RECORD OF PROCEEDINGS


      IN THE CASE OF:


      BOARD DATE:        28 APRIL 2005
      DOCKET NUMBER:  AR2004106884


      I certify that hereinafter is recorded the true and complete record
of the proceedings of the Army Board for Correction of Military Records in
the case of the above-named individual.

|     |Mr. Carl W. S. Chun               |     |Director             |
|     |Mr. Kenneth H. Aucock             |     |Analyst              |


      The following members, a quorum, were present:

|     |Mr. John Infante                  |     |Chairperson          |
|     |Mr. Ronald Blakely                |     |Member               |
|     |Mr. Peter Fisher                  |     |Member               |

      The Board considered the following evidence:

      Exhibit A - Application for correction of military records.

      Exhibit B - Military Personnel Records (including advisory opinion,
if any).

THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE:

1.  In effect, the applicant requests that she receive either a Medical
Evaluation Board (MEB) or that a line of duty investigation be conducted.

2.  The applicant states that the Department of Veterans Affairs (VA)
Muskogee disability board needs the documents to make a disability
determination.  In September 1997, while taking the Army Physical Fitness
Test (APFT) she had problems breathing.  She was seen by the medics and
referred to her private physician.  Tests showed that she had pulmonary
embolisms (blood clots in her lungs and slight asthma).  After being
released from the hospital, she met with National Guard officers, one of
who told her that if she wanted to get out of the Army National Guard he
would prepare the paperwork.  He stated that a medical review board would
have to be done.  Returning from a temporary leave of absence for medical
reasons, she was seen by another officer who told her that she needed to go
before a medical review board.  He informed her that any time she wanted to
leave the Guard, they could discharge her and still do a medical review
board.  In the last few years she has been having more difficulties with
asthma, and found out that she had been diagnosed with asthma when she had
pulmonary embolisms.  She could not get medical treatment from the VA
because her disabilities were not service connected.  She found out that
the VA needed a copy of the line of duty (LOD) investigation or the medical
review board determination.  She obtained a letter from her previous
personnel officer, who informed her that an LOD was not conducted because
of an administrative error. She understood at the time of her separation
that she would receive a medical review board.  She did not realize that
she had been assigned to the Army Reserve Control Group (Reinforcement)
[IRR] after her discharge from the Army National Guard, having been
informed that she could not be assigned to the IRR without a medical
review.

3.  The applicant provides a copy of a 16 November 1997 medical record, two
physical profile reports, a DA Form 7349-R (Initial Medical Review – Annual
Medical Certificate), a Noncommissioned Officer Evaluation Report (NCOER),
an OKARNG Form 17-1 (Separation/Discharge/Inactive National Guard Request),
a 2 April 2003 memorandum from an Oklahoma Army National Guard personnel
officer, a 15 September 1997 cardiovascular clinic encounter form, a 27
October 1997 radiological report, a 30 June 2003 statement from a
physician, a 7 August 2003 statement from another physician, a 7 November
2002 statement from a former comrade, a 15 September 2000 report of medical
examination, and a        7 October 1997 report of her history and physical
examination.


CONSIDERATION OF EVIDENCE:

1.  The applicant is requesting correction of an alleged error or injustice
which occurred on 7 September 1997.  The application submitted in this case
is dated   5 April 2004.

2.  Title 10, U.S. 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
Army Board for Correction of Military Records (ABCMR) to excuse an
applicant’s failure to timely file within the 3-year statute of limitations
if the ABCMR determines that it would be in the interest of justice to do
so.  The ABCMR has elected to conduct a substantive review of this case to
determine if it would be in the interest of justice to excuse the
applicant’s failure to timely file.

3.  The applicant enlisted in the Army National Guard for 8 years on
           27 November 1989.  She completed training and was assigned to
the             700th Support Battalion in Oklahoma City.  She continued
her service with the Oklahoma Army National Guard until her discharge in
1998.

4.  A 7 October 1997 medical report shows that the applicant had mitral
valve prolapse and had sharp pains under and over her left breast.  The
report stated   that whenever she ran she had to stop because of the pain.
When she breathed shallow, the pain went away.  She did not pass the APFT
last year.  She had mono two years ago and was tired most of the time.  She
had pleuritic chest pain off and on for the last two years.  A chest x-ray
showed a left lower lobe scar.  Her pulmonary function tests did not show
any dramatic change in her [previous] pulmonary function tests and her
airway resistance appeared to be normal.  The examining physician diagnosed
her condition as pleuritic chest pain, and indicated that there was a
question whether it was pleurisy secondary to the previous scar she had or
whether she might be having exercise induced bronchospasm or possibly even
PE (pulmonary embolism).

