DEPARTMENT OF HOMELAND SECURITY 

BOARD FOR CORRECTION OF MILITARY RECORDS 

 
Application for the Correction of 
the Coast Guard Record of: 
 
                                                                                BCMR Docket No. 2004-075 
 
Xxxxxxxxxxxxx 
  xxxxxxxxxxxx 

 

 

FINAL DECISION 

 
AUTHOR:  Andrews, J. 
 
This  proceeding  was  conducted  according  to  the  provisions  of  section  1552  of 
 
title 10 and section 425 of title 14 of the United States Code.  The application was dock-
eted on March 5, 2004, upon the BCMR’s receipt of the applicant’s military and medical 
records. 
 
 
appointed members who were designated to serve as the Board in this case. 
 

This  final  decision,  dated  November  17,  2004,  is  signed  by  the  three  duly 

REQUEST FOR RELIEF 

 
The applicant asked the Board to “[s]it as the first formal medical board in her 
 
case and find that she was unfit [for duty] by reason of disabilities that were incurred in 
the line of duty and not due to misconduct or neglect”; assign her appropriate disability 
ratings; and correct her military record to show either that she was separated by reason 
of disability or placed on the temporary disability retired list (TDRL) on July 1, 2002, 
instead of being discharged by reason of completion of required service.  
 

APPLICANT’S ALLEGATIONS 

 
 
The applicant alleged that at the time of her discharge, she “suffered from several 
unfitting  conditions  and  had  been  extended  on  active  duty  for  almost  a  year  due  to 
injuries suffered in a motor vehicle accident.”  She alleged that “[d]espite her extensive 
record of treatment for these injuries by several civilian care providers as well as mili-
tary  providers,  [she]  was  never  processed  for  an  initial  medical  board  [IMB].”    The 
applicant alleged that she should have been processed under the Coast Guard’s Physi-
cal  Disability  Evaluation  System  (PDES)  and  either  medically  separated  or  placed  on 

the TDRL.  Instead, she was released from active duty when her enlistment expired on 
July 1, 2002. 
 
The  applicant  alleged  that  one  of  her  unfitting  conditions  was  asthma.    She 
 
alleged that she required daily use of “inhalational bronchiodilators” or anti-inflamma-
tory medications while on active duty.  She noted that her medical record shows that 
she consulted doctors about her asthma on ten occasions between November 1998 and 
April 2002.  She also noted that pulmonary function testing had revealed “mild to mod-
erate restriction while taking asthma medication.”  The applicant alleged that since she 
suffered from mild to moderate restriction despite the help of asthma medications, she 
should have been rated as 30% disabled due to asthma. 
 
 
 
The applicant alleged that another unfitting condition was a “hip fracture dislo-
cation” that she incurred during a car accident in August 2001.  She referred the Board 
to summaries of this condition in her medical records dated April 29, 2002, and June 5, 
2002.  She pointed out that the records show that because of her hip problem, she is not 
able to run and she is “unable to walk for more than one hour due to pain.”  She alleged 
that because of her inability to run or to walk for extended distances, she was unfit to 
perform the duties of her grade and rating.  Although there is no rating for “hip fracture 
dislocation” under the Department of Veterans’ Affairs Schedule for Rating Disabilities 
(VASRD), she stated that her condition could be rated by analogy to VASRD code 5317 
since she had no traumatic arthritis. 
 
The applicant noted that at the time of her discharge, she suffered from several 
 
other medical conditions, but they did not render her unfit for duty.  She alleged that 
since  her  conditions  could  change  within  the  five  years  following  her  discharge,  she 
could have been placed on the TDRL.   
 
 
Finally,  the  applicant  argued  that  since  she  has  been  separated  from  the  Coast 
Guard, the only remedy available to her is for the Board to sit as a medical board and 
order direct relief. 
 

SUMMARY OF THE APPLICANT’S MEDICAL AND MILITARY RECORDS 

 
 
During a pre-enlistment physical examination on September 16, 1996, the appli-
cant  noted  on  a  Report  of  Medical  History  that  she  had  no  history  of  hay  fever  or 
asthma.  The physician noted that, aside from a fatty cyst removal in 1996, the applicant 
“denie[d] other injuries, illnesses, or asthma.”  She was found fit for enlistment. 
 
