IN THE CASE OF:	  

		BOARD DATE:	  11 June 2013

		DOCKET NUMBER:  AR20120019619 


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 correction of his records to show he was medically retired.

2.  The applicant states an Army doctor missed and did not diagnose his stage III colon cancer which was diagnosed 18 days after his discharge.  While he was stationed at Fort Lewis, WA, he was seen by numerous Army doctors for pain complaints and he was told he was fine.

3.  The applicant provides:

* U.S. Military Entrance Processing Command (USMEPCOM) 
Form 680-3A-E (Request for Examination)
* USMEPCOM Form 40-8-1-R-E (Human Immunodeficiency Virus (HIV) Antibody Testing Acknowledgement Form)
* USAMEPCOM Accession Verification Packet List
* DD Form 2005 (Privacy Act Statement – Health Care Records)
* 2008 DD Form 2808 (Report of Medical Examination)
* 2008 DD Form 2807-1 (Report of Medical History)
* 2008 DD Form 2807-2 (Medical Prescreen of Medical History Report)
* two DD Forms 2870 (Authorization for Disclosure of Medical or Dental Information)
* 2008 Puget Sound Region Medical Treatment Facilities Patient Cumulative Report (7 pages)
* 2008 Madigan Army Medical Center Radiologic Examination Report (4 pages)
* 2008 and 2009 Chronological Record of HIV Testing (Continuation) sheets
* 2008 permanent change of station orders
* Vaccine Administration Record
* Individual Readiness Record
* Madigan Army Medical Center Form 10006-B (Influenza Immunization Employee Screening and Order Form)
* two Standard Forms 600 (Chronological Record of Medical Care – Smallpox Vaccination Initial Note Page 1 and 2)
* Vaccine Administration Record
* DD Form 2766 (Adult Preventive and Chronic Care Flowsheet) (4 pages)
* DD Form 2215E (Reference Audiogram)
* Standard Form 600 (Chronological Record of Medical Care – Hearing Conservation Disposition)
* DA Form 4700 (Medical Record – Supplemental Medical Data)
* two Post-Deployment Health Assessments
* 17 Standard Forms 600 (Health Record – Chronological Record of Medical Care)
* 2011 Radiology Results
* 2011 Consultation Note
* 2011 Surgical Pathology Report
* two 2011 Operative Reports
* 2011 Diagnosis and Treatment Summary
* email correspondence authorizing release of notes contained in his medical records
* patient photograph of himself

CONSIDERATION OF EVIDENCE:

1.  The applicant was born on 31 July 1981.  He enlisted in the Regular Army on 2 April 2008 for a period of 3 years and 16 weeks.  He completed training and was awarded military occupational specialty (MOS) 11B (Infantryman).  He served in Iraq from 12 September 2009 through 28 August 2010.

2.  He was honorably released from active duty in pay grade E-4 on 22 July 2011 under the provisions of Army Regulation 635-200 (Active Duty Enlisted Administrative Separations), chapter 4, for completion of required active service after completing 3 years, 3 months, and 21 days of net active service with no lost time.  He was transferred to the U.S. Army Reserve Control Group (Reinforcement).

3.  The applicant provides his entrance and medical examinations, documentation pertaining to his entrance testing and vaccine administration record, and disclosure documents for his medical and dental information.

4.  The applicant provides 17 Standard Forms 600, dated between 4 April 2008 and 17 February 2011, which show he sought and received medical treatment for abrasion and blisters on his feet, urethritis, on and off shoulder pain, gastrointestinal symptoms, and left wrist pain between those dates.  These forms also report histories for his annual, pre and post-deployment, and routine vision examinations.

5.  The applicant provides a Consultation Note, dated 9 August 2011, which shows he was seen in an emergency room for left flank pain radiating to the left lower quadrant that had been intermittent for about the last year.  It noted he had episodes of grossly bloody stool very recently.

6.  The applicant provides a Surgical Pathology Report, dated 11 August 2011, which shows he was rendered a pre-operative diagnosis of a colonic mass.

7.  The applicant provides two Operative Reports, dated 15 August and 8 September 2011, which show he underwent an upper endoscopy and colonoscopy and a left hemicolectomy.

8.  The applicant provides a Diagnosis and Treatment Summary, dated 7 September 2011, which shows he was first diagnosed with colon cancer in September 2011 and was being seen for consideration of the need of adjuvant chemotherapy.

9.  Army Regulation 635-200 sets forth the basic authority for the separation of enlisted personnel.  Paragraph 4-2 provides for the discharge or release from active duty upon completion of periods of active duty or active duty for training.

