RECORD OF PROCEEDINGS


      IN THE CASE OF:


      BOARD DATE:        5 JANUARY 2006
      DOCKET NUMBER:  AR20050002596


      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             |
|     |Ms. Deborah L. Brantley           |     |Senior Analyst       |


      The following members, a quorum, were present:

|     |Mr. William Powers                |     |Chairperson          |
|     |Mr. Thomas Ray                    |     |Member               |
|     |Mr. Randolph Fleming              |     |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, in effect, disability retirement vice
disability separation.

2.  The applicant states he received a combined disability rating of only
20 percent under VA (Department of Veterans Affairs) codes 7703, 5099, and
5002. He states he feels the combined rating for the three codes are unjust
and should be higher.  The applicant states he was only rated for one code
for mild graft versus host disease but maintains that while he may be in
remission there is evidence that clearly states the leukemia is still
present in his body.  He cites two positive PCR (Polymerase Chain Reaction)
tests in October 2003 and in July 2004.

3.  He states that his physician stated that the positive PCR test result
meant that the leukemia was still present in his body and would need to be
watched carefully for the next couple of months and maybe for years.  He
states the VA acknowledged his leukemia by granting him a 10 percent
disability rating, which the Army has not.  He states that he should have
had a combined disability rating of 40 percent with independent ratings of
20 percent for code 5002, 10 percent for code 7703, and 10 percent for code
5099.

4.  The applicant provides a copy of his July 2004 TDRL (Temporary
Disability Retired List) summary, a copy of a September 2004 medical
record, and a September 2004 VA rating decision.

CONSIDERATION OF EVIDENCE:

1.  Records available to the Board indicate the applicant entered active
duty in August 1992.  He was promoted to pay grade E-5 in July 1997.  In
April 1999 he successfully completed an Army physical fitness test,
according to information contained on his final performance evaluation
report.

2.  Although there were no documents associated with the applicant’s
initial disability processing, his separation document indicates he was
released from active duty on 4 June 2000 by reason of disability and his
name was placed on the TDRL the following day.

3.  Documents which were available to the Board indicate the applicant was
seen for follow-up in the Bone Marrow Transplant Outpatient Clinic at the
Wilford Hall Medical Center located at Lackland Air Force Base in Texas in
May 2003, November 2003, January 2004, and March 2004.
4.  The May 2003 medical statement notes the applicant was about three and
a half years out from an allogeneic bone marrow transplantation for CML
(Chronic myelogenous leukemia) chronic phase who was being seen in follow-
up.  The evaluating physician noted the applicant was last seen at the
clinic in March of 2003 and at that time a PCR test showed no evidence of
recurrent leukemia.  The physician also noted, however, the applicant was
having chronic ongoing problems from graft versus host disease to include
compromised lung function, fatigue, dry eyes and dry mouth, and frequent
infections due to immunocompromise.  It noted he also had some esophageal
dysfunction due to his chronic graft versus host disease, but that had not
been bothering him lately.

5.  For clarity purposes the following simplified information is provided
from the National Cancer Institute Web site:

      a.  Chronic myelogenous leukemia (CML) is a myeloproliferative
disease that arises from a clonal process involving an early progenitor
hematopoietic stem cell.  Many patients with chronic leukemias are
asymptomatic and their disease is only identified by finding an abnormality
during routine laboratory testing.  These patients may develop
constitutional symptoms such as fatigue, anorexia, weight loss, sweats, and
fever.  With progressive bone marrow involvement and the development of
cytopenias, various infections can occur as well as hemorrhage, anemia-
related symptoms (eg, dyspnea, lightheadedness, and fatigue), and easy
bruising with petechiae and purpura.

      b.  Allogeneic bone marrow transplants involve the patient receiving
stem cells from the brother, sister, or parent, or a person who is not
related to the patient.

      c.  Bone marrow transplant is a therapy commonly used in the
treatment of leukemia and lymphoma.  Bone marrow is the soft, sponge-like
material found inside bones.  It contains immature cells known as
hematopoietic or blood-forming stem cells.  Bone marrow transplantation is
a procedure that restores stem cells that have been destroyed by high doses
of chemotherapy and/or radiation therapy.

      d.  PCR test is a reliable laboratory testing method for detecting
mycoplasmas.  Mycoplasmas are a specific and unique species of bacteria.
Today, over 100 documented species of mycoplasmas have been recorded to
cause various diseases in humans, animals, and plants.  Mycoplasma
pneumonia as well as at least seven other mycoplasma species have now been
linked as a direct cause or significant co-factor to many chronic diseases
including, rheumatoid arthritis, Alzheimer's, multiple sclerosis,
fibromyalgia, chronic fatigue, diabetes, Crohn's Disease, ALS, nongonoccal
urethritis, asthma, lupus, infertility, AIDS and certain cancers and
leukemia, just to name a few.

      e.  Graft versus Host Disease (GVHD) is a frequent complication of
allogeneic bone marrow transplant in which the engrafted donor cells attack
the patient's organs and tissue.  GVHD is two diseases: acute and chronic.
Chronic GVHD usually develops after the third month post-transplant.