 
On June 2, 1997, the applicant enlisted in the Coast Guard for four years.  During 
a recruit processing examination on June 4, 1997, she admitted to seasonal allergies (hay 
fever) and to wheezing and using an inhaler as a child.  She denied having been diag-
nosed as asthmatic.  The physician concluded that she had a history of asthma.   

 

 
 
Following  training,  the  applicant  became  a  xxxxxxxxxxxxxxxxxxxxxxxxxxxx.  
Several documents in her medical record indicate that she took Allegra or Claritin for 
hay fever while on active duty. 
 
 
On April 7, 1999, the applicant sought help for shortness of breath.  She stated 
that  she  had  recently  returned  from  visiting  xxxxxxxxxx,  California,  where  she  had 
gone to a hospital emergency room when she had intense difficulty breathing.  The doc-
tor noted that she had used an inhaler as a child and diagnosed her with mild asthma. 
 
 
On  January  25,  2000,  the  applicant  sought  treatment  for  “moderate  dyspnea” 
(shortness of breath).  She told the doctor that she had a prior medical history of “acute 
asthmatic attacks when she visits her home in xxxxxxxxxx, CA.”  She was treated with 
Albuterol and provided an Albuterol inhaler.  
 
 
At  the  expiration  of  her  enlistment  on  June  1,  2001,  she  extended  it  for  three 
months, through September 1, 2001.  On June 29, 2001, she underwent a physical exam-
ination in preparation for being released from active duty.  On the Report of Medical 
History  she  prepared,  she  indicated  that  she  was  in  good  health  and  that  she  took 
Claritin  D  for  seasonal  allergies.    She  also  told  the  doctor  that  she  had  “occasional 
episodes” of asthma and used an Albuterol inhaler.  On August 8, 2001, she was found 
fit  for  separation.    The  record  contains  no  indication  of  whether  the  applicant  agreed 
with this finding. 
 
 
On August 14, 2001, the applicant was hospitalized as a result of a car accident.  
The  admission  report  indicates  that  she  “was  driving  home  from  her  second  job  last 
evening when she sustained a motor vehicle accident on base as a single car that struck 
a telephone pole.  The patient believes she may have fallen asleep at the wheel. …  The 
patient  states  she  had  worked  doubled  shifts  yesterday  as  a  dental  tech  at  the  Coast 
Guard  Academy  and  then  at  [a  local  pub]  as  a  waitress.”    On  the  hospital  discharge 
report, dated August 23, 2001, her orthopedic surgeon, Dr. M, wrote the following: 
 

[T]rauma  evaluation  identified  a  right  acetabular  fracture  involving  both  the  posterior 
wall  and  posterior  column.  …  On  the  first  hospital  day  she  was  placed  into  balanced 
skeletal traction with a distal femoral traction pin. …  On the sixth hospital day, she was 
taken to the operating room at which time she underwent ORIF [open reduction, internal 
fixation] of her right acetabular fracture.  The patient did very well postoperatively.  She 
was transferred back to the orthopedic floor … .  The traction pin was removed. … She 
advanced  with  physical  therapy.  …  On  the  third  postoperative  day  she  had  already 
begun to start using stairs.  However, this was very slow for her and she appeared to be 
rebounding with further improvements in stamina and strength. 
 
 
 
After  being  discharged  from  the  hospital,  the  applicant  continued  physical 
therapy  and  had  monthly  follow-up  examinations  with  Dr.  M.    Her  enlistment  was 
extended because she was not physically qualified for separation.   

 

 On  January  8,  2002,  a  military  doctor  noted  that  Dr.  M  had  reported  that  the 

 
 
On  November  19,  2001,  Dr.  M  noted  that  the  applicant  had  been  doing  “very 
well” and that her “range of motion is full to hip flexion, abduction, adduction, internal 
and external rotation without limitation.”  Dr. M stated that the applicant was “ready to 
advance to weightbearing” in physical therapy so that she could begin walking without 
crutches.  On December 14, 2001, Dr. M noted that the applicant “is full weightbearing 
at present.  She has no pain whatever.  She has 5/5 strength to hip flexion, hip exten-
sion,  hip  abduction,  [and]  hip  adduction.  …    She  is  asked  to  walk  today  without  the 
crutches and she does have a significant adductor lurch, which is surprising given her 
strength on isolated abductor testing on the table.  She does need further physical ther-
apy to lose this abnormal stride/gait pattern.” 
 
 
applicant “will complete treatment, including healing of the fracture by 1 July 2002.” 
 
