RECORD OF PROCEEDINGS


      IN THE CASE OF:


      BOARD DATE:        01 MARCH 2005
      DOCKET NUMBER:  AR20040002443


      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. Walter Morrison               |     |Chairperson          |
|     |Mr. Robert Duecaster              |     |Member               |
|     |Mr. Antonio Uribe                 |     |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.  The applicant requests physical disability retirement.  He requests
that his     10 percent disability rating and separation with severance pay
be changed to a 30 percent disability rating with physical disability
retirement.

2.  The applicant states that the 10 percent disability rating he received
for fibromyalgia was inconsistent with the Department of Veterans Affairs
Schedule for Rating Disabilities (VASRD).  The Physical Evaluation Board
(PEB) did not rate him fairly according to the Department of Defense
Instructions (DODI) and the VASRD.

3.  The applicant provides a copy of a portion of a 17 December 2003 PEB
proceedings, a copy of a 14 December 2002 report of a psychiatry
consultation, a copy of a 10 November 2003 MEB (Medical Evaluation Board)
consultation, copies of pages extracted from DODI 1332.39, and a page
extracted from the VASRD.

CONSIDERATION OF EVIDENCE:

1.  The applicant enlisted in the Army for three years on 17 July 2001,
completed training as a supply specialist, and in December 2001 was
assigned to Fort Lewis, Washington.  He was promoted to pay grade E-4 on 17
July 2003.  On    27 February 2004 he was discharged in the grade of E-4
with a disability rating of 10 percent and awarded $8973.00 in severance
pay.

2.  The medical records available to this Board are those submitted by the
applicant.

3.  A 10 November 2003 consultation report prepared by the Rheumatology
Clinic at Madigan Army Medical Center in Tacoma, Washington, shows that the
applicant had a MEB consultation for chronic lower back pain and piriformis
syndrome, and was now being seen with complaints of two months of diffuse
muscle aching without joint effusions, erythema, or skin rash.  The report
indicated that the applicant claimed a history of muscle pain as well as
joint tenderness occurring for an extended period of time, although worse
over the last year.  He reported having a back injury, and had problems
ever since, and had seen multiple doctors for his complaints.  He now
reported pain to various parts of his body, which he stated was constant,
and had not improved.  He reported problems with dressing himself, eating
and drinking and walking outdoors.  He stated that he had difficulty
getting in and out of bed, washing and drying his entire body, bending down
to pick up clothing, or walking two miles.  He stated that he had feelings
of depression and anxiety, for which he had seen mental health [personnel].
 He stated that his fatigue was significant, that he was unable to do
almost anything at work and had been on a very limited profile.  He stated
that he did occasionally walk or swim, and that he exercised about one or
two times per week.  He stated that he had been on several medications to
deal with his pain.

4.  The examining physician stated that the applicant was an overweight
Soldier in no acute distress.  He presented himself to the clinic using a
cane to walk with, stating that he occasionally had numbness involving his
right leg.  He was noted to have tenderness at multiple points on
palpation; however, there was no evidence of synovitis.  His range of
motion was generally full throughout; although he did have some difficulty
with abduction and forward flexion of his shoulders.  When given adequate
time, he was able to have full range of motion of those joints.  He was
noted to have myofascial tender points.  Fibromyalgia tender points were
positive at 18/18 locations.  The neurological examination indicated that
he had full strength throughout.  The hip examination was significant for
some limitation in internal and external rotation bilaterally.  Imaging
studies were generally unremarkable.  The physician stated that the
applicant was currently being evaluated for obstructive sleep apnea, which
could cause similar symptoms.  He indicated that the applicant’s response
to certain medications had been relatively poor, and that his only
improvement had been with hydrocodone.  The physician stated that based on
the applicant’s chronic pain complaints and his inability to perform his
job, as well as perform his physical training, he did not meet the criteria
for retention in the Army because of fibromyalgia.  He recommended that the
applicant not be limited from doing any strengthening exercises, and stated
that the applicant should be able to walk, bicycle, and swim at his own
pace and distance, march up to two miles, as well as lift up to 20 pounds.
He recommended treatment regimens to include regular aerobic exercises and
other exercises as well.  He recommended the use of certain medications.

5.  On 14 November 2003 the applicant was evaluated by a psychiatrist as
part of an MEB appeal process, because of a history of depression
associated with his physical disability.  The examining psychiatrist
diagnosed the applicant’s condition as major depressive disorder manifested
by insomnia, anhedonia, sad mood, fatigue, low energy, problems with
concentration, and feelings of hopelessness, helplessness, and
worthlessness.  He stated that there was some suicidal ideation, but no
specific plans.  The approximate date of origin was in 2002.  He stated
that the applicant’s present condition was stable with chronic depression
and chronic pain, and that he could be managed in an outpatient setting.