6.  The applicant's November 2003 follow-up visit to the Bone Marrow
Transplant Clinic noted the applicant had a positive PCR test on 2 October
2003.  During that visit the attending physician noted the applicant was 4
years status post allogeneic transplant for CML chronic phase who does not
have any GVHD.  A repeat PCR test was done.

7.  The January 2004 follow-up visit noted that the applicant's November
2003 repeat PCR test was negative and that the applicant had no new
complaints, that his overall energy level was good and that he was back in
school.  Another PCR test was administered.

8.  The March 2004 follow-up visit noted that the January 2004 PCR test was
negative, that the applicant was then in no acute distress, with no new
complaints and was there mainly to get a PCR test done.

9.  In June 2004 the applicant was notified that he was to report to Fort
Sam Houston, Texas for a periodic physical examination.  He underwent a
TDRL examination on 9 July 2004.  In the narrative summary associated with
that examination, the examining physician noted that the applicant was a 5
year status post allogeneic bone marrow transplant for chronic phase CML.
It noted the applicant had undergone an allogeneic transplant for chronic
phase CML 5 years ago and developed limited, chronic graft versus host
disease.  The physician noted that overall the applicant had done fairly
well, was able to get back to school, but could not do any sort of daily
physical exertion without experiencing a great degree of fatigue.  The
physician rendered a final diagnosis of CML, chronic phase, 5 years status
post allogeneic transplant with molecular relapse in October 2003, followed
by negative tests since then (TDRL evaluation diagnosis 1) and mild limited
chronic graft versus host disease (TDRL evaluation diagnosis 2).  The
physician recommended the applicant continue to have PCR tests done about
every six months for the next couple of years given the fact that he had a
positive test in 2003.  He noted that otherwise, the applicant's chance for
a relapse requiring more than donor lymphocyte infusion was probably less
than about 10 percent over the next few years.  He concluded the
applicant's main ongoing long-term problem was mild chronic graft versus
host disease.
10.  On 16 August 2004 the applicant concurred with the findings and
recommendation of his TDRL examination, but submitted a statement on his
own behalf.  He noted in his statement that the examining physician had
forgotten to mention that he was taking medication because of his chronic
graft versus host disease, that he still had decreased lung function, and
that he still remained immunocompromised, all of which was related to his
GVHD.  He maintained that the disease will be a debilitating illness
throughout the remainder of his life.

11.  The applicant underwent an informal PEB on 31 August 2004.  The PEB
concluded the applicant's condition, based on his TDRL evaluation diagnosis
1 and 2 and the narrative summary, was considered sufficiently stable for
final adjudication and that the applicant remained unfit to reasonably
perform the duties required by his grade and military specialty.  The PEB
recommended the applicant be separated with severance pay with a 20 percent
rating under VASRD (VA Schedule for Rating Disabilities) Codes 7703, 5099,
and 5002.

12.  The applicant nonconcurred and demanded a formal hearing.

13.  A 9 September 2004 follow-up at the Bone Marrow Transplant clinic
noted the applicant had a positive PCR test in October 2003 followed by
three negative tests and another positive test in July 2004.  A repeat test
was being conduct that day.

14.  Although not available to the Board, there was apparently additional
medical information provided by the Wilford Hall Medical Center on 19
October 2004 which, after careful consideration by the PEB, found that no
change to the original findings were warranted and the additional
information contained no new objective medical or performance evidence that
would result in a change to his 31 August 2004 PEB findings and
recommendation.  It was noted, however, that the additional information
would be included for consideration by the applicant's formal PEB.

15.  A formal PEB convened on 28 October 2004 and based on the TDRL
evaluation diagnosis 1 and 2, the TDRL narrative summary, outpatient notes,
PCR report, sworn testimony and evaluee exhibits, concluded the applicant
had been appropriately rated at 20 percent under VASRD Code 7703, 5099, and
5002.

16.  The applicant submitted a statement of disagreement with the formal
PEB on 5 November 2004 and argued his positive PCR test showed the ongoing
presence of CML in his body and that he would need to be watched closely
for the next couple of years.  He maintains the PEB did not acknowledge his
two relapses and that because of his GVHD he may never have children.

