ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS THE CASE OF: BOARD DATE: 25 October 2021 DOCKET NUMBER: AR20200008110 APPLICANT REQUESTS: in effect, * entry into the disability evaluation system * findings by the physical evaluation board showing she met the criteria for a permanent disability retirement (a combined disabling rating of greater than 30 percent) on or about 30 June 2014 * correction to Orders 176-1037 dated 25 June 2014 issued by the Office of the Adjutant General of the State of to show she transferred to the permanent disability retired list * correction to her National Guard Bureau (NGB) Form 22 (National Guard Report of Separation and Record of Service) for the period ending 30 June 2014 to show permanent medical retirement instead of retirement for maximum years of service * retired pay and associated benefits effective 30 June 2014 APPLICANT'S SUPPORTING DOCUMENTS CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record) * DA Form 2697 (Report of Medical Assessment) dated 5 September 2011 * DD Form 214 (Certificate of Release or Discharge from Active Duty) for the period ending 6 October 2011 * DA Forms 2173 (Statement of Medical Examination and Duty Status) dated 26 May 2011, 27 January 2012, 3 May 2012 * DA Forms 3349 (Physical Profile) temporary dated 30 January 2013, 29 May 2013, 14 November 2013, 19 December 2013, 24 April 2014, 11 May 2014, 23 May 2014, and 28 June 2014, 17 September 2014 for Hearing * DA Forms 2823 (Sworn Statement) by Applicant dated 12 January 2012, 10 January 2013 * Applicant's employer's letter undated * multiple friends' statements dated 13 January 2013, 10 April 2013 * Department of Veterans Affairs Compensation and Pension Initial Evaluation for Post-traumatic stress disorder (PTSD) dated 21 May 2013 * Applicant letter to ARNG Troop Commander dated 19 June 2013 * * Department of Veterans Affairs (VA) letter dated 21 June 2013 * ARNG Email Responses 3 July 2013 * ARNG Letter to Applicant dated 6 September 2013 concerning Inspector General assistance * VA Rating Decisions dated 26 December 2013, 18 July 2014. 3 November 2017 * DA Form 3349 - Permanent Profile 29 April 2014 * ARNG Orders 176-1037 dated 25 June 2014 * Memorandum by Secretary of Defense (SECDEF) dated 3 September 2014 subject: Supplemental Guidance to Board for Correction of Military (BCMRs)/Naval Records (BCNRs) Considering Discharge Upgrade Requests by Veterans Claiming PTSD (known as the Hagel Memorandum) * William B. Cowles v. Secretary of the Army dated 30 September 2014 (25 pages) * Memorandum by Principal Deputy Under SECDEF, dated 24 February 2016, subject: Consideration of Discharge Upgrade Requests Pursuant to Supplemental Guidance to Military BCMRs/BNCRs by Veterans Claiming PTSD or Traumatic Brain Injury (TBI) * Memorandum by Under SECDEF for Personnel and Readiness, dated 25 August 2017, subject: Clarifying Guidance to BCMRs/BNCRs Considering Requests by Veterans for Modification of the Discharge Due to Mental Health Conditions, Sexual Assault, or Sexual Harassment (known as the Kurta Memorandum) * Memorandum by Under Secretary of Defense (SECDEF), dated 25 July 2018, subject: Guidance to Military Discharge Review Boards (DRBs) and BCMRs/BCNRs Regarding Equity, Injustice, or Clemency Determinations * two applicant's son's statements dated 3 May 2013 and 1 April 2020 * Social Security Administration letter to Applicant 22 February 2020 * Applicant's letter to Board dated 10 April 2020 (16 pages) * two applicant's spouse's statements dated 30 April 2014 and 14 April 2020 * VA Benefits Letter dated 6 March 2020 * Diagnostic and Statistical Manual of Mental Disorders (DSM) Fifth Edition excepts for PTSD and TBI * Service treatment records * Civilian medical treatment records * VA medical treatment records * FACTS: 1. The applicant did not file within the 3-year time frame provided in Title 10, United States 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. Within her application to the Board she states, in effect, the Army National Guard (ARNG) leadership neglected or failed to follow applicable Army regulations by not allowing her to process through the disability evaluation system (DES). Her chain of command blatantly disregarded her mental health conditions which include diagnoses of PTSD, TBI and other neurocognitive disorders. Based on her erroneous honorable retirement for maximum years of service on her mandatory removal date of 30 June 2014, she was denied entitlements due her had she been properly processed for a medical separation/retirement. 3. In the applicant's letter to the Board dated 10 April 2020 she states, in effect, she was erroneously diagnosed with an adjustment disorder on 7 July 2014 (by medical doctors/providers at a military hospital in). Their diagnosis of adjustment disorder deprived her of military disability retired pay and other tangible and intangible benefits that can accrue to individuals whom the military recognizes as being separated by a disability incurred because of service. Prior to the 7 July 2014 diagnosis of adjustment disorder by military medical providers, the VA diagnosed her with PTSD and TBI from her service in Iraq with a combined disabling rating of 70 percent. In 2019, she started receiving her military retired pay (early age drop from 60 years old) and she also qualified for and receives Concurrent Retirement Disability Pay (CRDP). (By law, she receives her military retired pay and her VA monetary benefits.) In effect, had she been processed through the DES in 2014 and found unfit with a rating of 30 percent or higher, she would have been medically retired and immediately eligible for retired pay. As her State leadership failed to process her through the DES, she lost approximately 5 years of retired pay and benefits. In April 2020, her VA combined disabling rating was 90 percent with a valuation of 100 percent because she is totally and permanently unemployable. a. She provides a timeline of events from her deployment, her demobilization, her military service post deployment, and her efforts to obtain line of duty determinations for her wrists, her PTSD with TBI diagnoses. She repeatedly submitted the documents her unit requested to support her line of duty paperwork, yet her State headquarters failed to follow through and submit her a. line of duty forms to NGB. In fact, State personnel reported two line of duty packets were lost and she had to resubmit them. b. She provides a summary of her 27 years of successful service in the ARNGUS to include serving as a battalion commander and State Inspector General. She was recognized for her service receiving awards and outstanding officer evaluation reports. As a civilian she was employed at a State Trooper. She provides her own sworn statements attesting to her successful military and civilian careers prior to her deployment to Iraq. c. At the time she was mandatorily retired based on attaining her statutory maximum years of service as a commissioned officer from the ARNG, the ARNG headquarters was processing her line of duty determinations under Army Regulation 600-8-4 (Line of Duty Policy, Procedures, and Investigations). The VA required her finalized line of duty determinations for their records. She further states, in effect, the ARNG did not comply with the timeliness standards of processing line of duty determinations outlined in this regulation. Their lack of complying with timeliness standards attributed