IN THE CASE OF:	  

		BOARD DATE:	  16 April 2015

		DOCKET NUMBER:  AR20140014067 


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, in effect, correction of her records to show the physical evaluation board (PEB) rated her at 30 percent (%) disabled or higher and she was placed on the Permanent Disability Retired List (PDRL). 

2.  The applicant states:

	a.  Since she has been out of the Army and in the Department of Veterans Affairs (VA) system, she feels as though she has been shifted to the side and forgotten about.  When she speaks to others about how her gynecologist prescribed her birth control, then she deployed, then she had pain in her legs which was actually a clot that she was unaware of, and that she had no idea she should go to the gynecologist for the pain in her legs, they tell her she should speak to someone or even to lawyers about it.  

   b.  She remembers she spoke to her commander about the depression, mental state, and the pain that she was in, and also about leaving the Army because she was too sad and depressed to progress or lead others.  However, she feels her commander and other members of the command should have known this and they should have spoken to her about it.  By the time she spoke to her commander, others had already convinced him that she had a ploy to get out of the military.  She felt hurt, angry, and more betrayed than ever.  It felt like they all put a negative twist on anything they spoke about but maybe they simply didn't know how much pain she was in.  There is no way to fake a pulmonary embolism or a tragic murder of a family member.
   
   c.  She was devastated mentally and emotionally due to the loss of her infant son and the brutal domestic murder of a close family member.  After these tragedies, her military and social life was challenged to the breaking point.  Prior to them, she was seeking treatment in a military mental health facility and she is not sure her issues were properly presented at the time of her medical evaluation board (MEB), PEB, or placement on the Temporary Disability Retired List (TDRL).  She was delirious, depressed, and felt there was no one in her command to ask for direction or guidance.  

	d.  She feels the PEB Liaison Officer took advantage of her vulnerability and emotional state.  More of her disabilities should have been noted and she should have been placed on the PDRL with the same 30% or more that she received when she was placed on the TDRL.  Especially because she was told the military didn't want Soldiers on active duty that had pulmonary embolisms.  

	e.  She should have been rated for depression and anxiety.  She was forced to deliver a stillborn baby even though she begged the physician to just take the baby while she was sleeping.  Despite the medications she took then and now, she still relives these moments.  It was stated that she must consciously deliver her stillborn son, look at him, and hold him but this wasn't good for her psychologically.  The physicians knew she had some mental problems because she was in the hospital for a long time.  Since she was already crazy and depressed, she can't understand why they would have her deliver while awake.

	f.  She had a permanent (P) 3 profile for no running and still had to take a timed walk for the Army Physical Fitness Test (APFT).  She was still expected to exercise and do regular physical training at 0630 with the rest of the unit.  She has now been rated at 100% disabled by the VA and her issues now are the same as when she was on active duty.  She should not be in the situation she is in now with no medical retirement, no Tricare, and one outlet for treatment that does not include her family; she can only use the VA [medical system].

	g.  She had a blood clot in her leg from her birth control and many people made remarks that she got the clot because she was lazy.  The blood clots suffocated her baby and he died.  She would like her records reviewed as a whole to see how many [medical] issues were overlooked.  She served in the Army for over 10 years and her blood pressure was high when she was on active duty; however, they just retook it until she was tired and they got a good result.  Please consider her VA evaluation even though she has heard that each board rates differently.  Her chest, back, neck, and migraine headaches are problems that are persistent and constant.  She is socially reclusive and doesn't like to be touched or judged.  Not a day goes by that she doesn’t have chest pain from the post-traumatic scar from the pulmonary embolism that causes chest tightness.  
	h.  Dr. RC, an active duty obstetrician in 2004 and Ms. KA, the civilian bereavement counselor in 2004, have photos of the coconut-sized clots that took her still-born son away from her and should be able to be reached by the Board.  