5.  A 27 October 1997 radiological report shows that the applicant had
multiple subsegmental pulmonary emboli and was to be admitted
[hospitalized] with full heparinization.  A 16 November 1997 medical report
indicates a diagnosis of pulmonary embolism and that she was on an
anticoagulant, and that her prognosis was good.  A physical profile report
of that same date shows that she had bilateral pulmonary embolism with a
T3, temporary profile.

6.  A 3 May 1998 physical profile report shows pulmonary embolism, and
indicated that she was restricted from strenuous physical activity.  That
report indicated that she should continue to see her private physician,
furnish reports on the progress of her treatment, and be referred to a
medical review board.  The report indicated that desk work was permitted if
under active physician care.  A    3 May 1998 initial medical review shows
that she was considered unfit [for duty] with a physical profile serial of
T3 1 1 1 1 1.  That review indicated that if she had the condition for more
than a year she should have a medical review board.

7.  The applicant’s NCOER for the one-year period ending in November 1997
contains the remark by her rater that she was on a temporary profile
pending resolution of medical treatment and MDRB [medical review board] for
possible permanent profile.  The report indicated that the applicant was a
fully capable NCO.

8.  On 28 September 1998 the applicant requested separation from the Army
National Guard because of medical reasons.  She stated that she was
hospitalized in October 1997 for one week due to pulmonary embolisms in
both lungs and was placed on Coumadin therapy until May 1998.  She stated
that she still had chest pain from time to time and had been placed on
aspirin therapy indefinitely.  She stated that she was unable to do the
APFT, participate in annual training, or attend school to become MOS
(military occupational specialty) qualified, rendering her from ever being
promoted.

9.  The applicant’s supervisor recommended that she be discharged in light
of her medical condition.  The regimental adjutant stated that he had
monitored her medical condition closely and reviewed her medical
documentation with the state surgeon.  He stated that her medical condition
precluded any consideration as a mobilization asset, and that she was
submitting the request in lieu of a medical duty review board.  He
recommended that she be separated.  A 29 October 1998 comment on her
request contained the remark to refer [her request] to medical branch for
MDRB opinion.

10.  The applicant was discharged from the Army National Guard on 29
October 1998.  The NGB Form 22 (Report of Separation and Record of Service)
shows    that her discharge was at her own request, and also shows that she
was assigned to the IRR for completion of 3 years and 27 days contractual
obligation/reenlistment bonus.  The applicant was assigned to the IRR on
      29 October 1998.

11.  On 15 September 2000 the applicant underwent a periodic physical
examination at Tinker Air Force Base in Oklahoma.  The report of that
examination shows a physical profile serial of 1 1 1 1 2 1.  The examining
official indicated that the applicant stated that she had dizziness from
1995 to the present time that was secondary to blood clots, and that the
last episode was     7 days ago.  She had pulmonary emboli in 1997, was
hospitalized for 10 days and treated with Heprin and Coumadin therapy for 8
months, and aspirin daily until pregnancy.

12.  On 27 November 2001 the applicant was discharged from the Army
Reserve.

13.  In a 2 April 2003 memorandum, an Oklahoma Army National Guard
lieutenant colonel stated that he was the applicant’s supervisor and
administered the APFT to her on 7 September 1997.  He stated that he
noticed that she was in physical distress while attempting to complete the
two-mile run portion of the APFT.  He terminated her participation in the
running event and directed on-site medical personnel to attend to her.  The
medics were not able to diagnose the problem; however, she appeared to
recover somewhat after several minutes.  When she no longer appeared to be
in physical distress, he told her to go home, to rest, and to see her
civilian physician.  At the time her inability to complete the APFT was not
thought to be injury-related and no line of duty documentation was
submitted.  On or about 7 October 1997 civilian medical authorities
determined    that she was suffering from pulmonary embolism.  There was no
manifestation of this medical problem prior to her participation in the
AFPT.  He stated that it would appear that the pulmonary embolism might
have been exercise induced or aggravated by the APFT.  A line of duty
investigation should have been initiated at that time.  There was no
medical evidence to indicate that the pulmonary embolism existed prior to
her participation in the APFT, but there was definitive medical evidence
that it did exist following the APFT, indicating that her pulmonary
embolism was related to the APFT of 7 September 1997, and if not caused by
the APFT, then aggravated by the APFT.  Her request for separation [in
1998] should have been delayed until after the MDRB had been completed.  A
MDRB might have determined that a line of duty investigation and report was
required and could have directed its completion.