to her abrupt retirement without due process through the DES. d. In her letter she cites Army Regulation 635-200 (Active Duty Enlisted Administrative Separations) as evidence to support her argument. As she retired in the rank and grade of lieutenant colonel (LTC)/O-5, any references she cites or arguments she makes regarding the separation of enlisted personnel for adjustment disorder or similar behavioral health conditions are not applicable to her application before the Board. Therefore, they will not be presented within this record of proceedings. e. She argues Title 10, U.S Code, section 1201 requires the Army to retire Soldiers based on disability and provides certain benefits to Soldiers. In effect, because of her VA ratings for PTSD with TBI she knows she met the requirements of this law and she should have been processed accordingly through the DES shortly after she redeployed from Iraq in 2011 or up to 30 June 2014. The ARNG should have extended her on active duty and placed her in a Warrior Transition Unit so she could undergo physical disability evaluation. She believes she was not given ample opportunity to recover from her military medical diagnosis of adjustment disorder before she was mandatorily retired based on maximum years of service. (For a commissioned officer in the rank of LTC/O-5, the maximum number of years they can serve by law is 28 years of commissioned service.) f. In her letter she argues Under Secretary of Defense Robert L. Wilkie's memorandum dated 25 July 2018 is applicable to her situation. In the subject a. memorandum, the guidance does not mandate relief, but provides standards and principles to guide the Discharge Review Boards (DRBs) and Boards for Board for Correction of Military Records (BCMRs) in application of their equitable relief authority. (This memorandum and others that she cites normally pertain to Soldiers who receive a less than honorable character of service or a dishonorable discharge or a bad conduct discharge. The two boards are required to take into consideration mitigating evidence including behavioral health disorders which could have potentially mitigated the misconduct that led to a less than honorable character of service.) g. She cites other memorandums issued by senior Department of Army or Department of Defense personnel in critical leadership positions. Each memorandum provides guidance or clarification to the DRBs and BCMR/NCR for service members separated with a less than honorable character of service whose military service ended because of their individual misconduct. The guidance allows the boards to consider mitigating behavioral health diagnoses, sexual assault, rape, and sexual harassment that in retrospect negatively impacted the service members' behavior that led to a less than honorable discharge character of service. [The process for determining a fitness for duty or unfitness for duty and eligibility for medical retirement is found in Army Regulation 635- 40 (Physical Evaluation for Retention, Retirement, or Separation) prescribes 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. 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.] 4. The applicant provided a copy of her military personnel file from the ARNG. From the documents she submitted for the Board's review, the following pertinent information was obtained. a. With prior enlisted service in the ARNG, she accepted an oath of office as a National Guard commissioned officer for the State of on 20 June 1986. She was appointed and received temporary Federal recognition as a second lieutenant (2LT)/pay grade O-1 in the Adjutant General Corps. She required two medical waivers under Army Regulation 40-501 (Standards of Medical Fitness) paragraph 2-10d for her knee and paragraph 2-41c for a benign tumor that was removed from her neck. a. b. On 17 December 1986, the NGB issued Special Orders Number 242 AR extending her Federal recognition as a 2LT effective the date of her appointment in the ARNG on 20 June 1986. c. On 3 March 1987, she and a senior officer affixed their signatures to DA Form 71 (Oath of Office - Military Personnel) attesting to the fact she was appointed a Reserve commissioned officer. d. On 19 June 1989 she was promoted to first lieutenant (1LT)/pay grade O-2 by the ARNG and received Federal recognition from NGB. e. After publication of ARNG Orders 209-11, dated 29 October 1990, she was relieved from her attached unit and honorably separated from the Army National Guard of the United States (ARNGUS) with an effective date of 29 August 1990. Her orders state that upon termination of her Federal recognition, she would revert to her status as a United States Army Reserve (USAR) commissioned officer under the provisions of Title 10, U.S. Code, section 3352(b). Accordingly, she was issued a NGB Form 22 (Report of Separation and Record of Service) showing she was honorably separated effective 29 August 1990 from the ARNG and the ARNGUS. f. On 30 August 1990 she was sworn into the ARNGUS and the Territory of the United States Virgin Islands. She was reappointed in the rank of 1LT/pay grade O-2. g. She requested a conditional release from the ARNGUS - United States Virgin Islands prior to entering active duty as a Reserve commissioned officer. h. She entered active duty serving for 1 year, 1 month and 15 days in the United States Virgin Islands. Upon her release from active duty on 6 August 1991, she was issued a DD Form 214 documenting her active service. i. On 8 January 1992 she was honorably separated from the ARNGUS and United States Virgin Islands and transferred to the USAR Control Group (Reinforcement). Concurrently, her Federal recognition was withdrawn by NGB. j. On 16 December 1994 she was promoted to captain (CPT)/pay grade O-3 in the USAR. She received a notification promotion letter dated 19 April 1995 from the U.S. Total Army Personnel Command attesting to her promotion. Her effective date of promotion to CPT was 18 June 1993. She remained in the USAR Control Group (Reinforcement). a. k. On 18 June 1997 she accepted an oath of office for the ARNGUS and the Commonwealth of (ARNG) in the rank and grade of CPT/O-3. l. On 24 July 1997 she was released from the USAR Control Group and assigned to the ARNG. m. On 7 August 1997, NGB published Special Orders Number 152 AR extending her Federal recognition in the ARNGUS as a CPT/O-3 effective 7 August 1997. n. On or about 10 August 2000, the U.S. Total Army Personnel Command notified NGB the applicant was selected for promotion to major (MAJ)/pay grade O-4 by a centralized Army promotion board. o. On 5 February 2001 the ARNG promoted her to MAJ/O-4. p. On 22 February 2001, the NGB extended her Federal recognition to MAJ/O-4 with the publication of Special Orders Number 45. q. On 10 March 2001 she transferred from the ARNG to the ARNG by Orders 123-50 dated 3 May 2001. She also executed an oath of office into the ARNG upon her transfer and was concurrently appointed a MAJ/O-4 in the ARNG. On 7 May 2001, she was extended Federal recognition in the ARNG by NGB with an effective date of 10 March 2011. r. On 4 January 2007, U.S. Army Human Resources Command (HRC) issued a memorandum informing NGB the applicant was selected for promotion to LTC/O-5 as a Reserve commissioned officer by a centralized promotion board that adjourned on 29 September 2006. s. On 25 July 2007 a ARNG medical officer initiated and approved a personnel action changing the