3.  The applicant provides:

* her DD Form 214 (Certificate of Release or Discharge from Active Duty)
* two letters from VA, dated 31 January 2013 and 16 April 2014
* 32 pages of medical documents, dated between 17 July 2007 and 15 June 2009

CONSIDERATION OF EVIDENCE:

1.  Title 10, U.S. Code, section 1552(b), provides that applications for correction of military records must be filed within 3 years after discovery of the alleged error or injustice.  This provision of law also allows the Army Board for Correction of Military Records (ABCMR) to excuse an applicant's failure to timely file within the 3-year statute of limitations if the ABCMR determines it would be in the interest of justice to do so.  While it appears the applicant did not file within the time frame provided in the statute of limitations, the ABCMR has elected to conduct a substantive review of this case and, only to the extent relief, if any, is granted, has determined it is in the interest of justice to excuse the applicant's failure to timely file.  In all other respects, there are insufficient bases to waive the statute of limitations for timely filing.

2.  The applicant enlisted in the Regular Army on 23 March 1992 and she held military occupational specialty (MOS) 91W (Health Care Specialist).  She was promoted to the rank/grade of specialist (SPC)/E-4 on 23 May 1994.  On 30 May 2001, she was assigned to the U.S. Army Medical Department Activity (MEDDAC), Fort Wainwright, AK.

3.  In an MEB statement, dated 20 May 2003, an orthopedic physician stated the applicant's chief complains were bilateral knee pain, bilateral foot pain, and back pain and this was a physician-directed MEB.  He stated, in part:

	a.  The applicant described her knee pain as being bilateral with the right greater than the left and mainly located behind both kneecaps.  She didn’t recall a specific injury and stated her pain was particularly aggravated by pivoting, stairs, and squatting.  She had swelling within her knees, periodic locking, and giving way.  She had no relief with medication, physical therapy (PT), or bracing and was taking Celebrex for the pain.  

	b.  She had a history of bilateral pes planus and plantar fasciitis mainly aggravated by activity.  She had a stabbing pin type of pain under her heels, some swelling, and the pain depended on her activity level.  Her lower back pain (LBP) was periodic, centered over the top of her spine in the lumbar region, had been present for several years, and she started having problems after her first pregnancy.  She had a history of shin splints and stress factures which were treated with activity modification and recurred after prolonged running or walking, particularly when preparing for the APFT.  

	c.  Her back examination demonstrated 5/5 motor strength bilaterally in her illiopsoas, hip abductors, quadriceps, hamstrings, tibialis anterior, extensor hallucis longus, gastroc, and peroneals.  She had negative sitting and supine straight leg raises, and a fair amount of hamstring tightness.  She had negative hip log rolls, an intact gait, and normal heel based and toe based gait.  She had normal gastroc single toe raises without fatigue and was tender to palpation over her paraspinal musculature as well as spinous process.  Her knees demonstrated a range of motion (ROM) of 0-130 degrees with a fair amount of retropatellar crepitus and clicking.  She had a negative J sign, was otherwise ligamentously stable with a negative Lachman, anterior drawer, and posterior drawer.  She had no varus or valgus instability at both 0 and 30 degrees of flexion, and had a negative McMurray's test.  Her feet had a normal varus heel swing with double toe raises.  She was tender to palpation over the insertion of her plantar fascia and had a normal Windlass mechanism.  

	d.  Presently, her multiple orthopedic conditions severely limited her ability to perform the functions required of an 91W.  She was unable to run, march, or perform lower body training.  She had difficulty with prolonged sitting, standing, squatting, and deep knees bends.  She had pain with [wearing a] rucksack or backpack, and with lifting children or weights.  This interfered with her ability to perform the duties of her MOS.  Her LBP should improve with PT and back classes but could be further aggravated by continued service.  

	e.  She was diagnosed with bilateral patellofemoral pain syndrome, bilateral foot flexible pes planus, bilateral planar fasciitis, mechanical LBP, and recurrent shin splints/stress fractures.  He stated she was referred to an MEB for proper adjudication.