10.  Title 10, U.S. Code, chapter 61, provides the Secretaries of the Military Departments with authority to retire or discharge a member if they find the member unfit to perform military duties because of physical disability.  The U.S. Army Physical Disability Agency, under the operational control of the Commander, U.S. Army Human Resources Command (HRC), is responsible for administering the Physical Disability Evaluation System (PDES) and executes Secretary of the Army decision-making authority as directed by Congress in chapter 61 and in accordance with Department of Defense Directive 1332.18 and Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation).

	a.  The objectives of the system are to:

* maintain an effective and fit military organization with maximum use of available manpower
* provide benefits for eligible Soldiers whose military service is terminated because of a service-connected disability
* provide prompt disability processing while ensuring that the rights and interests of the government and the Soldier are protected

	b.  Soldiers are referred to the PDES:

* when they no longer meet medical retention standards in accordance with Army Regulation 40-501 (Standards of Medical Fitness), chapter 3, as evidenced by a medical evaluation board (MEB)
* receive a permanent physical profile rating of 3 or 4 and are referred by an MOS Medical Retention Board
* are command-referred for a fitness-for-duty medical examination
* are referred by the Commander, HRC

	c.  The PDES assessment process involves two distinct stages:  the MEB and the physical evaluation board (PEB).  The purpose of the MEB is to determine whether the service member's injury or illness is severe enough to compromise his/her ability to return to full duty based on the job specialty designation of the branch of service.  A PEB is an administrative body possessing the authority to determine whether a service member is fit for duty.  A designation of "unfit for duty" is required before an individual can be separated from the military because of an injury or medical condition.  Service members who are determined to be unfit for duty due to disability are either separated from the military or are permanently retired depending on the severity of the disability and length of military service.  Individuals who are separated receive a one-time severance payment while veterans who retire based upon disability receive monthly military retirement payments and have access to all other benefits afforded to military retirees.

	d.  The mere presence of a medical impairment does not in and of itself justify a finding of unfitness.  In each case, it is necessary to compare the nature and degree of physical disability present with the requirements of the duties the Soldier may reasonably be expected to perform because of his/her office, grade, rank, or rating.  Reasonable performance of the preponderance of duties will invariably result in a finding of fitness for continued duty.  A Soldier is physically unfit when a medical impairment prevents reasonable performance of the duties required of the Soldier's office, grade, rank, or rating.

11.  Army Regulation 635-40 establishes the Army PDES and sets forth policies, responsibilities, and procedures that apply in determining whether a Soldier is unfit because of physical disability to reasonably perform the duties of his/her office, grade, rank, or rating.  Only the unfitting conditions or defects and those which contribute to unfitness will be considered in arriving at the rated degree of incapacity warranting retirement or separation for disability.

12.  Army Regulation 40-501 governs medical fitness standards for enlistment, induction, appointment (including officer procurement programs), retention, and separation (including retirement).  For an individual to be found unfit by reason of physical disability, he/she must be unable to perform the duties of his/her office, grade, rank, or rating.  Members with conditions listed in this regulation are considered medically unfit for retention on active duty and are referred for disability processing.  Once a determination of physical unfitness is made, the PEB rates all disabilities using the Department of Veterans Affairs Schedule of Rating Disabilities.  Ratings can range from 0 percent to 100 percent, rising in increments of 10 percent.

13.  Army Regulation 40-501, paragraph 3-42, provides for referral to an MEB for malignant neoplasms that are unresponsive to therapy or when the residuals of treatment are in themselves unfitting under other provisions of this chapter and for malignant neoplasms, when on evaluations for administrative separation or retirements, the observation period subsequent to treatment is deemed inadequate in accordance with accepted medical principles.

14.  Title 10, U.S. Code, section 1201, provides for the physical disability retirement of a member who has at least 20 years of service or a disability rating of at least 30 percent.  Title 10, U.S. Code, section 1203, provides for the physical disability separation of a member who has less than 20 years of service and a disability rating of less than 30 percent.

DISCUSSION AND CONCLUSIONS:

1.  The applicant's contentions were carefully considered.

2.  The evidence of record shows the applicant was 26 years and 9 months of age when he was seen by military doctors between April 2008 and February 2011 for various medical conditions, including abrasion and blisters on his feet, urethritis, on and off shoulder pain, gastrointestinal symptoms, and pain in his left wrist.  It appears, based on his age, general health, and stated medical problems, testing for cancer was a matter of concern.  On 22 July 2011, he was released from active duty by reason of the expiration of his term of service (ETS).

3.  In August 2011, he was seen in a civilian emergency room for left flank pain and recent blood in his stools.  He was subsequently diagnosed with colon cancer and underwent a left hemicolectomy.  In September 2011, his need for adjuvant chemotherapy due to positive lymph nodes was noted.

4.  While the Board is empathetic of his current medical condition and the timing of his symptoms with his ETS, there is no evidence of record and he did not provide sufficient evidence that shows he was misdiagnosed during his active duty service.  Given his young age, colon cancer would not have been a typical condition to test for.  The available documents show the applicant had multiple medical encounters in his last 6 months of service, but none of them included any abdominal pain or gastrointestinal symptom.

5.  There is no evidence he had a permanent physical condition at the time of his separation which would have rendered him unable to fulfill the duties of his grade and MOS.  There is also no evidence that his condition would have rendered him unfit if he had been diagnosed and treated while serving on active duty.  The evidence shows he did not receive a colostomy.  His need for chemotherapy would have made him temporarily non-deployable.  Soldiers are treated and retained for a wide variety of cancers.  

6.  In summary, there is no evidence of record and he did not provide any substantiating evidence that shows he was medically disqualified for retention or separation.  Nowhere in his record does it show he:

* was issued a permanent physical profile
* suffered an illness or an injury that rendered him permanently unable to perform the duties required of his grade or MOS
* was referred to the Army PDES

7.  The applicant's records indicate he was fit for duty at the time of his separation.  Therefore, he is not entitled to a medical retirement.

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 the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned.



      ___________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)                                         AR20120019619



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ABCMR Record of Proceedings (cont)                                         AR20120019619



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