applicant's duty status from deployable to non- deployable because of an unresolved medical case within the U.S. Army Health Clinic at. The medical officer did not identify the medical reasons the applicant was non-deployable. t. On 20 March 2008, she was promoted to LTC/O-5 in the ARNGUS receiving Federal recognition by NGB through publication of Special Orders Number 75. Concurrently, NBG issued her a separate memorandum promoting her to LTC/O-5 as a Reserve commissioned officer. a. u. On 2 February 2010, she received her Twenty-Year Letter notifying her she had completed the required years of service for non-regular retired pay upon application at age 60 under Title 10, U.S. Code, Chapter 1223. v. On 29 September 2010, Orders A-090026773 were issued by HRC ordering her to active duty for operational support under the provisions of Title 10, U.S. Code, section 12301(d). Her orders were for contingency operations for active duty support (ADOS) for Operation Iraq Freedom. Her orders were for 365 days with an active duty report date of 9 October 2010. She was to report to the Multi National Force Headquarters, Iraq. w. In Iraq she sought medical treatment for severe wrist and forearm pain in her right arm on or about 26 May 2011. The history of her injury stemmed from her long work hours and use of poor equipment or furniture that led to her injury. A unit commander or advisor in the rank and grade of colonel (COL)/O-6 signed her DA Form 2173 stating no formal line of duty was required and that her injury did occur in the line of duty. x. On 1 August 2012 a designee for the Secretary of the Army at the NGB signed a memorandum approving her DA Form 2173 as "IN LINE OF DUTY- EPTS [existed prior to service] SERVICE AGGRAVTION" for her right wrist tenosynovitis that occurred during her deployment. (This is her first approved line of duty determination. She argues she should have received two more from her service in Iraq.) y. On 10 August 2012 she was awarded the Defense Meritorious Service Medal for exceptionally meritorious service as Advisor, Ministry of Defense, Human Rights and Inspector General, Iraqi Training and Advisory Mission- Ministry of Defense, U.S. Forces-Iraq. She served in Iraq during Operation New Dawn. She interfaced with the Department of State, U.S. Agency for International Development, United Nations Assistance Mission-Iraq and the Government of Iraq. She further served assisting the U.S. Forces-Iraq and the Staff Judge Advocate Office with numerous detainee cases often bringing closure to open cases. She worked and advocated for Iraqi Women's Rights as an Action Officer to include assisting and developing the first female delegation of Iraqi female police. z. She received an officer evaluation report (OER) for the period from 1 September 2010 through 31 August 2011 prior to her redeployment from Iraq. Her principal duty title was Chief, Inspector General, Investigations and Assistance Division. Her OER states her strengths as a leader were motivating others toward mission accomplishment, building relationships and she sought self-improvement. Her rater stated her performance was superior gaining the trust of Iraqi people. She educated Iraqi personnel and others on detainee accountability, functions and requirements based on human rights laws. During her personal time, she organized the shipment of life support items for local Iraqi families, schools and churches. Her senior rater stated her overall performance and potential for promotion were outstanding placing her in a "Must Promote" category. Her senior rater was a lieutenant general who assessed her as being a "Best Qualified" officer for promotion. He stated she did a great job showing enthusiasm and eagerness to learn and understand the mission and the country of Iraq. She was a strong advocate for improving Human Rights in the Iraqi Armed Forces. aa. On 3 September 2011 she departed Iraq returning to the continental United States for the purpose of demobilizing in compliance with her mobilization orders. ab. On 7 September 2011, personnel at Fort Benning, Georgia where she was demobilizing issued her Orders 250-2239 releasing her from active duty, not by reason of physical disability, effective 8 October 2011. ac. On 8 October 2011 as ordered she was released from active duty and she was issued a DD Form 214 documenting her active service of 1 year with 10 months and 7 days of foreign service. Her DD Form 214 shows she served in Iraq from 17 October 2010 through 3 September 2011. Further review of her DD Form 214 shows she did not receive the Purple Heart or the Combat Action Badge. ad. Travel orders were issued by the ARNG authorizing her one day of pay for one day of duty going to VA medical centers on numerous dates in calendar year 2012. Her orders show she was ordered under Title 32 (National Guard), Code of Federal Regulations. ae. The Adjutant General for the State of notified her by memorandum that she was retained in the ARNG for an additional 2-year period. She was selected and nominated by the State of 2012 Selective Retention Board. Her file went before the state board because she had qualified for non-regular retirement when she received her Twenty-Year Letter in 2010. af. She continued serving as the ARNG Inspector General, not on active duty, until 27 September 2013 when she was removed from the position by orders and reassigned to an operations officer position in the ARNG G3 section. ag. On 15 April 2014 she was notified by memorandum that she was considered, but not selected for promotion to colonel/pay grad O-6 by the Fiscal Year 2014 Colonel Promotion Board held at HRC. The ARNG memorandum informed her that she would not go before the next Department of the Army (DA) Colonel Selection Board because her mandatory removal date was 30 June 2014 at 28 years' commissioned service. ah. On 20 June 2014 her Federal recognition in the NGUS and ARNG was withdrawn by NGB Special Orders 256. ai. On 25 June 2014 the ARNG issued Orders 176-1037 honorably separating her from the ARNGUS on 30 June 2014. These orders also transferred her to the Retired Reserve under HRC management. It states that upon termination of her Federal recognition, she would become a member of the USAR under Title 10, U.S. Code, section 3352. The reason for separating her from the ARNG and ARNGUS was because she had completed her maximum years of service as a commissioned officer. aj. On 30 June 2014, her mandatory removal date, the ARNG issued her NGB Form 22 (National Guard Report of Separation and Record of Service) honorably separating her from the ARNG and ARNGUS and transferring her to the USAR Retired Reserve. Her NGB Form 22 shows her total service for retired pay as 30 years, 5 months and 19 days. The authority for her retirement is shown as National Guard Regulation 635-100 (Commissioned Officer - Federal Recognition and Related Personnel Actions), paragraphs 5, 6, and 7. Additionally she was retired under Army Regulation 135-180 (ARNG and Army Reserve - Qualifying Service for Retired Pay Nonregular Service), paragraph 2- 1a and b. 5. The applicant provides the following evidence concerning her various medical conditions, the impact her mental health had on her ability to perform her military duties as a senior officer, and her augments that she was improperly retired without processing through the DES. a. Within her VA progress notes, it states a review of her service treatment records