4.  In an MEB statement, dated 31 May 2003, an internal medicine physician stated the applicant was referred for an MEB consultation in regards to her history of asthma and irritable bowel syndrome (IBS).  He stated, in part:

	a.  She first complained of asthma in March 2003 and stated for several years she had intermittent, exertional chest pain associated with difficulty breathing that limited her ability to perform adequately on the APFT or keep up in formation runs.  The lung function test with methacholine challenge revealed mildly reduced vital capacity in FEV1 at baseline and abdominal airway hyperreactivity occurring at a dose of 0.25 mg/cc of methacholine.  She had resolution with the inhalation of a bronchodilator and subsequently underwent two additional lung functions tests while she was off asthma therapy.  They were both within normal limits (emphasis added).  She stated the asthma treatment she had been on improved her symptoms and she was able to perform physical training and take the APFT without an asthma profile.  A 29 April 2003 chest x-ray was normal.

	b.  He initially treated her for IBS in August 2002.  Her medical records indicated she had a total of 14 clinic visits for abdominal pain since September 2001.  Her complaints included chronic epigastric pain, diarrhea alternating with constipation, and rectal pain due to constipation.  Her lab work including liver function testing, amylase, lipase, and urinalysis was negative in September 2001 and April 2003.  She had normal films of the abdomen in December 2002.  The April 2003 computed tomography (CT) scan was normal except for a small bowel umbilical hernia and she was referred to general surgery for repair of the hernia.  

	c.  Additional tests were normal and showed no evidence of esophagitis, gastritis, peptic ulcer disease, colon mass, colonic obstruction, or other problems. The colonoscopy revealed moderate internal hemorrhoids as well as anal fissures which are likely related to her constipation.  Her symptoms were severe enough to warrant multiple clinic visits and occasional emergency room (ER) visits as well to interfere with her ability to perform her duties due to being in the clinic, ER, or being placed on quarters.

	d.  Additional medical conditions which did not meet MEB referral criteria included hypertension, sinusitis, and a heart murmur with an echocardiogram revealing normal ejection fraction, mild thickening of a trileaflet aortic valve with no stenosis, mild aortic insufficiency, normal mitral valve, normal tricuspid valve, and very mild elevation of right ventricular systolic pressure at 34.

	e.  She was diagnosed with exercise-induced mild, persistent asthma, and IBS.  Her asthma was under control and did not require a profile.  The IBS was sub-optimally controlled due to her own incomplete adherence with the treatment plan.  The condition was stable and did not require specific assignment considerations.  It interfered with her functional status due to her multiple clinic and ER visits and excessive time on quarters.

5.  On 21 June 2004, she received a P-3 profile in the P (physical capacity or stamina) and L (lower extremities) categories of the profile status and was recommended to go before an MEB.  
6.  In a psychiatric addendum to the MEB, dated 5 August 2003, the psychiatrist stated, in part:

	a.  The applicant had 9 years of active duty in MOS 91B (Medical Specialist). She had trained for Air Traffic Controller but could not handle the anxiety and was retrained as a 91B.  She was assigned to Korea where she became ill with chronic sinusitis and then to Fort Campbell, KY, where the sergeant major picked on her and everyone.  She applied for orthopedic school for promotion and to avoid field assignments and was retrained in MOS 91W.  She was assigned to Walter Reed Army Medical Center, DC, where she married and visited the Mental Health Clinic (MHC) there twice because she felt inferior associated with frequent criticism and ridicule.  She was transferred to Fort Wainwright in May 2001.  She was barred from reenlisting in August 2001 after refusing to attend the primary leader development course and was removed from the promotion standing list.  She had been counseled for slow work performance, disrespect, failing to be in formation, APFT failure, being late for work, and for indebtedness.

