BOARD DATE:	  10 January 2012

		DOCKET NUMBER:  AR20110010979 


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 reconsideration of his previous application for correction of his record to show he was retired due to physical disability.

2.  He states the three medical conditions for which he was found unfit were "lumped together and not treated separately and rated accordingly."  He also contends that each diagnosis was incorrect.  

	a.  Regarding his diagnosis of chronic tendonitis of the left supraspinatus tendon, he states further diagnosis by the Department of Veterans Affairs (VA) between January and July 1994 indicated impingement and a possible rotator cuff tear.  After many visits to the orthopedic clinic, an arthrogram (magnetic resonance imaging (MRI)) was ordered and revealed a large partial rotator cuff tear.  According to the Proceedings in the previous consideration of his case, no revision was found to be warranted because the VA listed the claim for shoulder bursitis and not the actual injury itself.  He argues that a different medical condition would have resulted in a different medical evaluation code and more likely than not a higher disability rating.

	b.  Regarding his diagnosis of chronic tendonitis of the left patellar tendon, further examination proved it to be a chronic anterior cruciate ligament tear.  

	c.  The Medical Evaluation Board (MEB) failed to address his left ankle which was part of his permanent change of physical profile.  Addressing the ankle issue would have changed his rating.  X-rays from the VA revealed more than just a sprain, but old fractures.
	d.  The MEB failed to address other conditions that were granted service connection that could also have resulted in a higher rating.  Other conditions include his right ankle, the C-spine (his neck), the right Achilles tendon, and his lower back.  Each condition should have been considered when the MEB reviewed the evidence to determine his fitness for military duty.

3.  He provides 17 documents identified in a list.  

CONSIDERATION OF EVIDENCE:

1.  Incorporated herein by reference are military records which were summarized in the previous consideration of the applicant's case by the Army Board for Correction of Military Records (ABCMR) in Docket Number AR20100014685, on 4 January 2011.

2.  The applicant has provided documents which were not previously considered by the Board and warrant consideration at this time. 

3.  The applicant enlisted in the Regular Army on 2 March 1983.  After he completed initial entry training, he was awarded military occupational specialty (MOS) 54B (Chemical Operations Specialist). 

4.  A Medical Board Summary he provided in support of his previous application shows he underwent a physical examination on 2 September 1992.  

   a.  At the time, he stated he had constant pain in his left knee, pain in his left heel, and constant pain in his left shoulder.  The document shows he was unable to run, jump, march, lift, or carry anything over 20 pounds.  He could not participate in normal physical training or perform his MOS duties without pain.  
   
   b.  His complaint of left knee pain was first documented on 26 April 1984.  He was diagnosed with ligamentous strain and treated with nonsteroidal anti-inflammatories and rest.  He was seen for the same complaint on 23 October 1986, received the same diagnosis, and again treated with nonsteroidal anti-inflammatories and rest.  He was seen again on 11 December 1986 and referred to physical therapy for strengthening exercises.  In September 1990, he was diagnosed with patellofemoral syndrome of the left knee, which was treated with nonsteroidals and rest.  He was seen again in July 1991, received the same diagnosis and treatment, and was referred to orthopedics.  On 30 July 1991, he was diagnosed with jumper's knee and referred to physical therapy for rehabilitation.
   
	c.  He was first seen for left ankle pain in October 1987.  He was diagnosed with Achilles tendonitis and treated with rest and nonsteroidals.  

	d.  He was first treated for left shoulder pain on 2 August 1991.  He was diagnosed with tendonitis and treated with nonsteroidals and rest.

	e.  On 17 July 1992, he was diagnosed with chronic tendonitis of the left Achilles tendon and left shoulder and patellofemoral syndrome of the left knee.  At that time he was recommended for a permanent physical profile and referred to an MEB.

5.  MEB Proceedings he provided in support of his previous application show, on 29 December 1992, an MEB diagnosed him to have chronic tendonitis of the left supraspinatus tendon, left patellar tendon, and left Achilles tendon, and recommended that he be referred to a Physical Evaluation Board (PEB).  He concurred with the MEB findings and recommendation.

6.  A DA Form 199 (PEB Proceedings) he provided in support of his previous application shows a PEB convened to consider his case on 21 January 1993.  The PEB found him unfit due to tendonitis, chronic of the left supraspinatus tendon, left patellar tendon, and left Achilles tendon.  The PEB rated the diagnosed condition as 10 percent (%) disabling and recommended he be separated with severance pay.  

7.  On 28 January 1993, he concurred with the PEB findings and recommendation and waived a formal hearing of his case.  

8.  On 18 February 1993, he was honorably discharged due to physical disability with severance pay.  He completed 9 years, 11 months, and 17 days of active military service.

9.  The applicant provides:

	a.  Consultation Sheets showing:

		(1)  on 11 May 1992, he was given a provisional diagnosis of rotator cuff tendonitis.

		(2)  on an unknown date, he was referred to physical medicine and rehabilitation (PM&R) for evaluation of subacromial impingement in his left shoulder and taught rotator cuff strength exercises.