shows she was close to a blast from a rocket explosion that hit her camp in April 2011. By 3 August 2011, she was seeking treatment for migraine headaches. b. ARNG Medical Corps officers prepared and authenticated multiple DA Forms 3349 (Physical Profile) as follows: a. (1) On 1 November 2012, for PTSD identified as a temporary medical condition with her overall physical stamina rating a "3." The medical officer stated she could perform nine functional activities of soldiering. At the time she was not able to live in an austere environment for she was undergoing counselling at the VA. There was no requirement for a medical evaluation board as her profile was considered temporary. (2) On 28 February 2013, for PTSD and TBI with her temporary profile remaining active and it now included a profile rating of "3" for her psychiatric conditions. Her continued reason for remaining on a profile was she was not medically cleared to deploy to an austere environment. The medical profiling officer stated the applicant needed to provide more medical evidence. (3) Her temporary profiles for PTSD and TBI were continued on 12 July 2013, 20 September 2013, and 14 November 2013. On that date, a medical provider stated she should undergo a board review. By 25 January 2014 after her numerous VA ratings, her medical conditions now included back pain, knee pain, wrist pain, TBI and PTSD. She could not deploy to an austere environment. By 10 February 2014, a medical provider recommended she attend or schedule alternative monthly unit assemblies to reduce her stress and anxiety. Further, a note written within the temporary profile stated her temporary profile was under review for issuance of a permanent profile. On 24 March 2014, her temporary profile was automatically extended for 60 days. (4) On 29 April 2014 (two months before her mandatory removal date), she was issued a permanent profile that was approved by a medical doctor for chronic low back pain for which she was assigned a profile rating of "2" for her overall stamina. Her profile rating for the psychiatric factor remained "3" or "S3." By 10 June 2014, her hearing was profiled and rated a permanent "2" or "H2." This new profile for hearing was generated after hearing tests showed her hearing was impaired. The medical profiling officer noted she did not meet the medical retention standards of Army Regulation 40-501, chapter 3 and that she needed to undergo a medical evaluation board. c. Her multiple VA rating decisions contain the following pertinent information: * Effective 29 October 2012, her combined rating was 70 percent * Effective 22 April 2013, her combined rating was 100 percent * Effective 1 June 2013, her combined rating was reduced to 70 percent * Effective 5 February 2014, her combined rating increased to 90 percent * Effective 2 September 2015, she received notification of entitlement to individual unemployability and establishment of Dependents' Educational Assistance * d. For her behavioral health condition of PTSD with TBI, the documents show it was not related to combat though it was service-connected because of her deployment. Medical examiners were not able to distinguish the symptoms of TBI from the symptoms caused by PTSD. Therefore, the VA evaluated her symptoms under a single evaluation. Her PTSD ratings are as follows: * Effective 29 October 2012, 70 percent * Effective 22 April 2013, 100 percent under Chapter 38, Code of Federal Regulation, section or paragraph 4.29 * Effective 1 June 2013, 70 percent e. For her migraine headaches associated with TBI, her initial rating on 29 October 2012 was zero (0) percent and on 5 February 2014 it was increased to 50 percent because of frequent completely prostrating and prolonged attacks leading to severe economic inadaptability. The highest rating allowed for migraine headaches is 50 percent. Her TBI was not rated separately as it was affiliated with both her migraine headaches and PTSD. f. For TBI, the VA decisional document effective 29 October 2012 shows she had no deficiencies or severities for the following TBI criteria: * Memory, attention, concentration, or executive functions facets * Judgment, social interaction or orientation facets * Motor activity, visual spatial orientations, or subjective symptoms facets * Neurobehavioral effects and communication facets g. On or about 25 April 2013, a VA psychologist affirmed the applicant's diagnosis of PTSD and major depressive disorder (recurrent, moderate). From available VA records she also had diagnoses of migraines and TBI. For her PTSD treatment, she was undergoing cognitive behavioral therapy. She self- reported having difficulty interacting confidently with senior military officers. She had difficulty with her medical treatment protocol often avoiding exploring internal reasons for her distress. A summary progress note shows she received 19 individual psychotherapy sessions between 10 May 2013 and 21 October 2013 to target her symptoms of PTSD and depression. She also participated in an in- patient residential program. As she avoided exploring negative conditions underlying her emotional distress, it became a barrier to her treatment. h. On 21 June 2013, a VA psychologist stated by letter that the applicant was admitted to a VA residential treatment program on 17 June 2013. She was being treated for PTSD, depression, and TBI which were all related to her service in Iraq. The letter informs its intended recipient she would not be available for work. a. i. Concerning the processing of line of duty determinations, she provides the following pertinent evidence. She also provided many documents showing the progress of each line of duty determination through the State Medical Office, email communications with staff within the State Medical Office, and numerous VA medical treatment letters and some progress notes to support her assertion her line of duty determinations were not processed in accordance with governing regulations. She assumes that if two unsolved line of duty determinations were processed by the timeliness standards of the regulation, she would have entered the disability evaluation system and been found medical unfit and allowed to medically retire with immediate entitlement to retired pay. (1) On 27 January 2012 and again on 8 March 2013, a unit officer indicated on a DA Form 2173 that she required further medical evaluation in accordance with post-deployment health assessment directives. The notes state it was an initial DA Form 2173 and it was to be used only for authorization to undergo further medical treatment for medical conditions identified during the Post-Deployment Health Risk Assessment. She was authorized to undergo treatment at her VA local healthcare center for headaches, dizziness, left wrist pain, right wrist pain and symptoms of PTSD. The guidance for authorizing treatment is shown as Military Personnel Message (MILPER) 05-273 dated 3 November 2005. [This message required Soldiers of the USAR and ARNG to undergo a medical evaluation by a medical provider (physician, physician assistant, or nurse practionier) during the Post-Deployment Health Assessment. An initial DA Form 2173 is required for further medical treatment. The purpose of the health assessment post-deployment was to validate injury, illness, or condition claimed so further treatment could be provided, if warranted by a medical provider.] (2) On 31 October 2012 a medical provider in psychiatry with