	b.  She was first seen in the Fort Wainwright MHC in July 2001 when she complained of depression for the last 4 years and for as long as she could remember.  She was diagnosed with depressive disorder, not otherwise specified (NOS), with subjective complaints of depressed mood, hypersomnolence, fatigue, irritability, and mood swings.  She complained of being teased by co-workers, being underappreciated, too much work stress, and tearful reactions to counseling.  She appeared to "maximize everything" and dwell on issues.  She complained about marital problems, was overwhelmed by childcare issues, and she wanted to be discharged from the Army.  Her husband initiated a request that she be given a medical board and it should be noted that he underwent a medical board action prior to his separation.  One note in her records described that she appeared to exaggerate some symptoms.  She frequently requested a sick slip to avoid returning to her work place.  She requested "commitment" to resolve her difficulties and in February 2003 she determined her problem was undiagnosed bipolar disorder.  In April 2003 she began to assert she had manic depressive disorder.  She began seeking a medical board as a way to exit the military.  

	c.  She described chronic insecurity when she was in school [as a child], a feeling of being picked on by classmates, low self-esteem, and shyness.  By her own description, her obsessive behavioral traits may have developed as a result of her mother's demands for orderliness when she was growing up.

	d.  She was diagnosed with chronic, severe personality disorder, NOS, that existed prior to service (EPTS), did not occur in the line of duty (LOD), and was not service aggravated; chronic, mild personality traits and coping style affecting expression of symptoms, EPTS, not LOD, and not service aggravated; and minimal, routine stress.  Her global assessment of functioning was 65.  She had mild impairment for military duties and no impairment for social and industrial adaptability.  There were no duty limitations as a result of the psychiatric diagnoses, she was competent for pay and allowances, she was not dangerous to herself or others, and she had the mental capacity to participate in board or other administrative proceedings.

	e.  Her mental conditions did not represent a medical reason for separation or reclassification but may be a reason for administrative separation or other administrative actions if her day-to-day performance was sufficiently problematic for the command.  She appeared to have focused on obtaining a medical board as an acceptable and beneficial way of separating from further requirements of military duty.  Due to supervisory frustration with her job attendance as a consequence of her multiple medical appointments, the Commander, MEDDAC - AK, mandated the MEB procedure to determine her medical fitness for duty.

7.  In a Commander's Performance Statement, dated 16 August 2004, her immediate commander stated the applicant was currently working in the Orthopedics Clinic, Bassett Army Community Hospital (BACH), Fort Wainwright.  Her duties consisted of providing orthopedic medical care to various patients.  Her technical competence and professionalism towards patient care were good and her work performance had been fair.  She was admitted to BACH a number of times during the past year.  Her conditions had not affected her ability to perform her daily duties but it had caused her to miss work for a number of days when it flared up and she had not been able to take the APFT.  He felt she would continue to have periods she would not be able to complete mission requirements and should be separated from the Army.

8.  On 19 August 2004, an MEB convened and, after consideration of clinical records, laboratory findings, and physical examination found she had been diagnosed with status post-pulmonary embolus with persistent chest pain and shortness of breath and bilateral patellofemoral pain syndrome that were medically unacceptable under the provisions of Army Regulation 40-501 (Standards of Medical Fitness), chapter 3.  The MEB recommended she be referred to a PEB.  The MEB did not note that she had any other diagnoses which caused her to be medically unfit.

9.  On 31 August 2004, the applicant checked the block on the DA Form 3947 (MEB Proceedings) to show she did not desire to continue on active duty and concurred with the MEB findings and recommendation. 

10.  On 14 September 2004, an informal PEB convened and confirmed her unfitting disabilities of pleuritic chest pain following documented pulmonary embolus and bilateral patellofemoral syndrome.  The PEB, in part, stated:

	a.  The documented pulmonary embolus occurred in December 2003 when the applicant was pregnant.  The acute phase passed and she had been off Coumadin since June 2004 without imaging or clinical confirmation and normal pulmonary function test.  Complaints of shortness of breath on exertion and increased chest pain prevent field activities associated with Soldiering.  Rated for symptoms following resolution of acute embolism; not stable for final rating purposes.  She was rated under VA Schedule of Rating Disabilities (VASRD) code 6817 and assigned a temporary 30% disability rating.