 
On January 30, 2002, Dr. M noted that the applicant “is full weightbearing.  She 
has minimal limp walking on the right side.  … [S]he has 80+% return of strength but 
would  like  to  continue  her  strengthening  program.  …  She  has  full  flexion,  full  exten-
sion,  full  internal/external  rotation  without  any  limitation  whatsoever.  …    [A]t  this 
point  she  is  not  limited  in  any  activities  but  was  encouraged  to  continue  with  the 
strengthening  program  and  to  continue  to  walk  without  a  limp.  …  She  does  have  a 
small  amount  of  heterotopic  calcification  noted  which  is  further  calcified  proximal  to 
the acetabulum but has not significantly changed in overall size or advancement. … At 
present she is entirely off all medications.” 
 
 
On February 21, 2002, Dr. M noted that the applicant “comes in with [CWO C], 
representing the U.S. Military, with regards to an end point evaluation today in prepa-
ration for her discharge from the military and possible relocation back to California.”  
Dr. M reported that the applicant was in  
 

full ambulatory status without any pain whatsoever, and complete loss of the limp that 
she had in her early postoperative course.  She is able to perform virtually any function 
without difficulty or limitation whatsoever. … 
  
A new complaint … is an occasional thump or popping sound and thumping sensation 
that  she  feels  in  her  right  hip  when  she  maximally  flexes  forward  when  doing  an 
extended toe touch type flexibility drill. … 
 
… She shows full, symmetric range of motion with hip flexion/extension, internal rota-
tion, external rotation.  She is entirely stable on axial loading and unloading and exten-
sion, and  in flexion at 90 degrees or better. … {When] she goes  into a  sitting toe touch 
posture  and  with  hyperflexion  reaching  down  past  her  feet  there  indeed  is  a  sudden 
audible pop and shift of her left hip entirely consistent with transient subluxation of the 
right hip.  She immediately is reduced.  There is no other suggestion of instability.  There 
is  no  pain.  …    As  this  only  comes  on  with  a  truly  hyperflexion  gymnastic  type 
positioning,  my  advice  would  be  to  avoid  this  type  of  hyperflexion  and  to  avoid  any 

 

position that may duplicate these symptoms but I would not limit her in any other way. 
… She is certainly not at maximal medical improvement, and it would be another year or 
more, minimum, before we would be able to appreciate if indeed she were to go on to 
develop significant post-traumatic arthritis and to see the total extent of her heterotopic 
ossification  after  time  for  full  maturation  of  the  process  would  occur.  …  [R]ecom-
mendations  would  be  for  continued  orthopedic  follow  up  …  .    Only  in  this  manner 
would we be able to determine the likelihood of, and more appropriately the reality, of 
developing potential post-traumatic arthritis or other problems down the road. …  [She] 
is fully cleared to perform all activities and duties other than the hyperflexion activities 
with her right hip as previously instructed. 

 
 
In  March  and  April  2002,  the  applicant’s  physical  therapist  noted  on  several 
occasions  that  the  applicant  had  a  right  “Trendelenburg  and  trunk  lurch”  when  she 
walked and occasional right hip subluxation. 
 
 
On  April  11,  2002,  a  naval  orthopedic  surgeon,  Dr.  L,  evaluated  the  applicant.  
He noted that evaluation by a medical board was “probably indicated” because of her 
hip condition.  He reported that x-rays showed “minimal to no heterotopic ossification 
about the right hip,” “concentric reduction of the hip,” and “no significant signs of post-
traumatic arthritis,” but that “her likelihood for developing [arthritis] was very high. … 
The  single  largest  finding  on  her  physical  exam  was  right  hip  laxity  evidenced 
primarily by 70 degrees of internal rotation of the right hip vs. 45 degrees of internal 
rotation of the left hip.  Due to this extreme laxity of the hip, I felt that it was improper 
to make this patient worldwide deployable as of 11 April 2002.  My plan for this patient 
as of 11 April 2002 is for her to forgo any impact activities, and in particular no running.  
Any  additional  impact  activities  to  her  right  hip  are  more  likely  to  hasten  the  rate  at 
which she would develop post-traumatic arthritis of the right hip.” 
 