17.  The applicant's rebuttal was reviewed and it was determined that no
change to the original findings was warranted.  It noted the applicant's
rebuttal contained no objective medical information which would warrant
changing his disability rating and that his latest PCR test did not confirm
current malignancy.

18.  The United States Army Physical Disability Agency reviewed the
applicant's disagreement and the findings of the PEB and determined that
the findings and recommendation of the PEB were supported by substantial
evidence and were therefore affirmed.

19.  The applicant indicates in his application that his final disposition
occurred on 23 November 2004.  Records available to the Board, however, do
not contain copies of the order removing the applicant from the TDRL.

20.  In September 2004, prior to the applicant's formal PEB, the VA granted
the applicant a combined disability rating of 30 percent.  His chronic
myelogenous leukemia was independently rated at 10 percent, his decreased
lung function, residual of chronic graft versus host disease and reflux
gastritis, also a residual of chronic graft versus host disease were also
independently rated at 10 percent each.

21.  Army Regulation 635-40, which outlines the polices and provisions for
the physical evaluation of Soldiers for retention, retirement or
separation, states that the VASRD is primarily used as a guide for
evaluating disabilities resulting from all types of disease and injures
encountered as a result of, or incident to, military service.  Because of
differences between Army and VA application of rating policies, difference
in rating may result.  Unlike the VA, the Army must first determine whether
or not a Soldier is fit to reasonably perform the duties of his office,
grade, rank, or ratings.  Once a Soldier is determined to be physically
unfit for further military service, percentage ratings are applied to the
unfitting conditions from the VASRD.  These percentages are applied based
on the severity of the condition.  Military disability ratings are based
upon the degree to which a medical condition affects the ability to perform
duty and not upon the diagnosis or name attached to the condition.  By way
of comparison, the VA can and does rate an individual for pain in many
instances.  The Army can only rate the same painful condition if it impairs
the Soldier’s ability to perform assigned tasks.  The VASRD codes appearing
opposite the listed ratable disabilities are numbers for showing the basis
of the evaluation assigned and for statistical analysis.
22.  Percentage ratings for the Department of Veterans Affairs, however,
represent as far as can practicably be determined the average impairment in
earning capacity resulting from diseases and injuries and their residual
conditions in civil occupations.  Generally, the degrees of disability
specified are considered adequate to compensate for considerable loss of
working time from exacerbations or illnesses proportionate to the severity
of the several grades of disability.  Furthermore, 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.

DISCUSSION AND CONCLUSIONS:

1.  The evidence available to the Board indicates that the applicant's
primary unfitting condition stemmed from his mild limited graft versus host
disease, a residual of his allogeneic transplant which was necessary
because of the applicant's chronic myelogenous leukemia.  Only the
conditions resulting from the mild limited graft versus host disease
rendered the applicant unfit.  The evidence indicates that the applicant's
leukemia, in and of itself, did not render him unfit and therefore would
not have warranted a separate rating.  The fact that the VA chose to rate
that condition independently is also not evidence of any error or injustice
on the part the Army.

2.  The applicant's contention that his two positive PCR tests show the
continued existence of leukemia in his body and that his remission may be
only temporary or become permanent is also not something which would
require the Army to render an independent rating for that condition.  The
Army's rating is a snapshot in time, based on whether a condition rendered
an individual unfit at the time the evaluation was conducted.  Army ratings
are not intended to project into the future.  Future limitations or
manifestations of previous conditions fall under the purview of the VA
which can evaluate a veteran throughout his or her lifetime and adjust the
percentage of disability accordingly.

3.  The applicant has provided no compelling medical evidence or arguments
which show that the Army's final rating in October 2004 was in error or
unjust.

4.  The rating action by the VA does not necessarily demonstrate any error
or injustice in the Army rating.  The VA, operating under its own policies
and regulations, assigns disability ratings as it sees fit.  Any rating
action by the VA does not compel the Army to modify its rating.



5.  In order to justify correction of a military record the applicant must
show, or it must otherwise satisfactorily appear, that the record is in
error or unjust.  The applicant has failed to submit evidence that would
satisfy that requirement.

6.  In view of the foregoing, there is no basis for granting the
applicant's request.

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF

________  ________  ________  GRANT PARTIAL RELIEF

________  ________  ________  GRANT FORMAL HEARING

__WP ___  __TR ___  __RF ___  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.





                                  _____ William Powers________
                                            CHAIRPERSON



                                    INDEX

|CASE ID                 |AR20050002596                           |
|SUFFIX                  |                                        |
|RECON                   |YYYYMMDD                                |
|DATE BOARDED            |20060105                                |
|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.                      |                                        |


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