back pay and allowances and/or retired pay, less any entitlements already received. 

2.  The Board further determined the evidence presented is insufficient to warrant a 
portion of the requested relief.  As a result, the Board recommends denial of so much of 
the application that pertains to any relief without benefit of the review described above.

	 
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, United States Code, section 1552(b), provides that applications for 
correction of military records must be filed within 3 years after discovery of the alleged 
error or injustice.  This provision of law also allows the ABCMR to excuse an applicant's 
failure to timely file within the 3-year statute of limitations if the Army Board for 
Correction of Military Records (ABCMR) determines it would be in the interest of justice 
to do so.

2.  AR 635-5 provides, the DD Form 214 is a summary of a Soldier’s most recent period 
of continuous active duty. It provides a brief, clear-cut record of active duty service at 
the time of release from active duty, retirement, or discharge. 

   a.	Paragraph 2-1a(2), Reserve component (RC) Soldiers completing 90 days or 
more of continuous active duty for training (ADT), Full-Time National Guard Duty 
(FTNGD), active duty for special work (ADSW), temporary tours of active duty (TTAD), 
or Active Guard Reserve (AGR) service.  
   
   b.	Paragraph 2-1a (4), ARNGUS and USAR Soldiers mobilized under sections 
12301(a), 12302, or 12304, title 10, U.S. Code and ARNG Soldiers called into Federal 
service under chapter 15, or section 12406, title 10, U.S. Code, regardless of length of 
mobilization, when transitioned from active duty. A Soldier who reports to a mobilization 
station and is found unqualified for active duty will be excluded from this provision. He 
or she will only receive a DD Form 220 (Active Duty Report).

3.  NGR 600-200 (Enlisted Personnel Management) prescribes the criteria, policies, 
processes, procedures and responsibilities to classify; assign; utilize; transfer within and 
between states; provides Special Duty Assignment Pay; separate, and appoint to and 
from Command Sergeant Major, Army National Guard (ARNG) and Army National 
Guard of the United States (ARNGUS) enlisted Soldiers.

//NOTHING FOLLOWS//
ABCMR Record of Proceedings (cont)	AR20230003773


1
ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

RECORD OF PROCEEDINGS


1