the VA assessed the applicant's mental health. She indicated the applicant had diagnoses of PTSD, anxiety not otherwise specified, carpool tunnel syndrome and migraine headaches. Further the applicant was experiencing readjustment issues. She was prescribed medication for her symptoms. The medical provider did not recommend the applicant deploy or serve on active duty. (3) On 31 October 2012 she also signed a VA medical release form authoring the VA to transmit her treatment records to the ARNG State Surgeon's Office or State Medical Office. (4) On 19 November 2012 she underwent neuropsychology assessments. She informed the provider she was in close proximity to rocket propelled grenades while working at the United States Embassy in Iraq. She estimated the (1) rockets landed about a half of mile (1/2 mile) from her location. She reported a second exposure when two rocket propelled grenades landed near her building shaking the roof and shrapnel debris from the blast impact on the building fell around her. (5) On 13 June 2013 she wrote a memorandum to the Commanding Officer, 53rd Troop Command, ARNG. She stated she was seeking assistance with the processing of three line of duty determinations that were incomplete. She also requested a transfer to a Warrior Transition Unit (WTU) under Title 10, U.S Code so she could enter active duty for treatment and in effect, processing through the disability evaluation system. She stated her line of duty determinations were not finalized and the lack of finalization by the ARNG was impeding her ability to transfer to a WTU. Prior to her demobilization. personnel at Fort Benning told her she would receive instructions from her unit who would take care of her line of duty determinations. (a) In January 2012, she constructed the line of duty packets for her three medical conditions. She did an individual packet for each condition. She submitted them. Later after making inquiries into the status of her line of duty determinations, she was told two of the packets were lost. (b) In February 2013, she resubmitted the two missing packets to ARNG personnel. Again, she was told she had to wait because the senior medical advisor was departing and his replacement had not yet arrived for duty. It appears State internal operations for line of duty determinations required one senior officer to administratively process them. (c) She describes how her own cognitive impairments hindered her ability to comply with the various requests for information from the ARNG State Medical Offices. She attests to the fact her cognitive impairments were due to her TBI diagnosis. (6) On 3 July 2013 she received an electronic message from the senior medical officer/advisor ARNG. Within his email he identifies the three line of duty determinations by internal state identification numbers. (a) Number 1: tenosynovitis of hand and wrist was approved by the NGB as found in line of duty, existed prior to service, though aggravated by her active service when she deployed. (b) Number 2: for medical condition identified as "Other psychological or physical stress, not elsewhere classified" line of duty determination was pending review at the State for administrative accuracy. Upon completion and a finding (a) her packet was administratively correct, it would be forwarded to the State Surgeon General and State Judge Advocate for review. After the State review was complete, it would be forwarded to NGB. He could not provide her with a projected completion date advising her that, in effect, there were administrative delays in the processing of line of duty determinations. (c) Number 3: for special screening for TBI was administratively closed without entitlement because the investigating officer could not substantiate a TBI related incident that would lead to a diagnosis of TBI. Medical records showed she was treated for TBI symptoms, but not a diagnosis of TBI. (7) She submitted a written request to the State Inspector General concerning her line of duty determinations. She received a letter in response dated 6 September 2013 telling her that the State Medical Command had responded to her inquiry as follows: (a) Her line of duty determination for TBI was administratively closed because her case file lacked evidence she had a diagnosis of TBI. She was told when she provided medical documentation showing a (separate) diagnosis of TBI, her file would be reopened. (b) Concerning her request to transfer to a WTU, it was not submitted as of the date of the letter because she was receiving treatment at a VA inpatient program. From telephone conversations to the State Medical Command staff they understood she was happy with the VA treatment program and did not want to transfer to a WTU (presumably she would start a new treatment program with new medical providers upon entering active duty and assignment to a WTU). j. Concerning her statement, she received a diagnosis of adjustment disorder, there is a SF 600 (Chronological History of Medical Treatment) outlining her behavioral health history and how the State Surgeon General's Office worked with her to obtain the medical evidence required to issue her a permanent profile. It shows she was referred by her commander to the military hospital at for a command directed psychological evaluation on or about 14 April 2014. She was evaluated by a medical doctor who diagnosed her with adjustment disorder not otherwise specified, cognitive disorder, and borderline (personality) traits. Army medical doctors ruled out a diagnosis of TBI. These same medical doctors suspected she was experiencing dementia. They determined she was unfit for duty due to a serious mental condition that would not be resolved within 1 year. The medical notes show she would be issued a permanent profile and referred into the DES for a medical evaluation board. The medical doctor entered the permanent profile within an electronic medical profiling system on or about 28 April 2014. On 1 May 2014, her permanent profile was approved for "Chronic Low Back Pain" following surgery in December 2006 when she underwent a disc fusion L5-S1 with the insertion of titanium spacers. Her psychological factor is shown a permanent three or "S3" with no behavioral health condition identified on the DA Form 3349. The medical office received her separation orders from the ARNG on or about 7 July 2014. On 7 July 2014 her medical files to include the initiation of a medical evaluation board were closed. The final entry states, "Final Diagnosis: 309.1 - ADJUSTMENT REACTION WITH PROLONGED DEPRESSIVE REACTION." k. On 22 February 2020 she received a letter from the Social Security Administration attesting to the fact she is entitled for monthly disability benefits from that agency. l. She provides extensive evidence (estimate 680 pages) to support her application. She provides letters from her spouse, child and friends attesting to her mental health decline post-deployment. She provided a court case. Cowles v. Secretary of the Army concerning a PTSD diagnosis from the plaintiff's deployment in 2003. Army medical providers diagnosed him an adjustment disorder post deployed and he was administratively separated from the Army. He applied to the ABCMR for a correction of his record to show he was medically retired instead of administratively separated under enlisted administrative separation regulations. The ABCMR denied him relief and he went to the United States District Court - District of Connecticut. The court remanded it back to the ABCMR with instructions to amend its findings based on the court decisions. In turn, the ABCMR complied with the court's instructions. 