On April 29, 2002, a Senior Medical Officer provided a “health summary” to the 
 
applicant.  He noted that she required twice bilateral sniffs of Flonase and two tablets of 
Zyrtec per day for “seasonal allergies” and that she still had physical therapy four times 
a week due to her hip condition.  He also noted the following: 
 

RESIDUAL  LIMITATIONS:    Although  you  can  kneel  and  lower  into  a  crouching  posi-
tion,  you  cannot  run  and  have  been  instructed  by  your  orthopedic  surgeons  not  to 
attempt running because of your abnormal gait and because of pain.  Your gait involves a 
drop in the right hip as you swing the right leg forward.  The right femur has abnormally 
exaggerated internal rotation to 75 degrees and your gait requires swinging the leg out-
ward  in  abduction  and  ends  with  the  right  toe  pointed  inward  as  your  foot  touches 
down.  This abnormal gait limits your ability to walk to about one hour, after which you 
need  frequent  stops  to  rest  and  note  increasing  discomfort  in  the  pelvis,  right  hip  and 
right leg.  You also note an audible “clunk” in the right hip with hip flexion.  Your physi-
cal therapist and your orthopedic surgeons note that this is subluxation of the right hip 
joint and have cautioned you about the possibility of hip dislocation if you assume posi-
tions of extreme right hip flexion.  Consequently, your activity is limited in this regard as 
well. 
 

 

FUTURE  CONCERNS:    You  have  been  informed  that  your  recovery  from  the  pelvic 
fracture is mostly complete but there may be some continued improvement for another 
year or so.  You are aware that there is an area of heterotopic osteogenesis in the region of 
the  ORIF  but  that  there  is  no  impingement  on  surrounding  structures  at  this  time.  
Orthopedic follow up every six months to review this area is recommended for the next 
several years at least.  The very real probability is that the right hip structures are likely 
to undergo post-traumatic degeneration resulting in arthritis and will ultimately require 
hip replacement surgery. 
 
RECOMMENDATIONS:  I strongly urge you to continue your efforts in physical therapy 
to  maximize  your  functional  level.  …  Disability  evaluation  and  compensation  through 
the Veterans’ Administration is recommended. 

 
 
On July 1, 2002, the applicant was released from active duty upon her “comple-
tion of required active service.”  She became a member of the Individual Ready Reserve. 
 

VIEWS OF THE COAST GUARD 

 
 
On  May  28,  2004,  the  Judge  Advocate  General  (TJAG)  of  the  Coast  Guard  rec-
ommended that the Board grant the applicant partial relief that was recommended by 
the Coast Guard Personnel Command (CGPC) in a memorandum on the case. 
 
 
Regarding  the  applicant’s  asthma,  CGPC  argued  that  the  applicant’s  condition 
was controlled through medication and that it did not impair her ability to perform her 
duties.    CGPC  argued  that  because  the  asthma  did  not  render  the  applicant  unfit  for 
duty, it did not meet the criteria for evaluation under the PDES.  TJAG concluded that 
“[e]ven if the Board disagrees with the Coast Guard, it would be inappropriate for the 
Board to do as Applicant asks and evaluate the medical evidence itself.  The most the 
Board  should  do  is  order  the  Coast  Guard  to  consider  whether  Applicant’s  asthma 
interfered with her performance of duty at the time of her discharge at the same time it 
considers Applicant’s hip injury.” 
 
Regarding the applicant’s hip, CGPC stated that, although she was not “world-
 
wide deployable …, she was able to perform most of the duties [then] assigned to her.  
However,  the  evaluations  conducted  during  the  period  make  it  clear  that  the  Appli-
cant’s prognosis for full recovery was questionable.” 
 