14.  In a 7 November 2002 statement, a former comrade stated that she was a
tester at the APFT when the applicant fell out.  She attested to the
circumstances concerning the events on 7 September 1997.

15.  In a 30 June 2003 memorandum a physician stated that he was one of the
doctors who evaluated the applicant in 1997.  He stated that her diagnosis
of pulmonary emboli was directly correlated with the inability to do the
amount of activity she was asked to do for the APFT, and that there was no
question that was the cause for her inability to complete the test.

16.  Another doctor in a 7 August 2003 memorandum stated that the applicant
had a pulmonary embolism and some asthma in 1997.  He stated that her
pulmonary embolism was directly related to how she fared on her physical
fitness test, affecting her ability to do physical fitness training.

17.  In the processing of this case an advisory opinion was obtained from
the National Guard Bureau.  That agency stated that the applicant, when
requesting an administrative discharge for non-duty related conditions,
could have requested a review by a Physical Evaluation Board (PEB) for a
fitness determination.  Nonetheless, an informal LOD should have been
conducted to determine the necessity of a formal LOD, and if the injury was
found to be in the line of duty, the applicant would have been referred to
a Medical Evaluation Board (MEB), and if necessary a PEB.  The National
Guard Bureau recommended that the applicant be returned to active duty, her
complete medical records be provided, and an informal LOD investigation be
conducted.  The applicant concurred with the advisory opinion.

18.  Army Regulation 635-40, chapter 8, outlines the rules for processing
through the disability system Soldiers of the Reserve component who are on
active duty for a period of less than 30 days or on inactive duty training.
 Soldiers of the Reserve components are eligible for disability processing
from an injury determined to be the proximate result of performing annual
training, active duty special work, active duty for training, etc.

19.  It states in pertinent part that when a commander believes that a
Soldier not on extended active duty is unable to perform her duties because
of physical disability, the commander will refer the Soldier for medical
evaluation.  The medical treatment facility will forward the medical
evaluation board to the Soldier’s unit commander for disposition under
applicable regulations.

20.  Department of Defense Instruction (DODI) Number 1332.38 states that
members of the Ready Reserve with non-duty-related impairments, and who are
otherwise eligible, will be referred into the disability evaluation system
upon the request of the member or when directed under service regulations.
Referral will be solely for a determination of fitness for duty.

21.  Army Regulation 40-501, chapter 3, gives the various medical
conditions and physical defects which may render a Soldier unfit for
further military service and which fall below required standards for
retention in the Regular Army, Army National Guard, and the Army Reserve.
It states in pertinent part that a member with thromboembolic disease
(pulmonary embolism) will be referred to an MEB when response to therapy is
unsatisfactory, or when therapy is such as to require prolonged, intensive
medical supervision.

22.  DODI Number 1332.38 defines a line of duty investigation as an inquiry
used to determine whether an injury or disease of a member performing
military duty was incurred in a duty status; if not in a duty status,
whether it was aggravated by military duty; and whether incurrence or
aggravation was due to the member’s intentional misconduct or willful
negligence.

23.  Army Regulation 600-8-1 then in effect provides for line of duty (LOD)
investigations and states in pertinent part that LOD investigations are
conducted essentially to arrive at a determination of whether misconduct or
negligence
was involved in the disease, injury, or death and, if so, to what degree.
Depending on the circumstances of the case, an LOD investigation may or may
not be required to make this determination.

      a.  The LOD determination is presumed to be "LOD YES" without an
investigation in the case of disease, except when the injury, disease,
death, or medical condition occurs under strange or doubtful circumstances
or is apparently due to misconduct or willful negligence.


      b.  Investigations can be conducted informally by the chain of command
where no misconduct or negligence is indicated, or formally where an
investigating officer is appointed to conduct an investigation into
suspected misconduct or negligence.

24.  Documentation for an informal LOD investigation typically consists of
DA Form 2173 completed by the MTF (medical treatment facility) and the unit
commander and approved by the appointing authority, State AG, or higher
authority.

DISCUSSION AND CONCLUSIONS:

1.  The evidence is clear that the applicant was unable to complete the
APFT conducted on 7 September 1997 because she had pulmonary embolisms.
Whether or not she had this condition prior to that date is questionable –
two physicians recently stating that her pulmonary embolisms would have
affected her ability to do physical fitness training.