6. In the processing of this application, the staff of the Army Review Boards Agency (ARBA) requested an advisory from the Chief, NGB. In response, the Chief of Special Actions Branch replied by memorandum to ARBA on 13 April 2021. The advisory recommends partial approval. The advisory states: [The applicant] received a permanent profile (P3) in the Psychological (S) category of the Physical Capacity Stamina (PHULLHS) in May 2017. The Army National Guard (ARNG) did not request a Mandatory Removal Date (MRD) extension to allow for the initiation of a MEB in accordance with Army Regulation 40-501 dated 29 May 2007 paragraph 3-3d. The ARNG did not properly process the Soldier for her medical condition by initiating a Formal Line of Duty (LOD) investigation, which may have led a Medical Evaluation Board (MEB) review and enrollment in the Integrated Disability Evaluation System (IDES). [A note from the analyst of record, the applicant was in the ARNG from 10 March 2001 to 30 June 2014, her mandatory removal date for maximum years of service as a commissioned officer. She was not in the ARNG during the period under review within this application. Secondly, her permanent profile was approved by the approval authority on 1 May 2014 not "May 2017" as stated within the advisory.] a. The advisory recommends the U.S. Army Human Resources Command direct a formal line of duty determination for her S3 and any other medical conditions for which she received a permanent 3 rating prior to her separation. If a formal line of duty determination determines her medical condition is a service connected disability, then she should be referred for a medical evaluation board for adjudication through the DES. If the DES finds her medically unfit, then correct her non-regular retirement orders to show she was retired by reason of physical disability. b. In compliance with the law, the applicant was sent a copy of the advisory for her review and rebuttal. On 20 April 2021 she replied stating she now believes she was administratively separated instead of retiring on or new her mandatory removal date. She continues stating upon her release from active duty after her period of mobilization she planned to transfer to the Military Police Corps and begin the process of preparing for her promotion to colonel/pay grade O-6. She states she was eligible for the O6 promotion board. It was not her intent to retire. She then outlines the history of her injury to her lower back resulting in the permanent profile for her lower back. During her deployment to Iraq, the requirement to wear protective clothing exacerbated her back pain. She acknowledges she receive a permanent profile for lumbago (low back pain). She also discussed her knee condition which also was aggravated by her deployment. c. As evidence to support her rebuttal statement she resubmits 49 pages of evidence she initially provided with her application in April 2020. Her permanent profile dated by the approval authority on 1 May 2014 shows she required an MEB. Her psychological factor was rated "3" or S3. 7. As the applicant is requesting entry into the disability evaluation system, the Army Review Boards Agency medical officers conducted a medical review of the applicant's service treatment records and VA records through the Joint Legacy Viewer. The medical doctors upon the conclusion of their review will provide a recommendation to the Board. See "MEDICAL REVIEW." 8. Army Regulation 600-8-4 dated 4 September 2008 and in effect during the applicant's period of service provides the following instructions. 1. a. The Chief, NBG will be responsible for the line of duty investigation process within the ARNG. He will act in the name of the Secretary of the Army as the final approval authority for the ARNG except for those Soldiers in a Federalized status or attending an Active Army Service School. b. The HRC serves as the functional responsibility for line of duty determinations for the Secretary of the Army on all line of duty determinations and appeals referred to Headquarters, Department of the Army. 9. Army Regulation 600-8-4 underwent a major revision with its publication date effective 15 March 2019. It incorporated Department of Defense Instruction 1300.18 (DoD Personnel Casualty Matters, Policies and Procedures) requirement for 30-day investigation updates. It also implements the ARNG and USAR Electronic Medical Management Processing System. a. The Chief, NBG remained responsible for the line of duty investigation and determination process for all non-mobilized ARNG Soldier. The Chief will act as the approval authority for formal and informal line of duty determinations for non- mobilized Soldiers. Among duties and responsibilities, it states line of duty determinations that were found not to be in the line of duty were not required to be forwarded HRC. However, a Soldier who was appealing a NGB denial decision, there was a requirement to forward it to HRC. If based on the findings of an informal investigation, he could direct a formal investigation to confirm that the findings were legally sufficient, through the supporting legal office. b. The Deputy Chief of Staff, G1 (Headquarters, Department of the Army) maintains the functional responsibility for line of duty determinations. If a The Adjutant General of the Army has previously reviewed a case and rendered or overturned a finding during an appeal process the final approval authority will be Commanding General, HRC. 10. Army Regulation 40-501 (Standards of Medical Fitness) provides information on medical fitness standards for induction, enlistment, appointment, retention, retirement and related policies and procedures. Chapter 3 describes the various medical conditions and physical defects which may render a Soldier unfit for further military services. The regulation in effect on 29 May 2007 cited by the NGB advisory states in paragraph 3-3d physicians who identify Soldiers with medical conditions listed within Chapter 3 should initiate a MEB at the time of identification. Physicians should not deter initiating the MEB until the Soldier is being processed for nondisability retirement. The medical conditions PTSD and TBI are not medical conditions identified within the regulation. A review of the current publication dated 16 December 2016 shows the same guidance is valid. 1. However, TBI is now identified as a medical condition that potentially would render a Soldier unfit for duty. a. Paragraph 3-30 (Neurological Disorders), subparagraph j provides for other neurologic conditions including TBI or other etiology, when after adequate treatment there remains residual symptoms and impairment such as persistent server headaches, uncontrolled seizures, weakness, paralysis or atrophy of important muscle groups, deformity, uncoordination, tremor, pain or sensory disturbance alteration of consciousness, speech, personality or mental function of such a degree as to significantly interfere with the performance of duty. b. There is no provision under Chapter 3 for PTSD for separating Soldiers through the military medical disability evaluation system. However, it does identify anxiety, somatoform, dissociative disorders, mood disorders, disorders with psychotic features and dementia and other cognitive disorders due to general medical condition(s). c. Paragraph 3-36 (Adjustment Disorders) provide that situational maladjustments due to acute or chronic situational stress do no render an individual unfit because of physical disability, but may be the bases for administrative separation if recurrent and causing interference with military duty. 11. 