		(3)  on 16 April 1993, he was referred to the orthopedic clinic for further examination of a neck strain, lower back strain, left shoulder pain, left knee pain, a left ankle sprain, heel spurs, and his left Achilles.

	b.  A Physical Profile, dated 17 July 1992, showing he was diagnosed with chronic tendonitis of the left supraspinatus (shoulder), left patellar tendon (knee), and left Achilles tendon (ankle).  This form shows he was not to be assigned to duties requiring running, jumping, or marching, and he was to limit lifting and carrying over 20 pounds.

	c.  A VA Medical Certificate, dated 14 January 1994, showing he was seen for left shoulder pain.

	d.  A VA Service Treatment Plan, dated 17 May 1994, showing he was seen for left shoulder pain, diagnosed with subacromial impingement, prescribed nonsteroidal anti-inflammatories, and referred to PM&R for rotator cuff strengthening exercises.

	e.  Radiology Diagnostic Reports showing:

		(1)  On 20 August 2000, an MRI examination of his left shoulder showed evidence of tendonosis of the supraspinatus tendon and no evidence of rotator cuff tear.

		(2)  On 20 August 2000, an MRI showed degenerative changes in the meniscus of his left knee, no evidence of a tear involving the articular surface of the meniscus, intact anterior and posterior cruciate ligaments, and no abnormalities in the patellar tendon complex, medial and lateral collateral ligaments.

		(3)  On 16 November 2000, examination of his left ankle indicated a probable old fractured medial malleolus and calcaneal spurring.

		(4)  On 9 May 2001, examination of his cervical spine and lumbosacral spine showed cervical spine anterior degenerative change and disc narrowing at multiple levels compatible with degenerative disc disease and mild L4-5 posterior disc narrowing an minimal anterior degenerative change.

		(5)  On 20 July 2001, an arthrogram of his left shoulder showed evidence of a large partial rotator cuff tear.

		(6)  On 4 November 2003, bilateral examination of his knees found minimal degenerative changes.
		(7)  On 4 November 2003, bilateral examination of his ankles found evidence of probable old fractures in his right and left ankles.

	f.  A VA Rating Decision, dated 28 September 2004, showing he was granted service-connection for:

		(1)  left shoulder tendonitis rated at 20% from 1 May 2000.

		(2)  degenerative joint disease, medial and lateral meniscus, left knee, rated at 20% from 1 May 2000.

		(3)  left ankle sprain rated at 0% from 19 February 1993 and 20% from 16 November 2000.

		(4)  cervical spine degenerative joint disease with cervical strain rated at 0% from 19 February 1993 and 20% from 26 September 2001.

		(5)  degenerative joint disease of the lumbar spine rated at 20% from 26 September 2001.

		(6)  hypertension rated at 10% from 16 April 1993.

		(7)  tinnitus rated at 10% from 10 June 1999.

	g.  An Operative Report showing, on 24 January 2005, he underwent surgery for repair of the supraspinatus tendon, subacromial decompression and resection of the coracoacromial ligament, debridement of the subscapularis tendon and superior labrum, and insertion of a pain pump.

	h.  A record of an examination of his left knee, dated 10 November 2005, showing he was diagnosed with a chronic anterior cruciate ligament (ACL) tear and referred for an MRI.

	i.  A record of an MRI examination of his left knee, dated 16 November 2005, showing evidence of a high-grade ACL tear.

10.  Title 10, U.S. Code, section 1203, provides for the physical disability separation of a member who has an impairment rated at less than 30% disabling.  It further provides at section 1201 for the physical disability retirement of a member who has an impairment rated at least 30% disabling.

11.  Title 38, U.S. Code, sections 310 and 331, permit the VA to award compensation for a medical condition which was incurred in or aggravated by active military service.  The VA, however, is not empowered by law to determine medical unfitness for further military service.  The VA, in accordance with its own policies and regulations, awards compensation solely on the basis that a medical condition exists and that said medical condition reduces or impairs the social or industrial adaptability of the individual concerned.  Consequently, due to the two concepts involved, an individual's medical condition, although not considered physically unfitting for military service at the time of processing for separation, discharge, or retirement, may be sufficient to qualify the individual for VA benefits based on an evaluation by that agency.

DISCUSSION AND CONCLUSIONS:

1.  The available records show the applicant was medically discharged after receiving a 10% disability rating from a PEB for the diagnosis of chronic tendonitis of his left supraspinatus tendon, left patellar tendon, and left Achilles tendon.  He was fully aware of the unfitting conditions with which he had been diagnosed, and he concurred with the MEB and PEB findings and recommendations that led to his medical discharge.  

2.  Several years after he was discharged, he was diagnosed with a rotator cuff tear in his left shoulder and an ACL tear in his left knee.  The available records show no evidence that these conditions existed during his military service.  

3.  The VA granted him service-connected disability ratings for cervical spine degenerative joint disease with cervical strain and degenerative joint disease of the lumbar spine; however, the available records do not show he complained of symptoms of these conditions prior to being referred to an MEB/PEB or that these conditions could be detected by medical personnel at that time.  

4.  An Army disability rating is intended to compensate an individual for interruption of a military career after it has been determined that the individual suffers from an impairment that disqualifies him or her from further military service.  The VA, which has neither the authority nor the responsibility for determining physical fitness for military service, awards disability ratings to veterans for conditions that it determines resulted from or were exacerbated by military service and subsequently affect the individual's social or industrial adaptability.  Furthermore, the VA can evaluate a veteran throughout his or her lifetime, adjusting the percentage of disability based upon that agency's examinations and findings.  It is common for the VA to make new diagnoses as a 


veteran ages and incurs new disabling conditions or experiences the progression of previously existing disabling conditions.  

5.  In the absence of evidence showing an error or injustice in the applicant's medical discharge processing, there is no basis for granting the relief he requests.  

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF 

________  ________  ________  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

___x__  _x_______  ____x____  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 to amend the decision of the ABCMR set forth in Docket Number AR20100014685, dated 4 January 2011.



      _________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)                                         AR20110010979



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ABCMR Record of Proceedings (cont)                                         AR20110010979



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