IN THE CASE OF:	  

		BOARD DATE:	    24 March 2011

		DOCKET NUMBER:  AR20100013076 


THE BOARD CONSIDERED THE FOLLOWING EVIDENCE:

1.  Application for correction of military records (with supporting documents provided, if any).

2.  Military Personnel Records and advisory opinions (if any).


THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE:

1.  The applicant requests reinstatement to active duty for medical treatment and evaluation by a Medical Evaluation Board (MEB) for lymphoma.  

2.  He states he was discharged without an evaluation of his severe medical diagnosis of lymphoma.  

3.  He provides medical documentation and a memorandum, dated 15 March 2010, from a physician on the Staff Attending Hematology Oncology Service, Department of Medicine, Tripler Army Medical Center (TAMC).  

CONSIDERATION OF EVIDENCE:

1.  The applicant completed prior service in the U.S. Army Reserve from 13 May 1998 to 12 February 2001.  He enlisted in the Regular Army on 13 February 2001 and continued to serve on active duty through two reenlistments.  

2.  He served in Iraq from 6 April 2003 to 29 April 2004, Kuwait from 28 October 2005 to 24 October 2006, and Iraq from 15 October 2008 to 15 October 2009.  

3.  A review of his medical documentation shows he was evaluated at TAMC on 9 January 2010 for complaints of a sore throat and swelling of his jaw and face.  His Standard Form 600 (Chronological Record of Medical Care) indicated he had a subjective moderate fever with chills and a mild nonproductive cough.  

4.  On 10 January 2010, he had a computerized tomography (CT) of the soft tissue of his neck.  The findings revealed concern for lymphoma.  He spoke with a radiologist and he was told his neck CT was consistent with lymphoma.  The radiologist advised him that the diagnosis was not definite and further studies needed to be done.  

5.  On 13 January 2010, he was referred to the Ear, Nose, and Throat Clinic for lymphadenopathy.  

6.  On 30 January 2010, he was honorably discharged under the provisions of chapter 4, Army Regulation 635-200 (Personnel Separations), by reason of completion of required active service.  

7.  On 12 February 2010, he had a right cervical lymph node biopsy to diffuse his large B cell lymphoma with mixed anaplastic features.  

8.  A memorandum addressed to the Headquarters, Department of the Army, G-1 Retention Office, dated 15 March 2010, from a physician on the Staff Attending Hematology Oncology Service, TAMC requested that the applicant be reinstated to active duty to establish appropriate medical care.  The physician stated:  

   a.  The applicant was currently under the care of the Hematology/Oncology Clinic at TAMC for stage IVB lymphoma and he was being treated with chemotherapy.
   
   b.  The applicant was being evaluated for this disease prior to discharge from active service on "31" January 2010.
   
   c.  The applicant had a fine needle aspiration performed on 13 January 2010 on several of his enlarged neck nodes.  On 15 January 2010, a final report was issued that supported a diagnosis of lymphoma, but a larger piece of tissue was required for a more precise diagnosis.  
   
	d.  A definitive diagnosis was not established by 31 January 2010 as the applicant was in the process of a full evaluation for lymphoma.  A definitive diagnosis was rendered on 8 February 2010 and curative therapy was initiated on 22 February 2010 that will last for 6 to 8 months.

9.  In the processing of this case, an advisory opinion was obtained from the Director, Health Policy and Services, Office of the Surgeon General, Falls Church, VA.  This office stated the applicant had a past medical history of a concussion and post traumatic stress symptoms.  This office opined that there was no documentary evidence the applicant received any administrative counseling regarding the effect of the cancer on his discharge until after he was separated from the Army.  This office supports the issuance of invitational orders to the applicant so that he may return to active duty for treatment "with the qualification that the Soldier be counseled as to which situation (active duty versus VA [Department of Veterans Affairs] with 100 percent disability) would be the most advantageous for him.”  

10.  He was provided a copy of the advisory opinion to allow him to provide comments or a possible rebuttal; however, he did not respond within the allotted timeframe.   

11.  Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) governs the evaluation of physical fitness of Soldiers who may be unfit to perform their military duties because of physical disability.  The unfitness is of such a degree that a Soldier is unable to perform the duties of his office, grade, rank or rating in such a way as to reasonably fulfill the purposes of his employment on active duty.  

12.  Army Regulation 635-40 states a Soldier whose normal scheduled date of nondisability retirement or separation occurs during the course of hospitalization may, with his or her consent, be retained in the service until he or she has attained maximum hospital benefits and completion of disability evaluation if otherwise eligible for referral into the disability system.

DISCUSSION AND CONCLUSIONS:

1.  The applicant’s contention that he was discharged without an evaluation of a severe medical diagnosis of lymphoma is acknowledged and supported by the available evidence.  

2.  The evidence shows he began an evaluation for lymphoma on 13 January 2010.  However, he was not diagnosed with this disease prior to discharge on
30 January 2010.  It also appears he was not afforded the opportunity to be retained on active duty to complete the medical evaluation.

3.  In the 15 March 2010 memorandum, the physician stated that a definitive diagnosis of lymphoma was made on 8 February 2010 and the applicant was under the care of the Hematology/Oncology Clinic at TAMC for stage IVB lymphoma and he was being treated with chemotherapy.



4.  Based on the advisory opinion recommendation from the Office of the Surgeon General, the applicant should be issued invitational travel orders to return to active duty for medical treatment.  In addition, he should be afforded the opportunity to have his medical fitness determined by an MEB/Physical Evaluation Board for lymphoma if he is found to be unfit for retention.  

BOARD VOTE:

___X_____  ___X_____  __X__  GRANT FULL RELIEF 

________  ________  ________  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

________  ________  ________  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

1.  The Board determined that the evidence presented was sufficient to warrant a recommendation for relief.  As a result, the Board recommends that all Department of the Army records related to this case be corrected by voiding the applicant’s 30 January 2010 discharge and restoring him to active duty with all due pay and allowances.

2.  That the applicant be evaluated by a MEB as soon as he is restored to active duty.   




      _______ _  X_______   ___
               CHAIRPERSON
      
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.

ABCMR Record of Proceedings (cont)                                         AR20100013076



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ABCMR Record of Proceedings (cont)                                         AR20100013076



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