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. 12. Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) prescribes 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. Effective 19 January 2017, the DES legacy process will be used for Army Veterans referred to the DES by ABCMR. The Secretary of the Army or designee approves requests for legacy processing on a case-by-case basis. The VA Form 21-0819 (DoD Referral to Integrated Disability Evaluation System (IDES)) will not be used, to include cases referred by the ABCMR when the applicant does not have an active status in the U.S. Army. The VA will not conduct the examination upon which the MEB findings are based. Instead, the MEB convening authority will assign a physician or physicians to conduct the required examination(s). The examinations will meet the minimum criteria of the VA medical examinations. Medical conditions evaluated during the DES will solely consist of those conditions for which a P3/P4 profiles was approved and any other conditions which the physician conducting the MEB finds individually or in combination are not likely to meet medical retention standards. Cases referred by the ABCMR address conditions in the context of their status at the time of the Veteran's separation. 13. Title 10, USC, 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, USC, section 1203, provides for the physical disability separation of a member who has less than 20 years of service and a disability rating at less than 30 percent. 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, Code of Federal Regulations, Part IV is the VA's schedule for rating disabilities. The VA awards disability ratings to veterans for service-connected conditions, including those conditions detected after discharge. As a result, the VA, operating under different policies, may award a disability rating where the Army did not find the member to be unfit to perform his duties. Unlike the Army, the VA can evaluate a veteran throughout his or her lifetime, adjusting the percentage of disability based upon that agency's examinations and findings. 16. MEDICAL REVIEW: The Army Review Board Agency (ARBA) Medical Advisor reviewed the supporting documents and the applicant's military service records. A review of the Armed Forces Health Longitudinal Technology Application (AHLTA) & Health Artifacts Image Solutions (HAIMS) indicates she was seen in theater due to sleep issues and migraine headaches. She was evaluated on 15 Apr 2014. She was diagnosed with Anxiety Disorder, not otherwise specified and Cognitive Disorder. The provider noted that had not improved with a year of psychiatric treatment. She was found not fit for duty. The provider stated a permanent profile was needed along with referral for MEB. A review of JLV indicates she has a service connected disability rating of 90%. A review of her supporting documents including VA and civilian medical records it is clear that her PTSD was directly related to her deployment in 2011 and thus should be line of duty. Her VA disability rating for PTSD to include TBI is 70% effective 29 Oct 2012 and was increased to 100% effective 22 Apr 2013. The applicant should have been referred for a MEB and medically retired. Recommend referral of her case to the Integrated Disability Retirement System for review and determination of all applicable benefits BOARD DISCUSSION: After reviewing the application and all supporting documents and evidence with the military record, the Board determined that partial relief was warranted. The applicant's contentions, military record, and regulatory guidance were carefully considered. The Board determined that the Army National Guard (ARNG) leadership neglected or failed to follow applicable Army regulations by not allowing the applicant to process through the disability evaluation system (DES). The Board considered the Army Review Board Agency (ARBA) Medical Advisory and concurred with the advisory finding that the applicant's PTSD is directly related to her deployment in 2011, and as such, should have been referred to a Medical Evaluation Board. Based on the preponderance of evidence available for review, the Board determined the evidence presented sufficient to warrant a recommendation for partial relief. 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 review to determine if the disability evaluation he received from the Army accurately depicted his conditions as they existed at the time. 1. a. If a review by the Office of The Surgeon General determines the evidence supports amendment of his disability evaluation records, the individual concerned will be afforded due process through the Disability Evaluation System for consideration of any additional diagnoses (or changed diagnoses) identified as having not met retention standards prior to his discharge. b. In the event that a formal 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 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 changing the narrative reason for separation. 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. Army Regulation 135-180 (ARNG and Army Reserve - Qualifying Service for Retired Pay Nonregular Service) dated 1 July 1987 and in effect at the time of 1. the applicant's period of service, implements statutory authorities governing the granting of "retired pay" to Soldiers and former Reserve Component Soldiers. Paragraph 2-1a states to be eligible for retired pay, an individual need not have a military status at the time of their application for retired pay, but they must be age 60 (unless an early age drop) and completed a minimum of 20 years of qualifying service. Paragraph 2-1b states an applicant for retirement may not be entitled to retired pay from the Armed Force under any other provision of law; not have elected to receive disability severance pay in lieu of retired pay at age 60; and do not fall within the purview of the "Hiss Act" of 1 September 1954. 3. National Guard Regulation 635-100 (Personnel Separations - Termination of Appointment and Withdrawal of Federal Recognition) in effect at the time prescribes the policies, criteria and procedures governing the separation of commissioned officer of the Army National Guard (ARNG). The authorities are under Title 32, U.S. Code, sections 323 and 324. The termination of an officer's appointment in the ARNG is a function of the State. The withdrawal of Federal recognition of an officer is the function of the Chief, National Guard Bureau, acting for the Secretary of the Army. a. Paragraph 5 pertains to the termination of a State appointment. Paragraph 5a (2) pertains to completion of maximum service. It states an officer will be removed from an active status in the ARNGUS on the date that is 30 days after completion of the total years of service. Lieutenant colonels and below from all branches will be removed at 28 years of total commissioned service. Officers removed from an active status by reason of attainment of maximum years of service may be transferred to the Retired Reserve, if they are qualified and if they apply for transfer. b. Paragraph 6 pertains to retaining an officer beyond their mandatory removal date. In reviewing the instructions there is no provision for extending an officer beyond their mandatory removal date for processing through the disability evaluation system. Limited extensions may be granted for Chaplains, Medical Corps officers, general officers, ARNG Technicians, and select officers holding key leadership positions. A request for an exception to retain an officer beyond their mandatory removal date must be submitted 6 months prior to their mandatory removal date. The request must be completely justified and submitted to the Chief, National Guard Bureau. c. Paragraph 7 states unless an officer is discharged as a Reserve of the Army Officer, an officer of the ARNGUS becomes a member of the Army Reserve when Federal recognition is withdrawn. Upon separation from the ARNG, State orders will specify the USAR unit or the USAR control group to which the officer will be assigned. a. 4. Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) prescribes 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. It implements the requirements of Title 10, U.S. Code, chapter 61; Department of Defense Instructions (DoDI) 1332.18 (Disability Evaluation System (DES)); DoD Manuel 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 Surgeon General of the Army will establish and interpret medical standards for retaining Soldiers on active duty. b. 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 that meets the medical retention standards of Army Regulation 40-501. c. 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, physical evaluation boards, counseling of Soldiers, and mechanisms for the final disposition of disability evaluations by appropriate personnel. d. 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. (1) e. A medical evaluation board 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. f. The physical evaluation board (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 physical evaluation board also makes certain administrative determinations that may benefit implications under other provisions of law. The PEB is not a statutory board. It is a fact finding board evaluating the physical condition of the Soldier against the physical requirement of the Soldier's office, grade, rank or raring. g. The PEB may permanently retire a Regular Army Soldier if he has at least 20 years of service as defined in section 1208, Title 10, U.S. Code. h. 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. i. The DES legacy process will be used for Army Veterans referred to the DES by the ABCMR. The Secretary of the Army or designee approves requests for legacy processing on a case-by-case basis. The VA Form 21-0819 (DOD Referral to Integrated Disability Evaluation System (IDES)) will not be used, to include cases referred by the ABCMR when the applicant does not have an active status in the U.S. Army. The VA will not conduct the examination upon which the MEB findings are based. Instead, the MEB convening authority will assign a physician or physicians to conduct the required examination(s). The examinations will meet the minimum criteria of the VA medical examinations. Medical conditions evaluated during the DES will solely consist of those conditions for which a P3/P4 profiles was approved and any other conditions which the physician conducting the MEB finds individually or in combination are not likely to meet medical retention standards. Cases referred by the ABCMR address conditions in the context of their status at the time of the Veteran's separation. 5. Army Regulation 40-501 (Standards of Medical Fitness) provides information on medical fitness standards for induction, enlistment, appointment, retention, retirement and related policies and procedures. Chapter 3 describes the various medical conditions and physical defects which may render a Soldier unfit for further military services. These medical conditions and physical defects, 1. individually or in combination, are those that significantly limit or interfere with the Soldier's performance of duty; may compromise or aggravate the Soldier's health or well-being, if they were to remain in the military Service such as frequent clinical monitoring; may compromise the health or well-being of other Soldiers; and may prejudice the best interest of the Government if the individual were to remain in the military Service. Soldiers who do not meet the required medical standards will be evaluated by a medical evaluation board. a. The general policy states that possession of one or more of the conditions listed in this chapter does not mean automatic retirement or separation from the Service. Physicians are responsible for referring Soldiers with conditions in this chapter to a medical evaluation board. b. Paragraph 3-32 refers to mood disorders and paragraph 3-33 refers to anxiety, somatoform, or dissociative disorders may be referred to a medical evaluation board providing the following criteria is met: * persistence or recurrence of symptoms sufficient to require extended or recurrent hospitalization * persistence or recurrence of symptoms necessitating limitations of duty or duty in protected environment * persistence or recurrence of symptoms resulting in interference with effective military performance c. Paragraph 3-34 refers to dementia and other cognitive disorders due to general medical conditions. It states a cause for referral to an MEB includes persistent symptoms or associated personality change sufficient to interfere with the performance of duty or social adjustment. d. Paragraph 3-36 refers to adjustment disorders stating situational maladjustments due to acute or chronic situational stress do not render an individual unfit because of physical disability, but may be the basis for an administrative separation if recurrent and causing interference with military duty. 6. Title 38, U.S. Code, section 1110 (General - Basic Entitlement) states for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service, during a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation as provided in this subchapter, but no compensation 1. shall be paid if the disability is a result of the veteran's own willful misconduct or abuse of alcohol or drugs. 7. Title 38, U.S. Code, section 1131 (Peacetime Disability Compensation - Basic Entitlement) states for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service, during other than a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation as provided in this subchapter, but no compensation shall be paid if the disability is a result of the veteran's own willful misconduct or abuse of alcohol or drugs. 8. Army Regulation 15-185 (ABCMR) prescribes the policies and procedures for correction of military records by the Secretary of the Army, acting through the ABCMR. The ABCMR considers individual applications that are properly brought before it. In appropriate cases, it direct or recommend correction of military record(s) to remove an error or an injustice. The ABCMR will decide cases on the evidence of record. It is not an investigative body. It begins its consideration of each case with the presumption of administrative regularity meaning what Army personnel did at the time of the Soldier's or Veteran's area of service was administratively correct. The applicant has the burden of proving an error or injustice by a preponderance of the evidence. //NOTHING FOLLOWS//