	b.  Patellofemoral syndrome, bilateral; she had knee pain with full range of motion, good stability, and normal imaging.  Pain prevents completion of military tasks associated with field exercises.  Rated analogous to degenerative joint disease (DJD) without loss of motion or radiographic changes.  She was rated under VASRD codes 5099 and 5003 and assigned a 0% disability rating.

	c.  Her functional limitations in maintaining the appropriate level of stamina caused by the physical impairments recorded above made her medically unfit to perform the duties required of a Soldier of her rank and primary specialty.  

	d.  Her impairments were rated at a disability level of 30% but were such that a permanent evaluation was not possible.  Therefore, she was placed on the TDRL and she must keep the Army informed of her current address, report for scheduled examinations when and where directed.  She must furnish the examining physician copies of all medical records documenting treatment since placement on the TDRL or last TDRL evaluation.  Failure to comply with these requirements may result in termination of disability retired pay.

   e.  The PEB found she was physically unfit, recommended a combined temporary disability rating of 30%, and placement on the TDRL.  The PEB did not note that she had any other diagnoses which caused her to be medically unfit.
   
11.  On 17 September 2004, after being counseled on her rights and options, she waived her right to a formal hearing and concurred with the PEB findings and recommendation.

12.  She was honorably retired from active duty on 15 November 2004 in the rank of SPC and she was placed on the TDRL.  The DD Form 214 she was issued shows she completed 12 years, 7 months, and 23 days of creditable active service.
13.  In March 2006, the applicant underwent a regularly scheduled TDRL physical examination.  Her records contain:

	a.  A radiology/imaging report, dated 28 March 2006, wherein it shows she underwent an CT scan for her history of abdomen and chest pain with a history of nausea and vomiting.  The radiologist noted the abdominal bowel gas pattern was normal; no urinary calculi were identified although the kidneys were partially obscured by overlying bowel.  The bones were unremarkable and there was no evidence of acute disease. 

	b.  A radiology/imaging report, dated 28 March 2006, wherein it shows she underwent an CT scan of the abdomen with contrast for her history of tubule, partial hernia repair.  The radiologist noted her spleen, pancreas, and kidneys appeared normal and the small intestine and colon were nondilated.  The mesenteric fat appeared a bit more dense in the right mid-abdomen but may be due to partial volume averaging of adjacent bowel loops.  The CT scan of the pelvis with contrast showed the umbilicus was quite thickened which may be due to cellulites or possible fibrosis (as with a keloid scar).  No pelvic masses or fluid collections were identified and there was no convincing evidence of acute intra-abdominal disease.   

	c.  A radiology/imaging report, dated 29 March 2006, wherein it shows she underwent an ultrasound for her history of incarcerated hernia pain.  The radiologist noted her gallbladder was normal without stones or wall thickening.  He intrahepatic ducts were not dilated.  Head and pancreas was unremarkable.  It was a normal gallbladder ultrasound.  

	d.  A radiology/imaging report, dated 29 March 2006, wherein it shows she underwent an echocardiography on that date.  The radiologist noted it was technically a fairly good quality study with mild respiratory interference.  There was normal left ventricle (LV) size and global systolic function.  There was mild concentric LVH with Doppler evidence of early LV diastolic dysfunction and no significant dyspnea.  The other cardiac chambers were normal in size, normal mitral valve and aortic valve, no masses or shunt, and no pericardial disease.

14.  On 8 May 2006, an informal PEB convened and confirmed her unfitting disabilities of chronic pleuritic chest pain and bilateral patellofemoral syndrome.  The PEB, in part, stated:




	a.  Chronic pleuritic chest pain with no episode of pulmonary embolus since December 2003 was rated as slight/constant; no medication profile was submitted.  She was rated under VASRD codes 5099 and 5003 and assigned a 10% disability rating.

	b.  Chronic bilateral patellofemoral syndrome not requiring activity modifications.  Full range of motion reported by examination.  Rated analogous to DJD without limitation or motion (orthopedic evaluation).  She was rated under VASRD codes 5099 and 5003 and assigned a 0% disability rating.

	c.  Based on her TDRL examination the PEB found she remained unfit to reasonably perform the duties required of her previous grade and MOS and her condition was considered sufficiently stable for final adjudication.  The PEB found she was physically unfit with a combined disability rating of 10% and recommended she separated with entitlement to severance pay if otherwise qualified.   