2.  Medical evidence shows that she was diagnosed with pulmonary embolisms
and given a temporary profile because of her condition, limiting her
physical activity.  The 3 May 1998 medical review indicates that she was
unfit for duty and should be referred to a medical review board.

3.  The applicant, however, decided to request a discharge from the Army
National Guard because she felt that her medical condition precluded her
from completing the APFT, attending annual training away from her unit, and
competing with her contemporaries for promotion.  The regimental adjutant,
in recommending her separation, stated that she was requesting this
discharge in lieu of a medical review board.  She was discharged and
transferred to the IRR.

4.  While in the IRR she underwent a physical examination.  The examining
official determined, in effect, that she was physically fit with a physical
profile serial of 1 1 1 1 2 1, noting her blood clots, and also noting that
the applicant stated that she had dizziness dating from 1995.  He also
noted that she was diagnosed with pulmonary emboli in 1997, hospitalized
and treated.

5.  The evidence suggests that the applicant could have undergone a medical
review board if she had not requested discharge from the Army National
Guard.  She herself felt that she was physically unfit to perform certain
tasks; however, and in spite of her temporary profile, she apparently
performed her duties capably subsequent to her hospitalization for
pulmonary embolisms.  Two years after her discharge from the Army National
Guard she was determined to be physically fit as evidenced by the report of
physical examination.  Consequently, there appears to be no error or
injustice done to her by the fact that she was discharged from the Army
National Guard in 1998 and the Army Reserve in 2001.

6.  Nevertheless, on 7 September 1997, the applicant was physically unable
to perform the run portion of the APFT, attended to by medical personnel,
and after resting, was told to go home and see her doctor.  Her duty was
interrupted on this occasion, and an informal line of duty investigation
should have been conducted at that time.  In this respect, the Board agrees
with the advisory opinion provided by the National Guard Bureau.

7.  The evidence holds, however, that the applicant’s condition, pulmonary
embolisms, whether or not existing prior to the date of the APFT, was in
line of duty.  Medical documents; a statement from her former supervisor
and a former comrade as to the events on 7 September 1997, attest to this
line of duty determination.

8.  The applicant’s condition, pulmonary embolism, for which she was
diagnosed in October 1997, required that she be referred to an MEB.

9.  The National Guard Bureau, in the advisory opinion, recommended that
the applicant be returned to active duty.  The applicant, however, was not
on active duty at the time of her discharge from the Army National Guard.
It would appear that the National Guard Bureau is recommending that she be
returned to an active status in the Army National Guard.

10.  The Board agrees.  The applicant should be afforded the opportunity
for an MEB.  In this respect, the National Guard Bureau should return the
applicant to an active status in the Army National Guard for the purpose of
conducting a line of duty investigation and an MEB.

BOARD VOTE:

__JI ____  ___RB __  ___PF___  GRANT FULL RELIEF

________  ________  ________  GRANT PARTIAL RELIEF

________  ________  ________  GRANT FORMAL HEARING

________  ________  ________  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

The Board determined that the evidence presented was sufficient to warrant
a recommendation for relief and to excuse the failure to timely file.  As a
result, the Board recommends:

      a..  that the National Guard Bureau contact the applicant and offer
her the opportunity to return to an active status in the Army National
Guard for the sole purpose of conducting a line of duty investigation and
an MEB; and

      b.  that should the applicant accede to return to an active status in
the Army National Guard, the National Guard Bureau conduct a line of duty
investigation, an MEB, and a PEB if necessary, as recommended by the
advisory opinion.







                                  ______ John Infante______
                                            CHAIRPERSON



                                    INDEX

|CASE ID                 |AR2004106884                            |
|SUFFIX                  |                                        |
|RECON                   |YYYYMMDD                                |
|DATE BOARDED            |20050428                                |
|TYPE OF DISCHARGE       |(HD, GD, UOTHC, UD, BCD, DD, UNCHAR)    |
|DATE OF DISCHARGE       |YYYYMMDD                                |
|DISCHARGE AUTHORITY     |AR . . . . .                            |
|DISCHARGE REASON        |                                        |
|BOARD DECISION          |GRANT                                   |
|REVIEW AUTHORITY        |                                        |
|ISSUES         1.       |108.00                                  |
|2.                      |                                        |
|3.                      |                                        |
|4.                      |                                        |
|5.                      |                                        |
|6.                      |                                        |


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