6.  On 17 December 2003 a formal PEB found that the applicant was
physically unfit because of fibromyalgia and recommended that he be
separated with a     10 percent disability rating.  The board indicated
that the applicant had an onset of mild symptoms approximately two years
ago; however, an official diagnosis by rheumatology was not made until
quite recently.  His condition was manifested by generalized body pain with
18/18 tender points, as well as tender control points.  The board stated
that there was superimposed a specified low back injury by being struck in
the back by wall lockers; however, extensive examinations found little
evidence of specific back pathology, with normal range of motion reported,
as well as no radiculopathy.  It indicated that the applicant had been
diagnosed with depression, but stated that was an expected association with
fibromyalgia.  The PEB indicated that the other conditions listed as
medical board diagnoses were considered by the PEB and found to be not
unfitting and not ratable.  The PEB indicated that this was an
administrative correction to the formal PEB to reflect his current rank as
private first class.

7.  The portion of the PEB proceedings which would indicate whether or not
the applicant concurred in the PEB decision is not available to the Board.
Nor are the informal PEB proceedings or any of the MEB proceedings
available.

8.  Congress established the VA Schedule for Rating Disabilities (VASRD) as
the standard under which percentage rating decisions are to be made for
disabled military personnel.  Percentage ratings in the VASRD represent the
average loss in earning capacity resulting from diseases and injuries.  The
ratings also represent the residual effects of these health impairments on
civil occupations.

9.  Part 4, paragraph 4.1 of the VASRD states that the rating schedule is
primarily a guide in the evaluation of disability resulting from all types
of diseases and injuries encountered as a result of or incident to military
service.  The percentage ratings represent as far as can practicably be
determine the average impairment in earning capacity resulting from such
disease and injuries and their residual conditions in civil occupations.

10.  Diagnostic code numbers appearing opposite the listed ratable
disabilities in the VASRD are arbitrary numbers for the purpose of showing
the basis of the evaluation assigned and for statistical analysis by the
VA, and extend from 5000 to a possible 9999.  When an unlisted disease,
injury, or residual condition is encountered, requiring rating by analogy,
the diagnostic code number will be “built up.”  The first 2 digits will be
selected from that part of the schedule most closely identifying the part,
or system, of the body involved; the last 2 digits will be “99” for all
unlisted conditions.

11.  The rating for fibromyalgia as shown in the VASRD ranges from a high
of    40 percent to 10 percent.

12.  DODI 1332.39 provides instructions for specific VASRD codes, to
include fibromyalgia, and states that fibromyalgia is a syndrome of
chronic, and widespread musculoskeletal pain associated with multiple
tender or “trigger” points, and is often accompanied by multiple somatic
complaints.  It is a condition for which diagnostic criteria were formally
established in 1990.

DISCUSSION AND CONCLUSIONS:

1.  Notwithstanding the applicant’s contentions and the information he
submits, he has not provided evidence that the 10 percent disability rating
given him was incorrect or unjust.  He had pain, fibromyalgia; however, the
available evidence is insufficient to refute the rating decision given by
the December 2003 PEB.  He has not shown to the satisfaction of this Board
that his disability rating was improper.

2.  The applicant has submitted neither probative evidence nor a convincing
argument in support of his request.

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF

________  ________  ________  GRANT PARTIAL RELIEF

________  ________  ________  GRANT FORMAL HEARING

___WM__  ___RD __  ___AU __  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

The evidence presented does not demonstrate the existence of a probable
error or injustice.  Therefore, the Board determined that the overall
merits of this case are insufficient as a basis for correction of the
records of the individual concerned.





                                  _____Walter Morrison_______
                                            CHAIRPERSON



                                    INDEX

|CASE ID                 |AR20040002443                           |
|SUFFIX                  |                                        |
|RECON                   |YYYYMMDD                                |
|DATE BOARDED            |20050301                                |
|TYPE OF DISCHARGE       |(HD, GD, UOTHC, UD, BCD, DD, UNCHAR)    |
|DATE OF DISCHARGE       |YYYYMMDD                                |
|DISCHARGE AUTHORITY     |AR . . . . .                            |
|DISCHARGE REASON        |                                        |
|BOARD DECISION          |DENY                                    |
|REVIEW AUTHORITY        |                                        |
|ISSUES         1.       |108.00                                  |
|2.                      |                                        |
|3.                      |                                        |
|4.                      |                                        |
|5.                      |                                        |
|6.                      |                                        |


-----------------------
[pic]