15.  On 18 May 2006, after being counseled on her rights and options, she nonconcurred with the PEB findings and recommendation and requested a formal PEB be held without a personal appearance.

16.  On 6 June 2006, a formal PEB convened and confirmed her unfitting disabilities of chronic pleuritic chest pain and bilateral patellofemoral syndrome.  The PEB, in part, stated:

	a.  Chronic pleuritic chest pain with no episode of pulmonary embolus since December 2003 was rated as slight/constant; her symptom's of dyspnea could be attributed to her asthma.  A 29 March 2006 cardiology evaluations stated she had no significant dyspnea.  No medication profile was submitted, evaluee exhibit and statements by her counsel on her behalf.  She was rated under VASRD codes 5099 and 5003 and assigned a 10% disability rating.

	b.  Chronic bilateral patellofemoral syndrome not requiring activity modifications; full range of motion reported by examination.  Rated analogous to DJD without limitation or motion (orthopedic evaluation), evaluee exhibit and statements by her counsel on her behalf.  She was rated under VASRD codes 5099 and 5003 and assigned a 0% disability rating.

	c.  During formal proceedings, the PEB reevaluated all available medical records and statements by her counsel on her behalf.  Based on the review, the board considered her appropriately rated as stated [in paragraphs a and b] above.  The PEB found she was physically unfit with a combined disability rating of 10% and recommended she be separated with entitlement to severance pay if otherwise qualified.   

	d.  On 9 June 2006, after being counseled on her rights and options, she concurred with the PEB findings and recommendation.

17.  Orders D165-06, dated 13 June 2006, issued by the U.S. Army Physical Disability Agency, removed her from the TDRL and honorably discharged her on 13 June 2006 with entitlement to separation pay.

18.  The applicant provides, in part:

	a.  Various medical documents, dated between 17 July 2007 and 15 June 2009, wherein it shows she was treated by a dermatologist for several skin disorders, by a urologist for burning and pain in her bladder, and by an oral surgeon for management of temporomandibular disorder.

	b.  A letter, dated 31 January 2013, from the VA Medical Center (VAMC), Decatur, GA, wherein a nurse stated the applicant was seen in the outpatient MHC for individual counseling and medication management.  She had been diagnosed with bipolar disorder and continued to have issues with mood, anger outbursts, anxiety, isolation, and poor sleep.  Her chronic symptoms prevented her from maintaining any gainful employment.

	c.  A letter, dated 16 April 2014, from the VAMC, Decatur, GA, wherein a physician stated the applicant was a patient at the Atlanta VAMC, was diagnosed with bipolar disorder, was 100% service-connected for schizoaffective disorder and was unable to work due to the severity of her mental health issued.  She was hospitalized in January 2014 for depression with suicidal ideation, as well as in 2007 for manic episodes.  She was totally and permanently disabled per the VA.

19.  Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) establishes the Army Physical Disability Evaluation System (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 or her office, grade, rank, or rating.  It states there is no legal requirement in arriving at the rated degree of incapacity to rate a physical condition which is not in itself considered disqualifying for military service when a Soldier is found unfit because of another condition that is disqualifying.  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.  The mere presence of impairment does not, of itself, justify a finding of unfitness because of physical disability.  
20.  Army Regulation 40-501 governs medical fitness standards for enlistment; induction; appointment, including officer procurement programs; retention; and separation, including retirement.  Once a determination of physical unfitness is made, the PEB rates all disabilities using the VASRD.  Ratings can range from 0 percent to 100 percent, rising in increments of 10 percent.

21.  The VASRD is used by the Army and the VA as part of the process of adjudicating disability claims.  It is a guide for evaluating the severity of disabilities resulting from all types of diseases and injuries encountered as a result of or incident to military service.  This degree of severity is expressed as a percentage rating.  

22.  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 at less than 30 percent.

23.  Title 38, U.S. Code, sections 1110 and 1131, permit the VA to award compensation for disabilities which were incurred in or aggravated by active military service.  However, an award of a higher VA rating does not establish an error or injustice in the Army rating.  The Army rates only conditions determined to be physically unfitting at the time of discharge which disqualify the Soldier from further military service.  The Army disability rating is to compensate the individual for the loss of a military career.  The VA does not have authority or responsibility for determining physical fitness for military service.  The VA awards disability ratings to veterans for service-connected conditions, including those conditions detected after discharge, to compensate the individual for loss of civilian employability.  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 of record confirms that on 19 August 2004 an MEB found the applicant's conditions of chronic pulmonary embolus and bilateral patellofemoral syndrome were medically unacceptable and did not meet retention standards.  The MEB psychiatric addendum showed her diagnoses of psychiatric disorders were EPTS conditions, were not unfitting at that time, and that she did not have any other conditions that prevented her from performing her duties.  The MEB recommended that she be referred to a PEB.  She concurred with the MEB findings and recommendation.

2.  On 14 September 2004, the PEB found her unfit due to pleuritic chest pain following documented pulmonary embolus in December 2003 and bilateral patellofemoral syndrome that prevented her from performing her military duties.  These were the only conditions that were found to have prevented her from performing her duties.  As her condition was not stabilized, the PEB assigned her a combined temporary 30% disability rating and she was placed on the TDRL.  

3.  On 8 May 2006, based on a TDRL examination, the PEB found her condition was stable and her chronic pleuritic chest pain with no episode of pulmonary embolus since December 2003 was rated as slight/constant.  Her condition of chronic bilateral patellofemoral syndrome did not require any activity modifications and she had full range of motion.  The PEB reviewed all the available and appropriate evidence and no other unfitting conditions found.  The PEB recommended her separation with entitlement to severance pay with a combined 10% disability rating.  She nonconcurred with the findings and recommendation of the PEB and requested a formal hearing.  

4.  On 6 June 2006, a formal hearing was held.  The PEB reevaluated all the available and appropriate evidence and her condition of chronic pleuritic chest pain with no episode of pulmonary embolus since December 2003 was rated as slight/constant.  Her condition of chronic bilateral patellofemoral syndrome did not require any activity modifications and she had full range of motion.  The PEB again recommended her separation with entitlement to severance pay with a combined 10% disability rating.  On 9 June 2006, she concurred with the findings and recommendation of the PEB.

5.  A disability rating assigned by the Army is based on the level of disability at the time of the Soldier's separation and can only be accomplished through the PDES.  The evidence of record shows the applicant was properly rated at a combined rating of 10% for chronic pleuritic chest pain and bilateral patellofemoral syndrome.  There is no evidence in her available records to support a higher rating for either condition.  Since this rating was less than 30%, by law she was only entitled to severance pay.

6.  Her physical disability evaluation was conducted in accordance with law and regulation.  There does not appear to be an error or an injustice in her case.  She has not submitted substantiating evidence or an argument that would show an error or injustice occurred in her case.  She only submitted evidence that shows after she was discharged she was subsequently treated for and/or diagnosed with medical conditions or disorders that did not exist or were not unfitting at the time of her PEB in May 2006.

7.  While she may have been rated at 100% disabled by the VA after her discharge from the Army on 13 June 2006, a disability decision rendered by another agency does not establish an error on the part of the Army.  Operating under different laws and its own policies, the VA does not have the authority or the responsibility for determining the medical condition of a Soldier at the time of their discharge from active duty.  The VA may award ratings because of a service-connected disability that affects the individual's civilian employability. 

8.  In view of the foregoing, there is insufficient evidence to grant the requested relief.

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 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.



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