 
CGPC stated that under Article 12.B.6. of the Personnel Manual, the applicant’s 
discharge physical examination dated June 29, 2001, was “technically operative at the 
time  of  her  separation  in  July  2002,  [but]  it  obviously  did  not  take  into  account  the 
injuries  she  suffered  on  August  12,  2001,  and  the  provisions  of  the  PDES  Manual 
providing  a  presumption  of  fitness  for  duty  when  a  member  undergoing  separation 
processing has continued in the service with known impairments are not applicable in 
this  case.”    CGPC  pointed  out  that  because  her  injuries  occurred  after  her  discharge 
physical,  “she  had  no  reasonable  opportunity  to  object  to  the  presumption  that  she 

 

remained physically qualified for separation.”  CGPC stated that her command should 
have ordered another examination and that “there is sufficient evidence in the record to 
[indicate]  that  an  Initial  Medical  Board  [IMB]  should  have  been  convened  to  fully 
evaluate the Applicant’s condition resulting from her accident.” 
 
 
CGPC  recommended  that  partial  relief  be  granted  by  conducting  an  IMB  “to 
evaluate the Applicant’s medical condition at the time of her separation, resulting from 
the injury suffered to her hip on August 12, 2001.  If the IMB determines [her] injuries 
rendered her unfit for continued service prior to separation,” her case should be proc-
essed under the PDES. 
 

APPLICANT’S RESPONSE TO THE VIEWS OF THE COAST GUARD 

 
On  June  1,  2004,  the  Chair  sent  the  applicant  a  copy  of  the  views  of  the  Coast 
 
Guard  and  invited  her  to  respond  within  30  days.    The  applicant’s  response  was 
received on June 13, 2004.  She agreed with the recommendation that the Coast Guard 
conduct  an  IMB  to  evaluate  her  condition.    However,  she  disagreed  with  the  recom-
mendation that only her hip injury be reviewed by the IMB.  She argued that under the 
PDES  Manual,  an  IMB  should  “conduct  a  detailed  physical  and  evaluate  each  poten-
tially unfitting condition.”  She asked the Board to order the Coast Guard to “conduct 
an IMB for [her] regarding all potentially unfitting conditions” in accordance with the 
PDES Manual. 

 

 

 
Personnel Manual (COMDTINST M1000.6A) 
 

APPLICABLE LAW 

Article  12.B.6.a.  of  the  Personnel  Manual  provides  that  “[b]efore  retirement, 
involuntary  separation,  or  release  from  active  duty  (RELAD)  into  the  Ready  Reserve 
(selected drilling or IRR), every enlisted member … shall be given a complete physical 
examination in accordance with the Medical Manual, COMDTINST M6000.1 (series). …  
The examination results shall be recorded on Standard Form 88. … All physical exam-
inations for separations are good for 12 months. …” 
 

Article  12.B.6.b.  provides  that  “[w]hen  the  physical  examination  is  completed 
and  the  member  is  found  physically  qualified  for  separation,  the  member  will  be 
advised  and  required  to  sign  a  statement  on  the  reverse  side  of  the  Chronological 
Record of Service, CG-4057, agreeing or disagreeing with the findings.”  Article 12.B.6.c. 
provides that “[i]f a member objects to a finding of physically qualified for separation, 
the  Standard  Form  88  together  with  the  member’s  written  objections  shall  be  sent 
immediately to Commander, (CGPC-epm-1) for review.” 

 
Article  12.B.6.d.  states  that  “[w]hen  the  examination  for  separation  finds  dis-
qualifying  physical  or  mental  impairments,  use  the  following  procedures:  …  3.  If  the 
member does not desire to reenlist or is being discharged for reasons other than enlist-
ment expiration and the physical or mental impairment is permanent, a medical board 
is  convened  under  Chapter  17  and  the  member  remains  in  service  under  Article 
12.B.11.i.” 
 
Medical Manual (COMDTINST M6000.B) 
 
 
Chapter 3.D. lists the medical conditions that are disqualifying for enlistment in 
the Coast Guard.  Chapter 3.D.24.d. states that one cause for rejection for enlistment is 
asthma,  
 

[i]ncluding reactive airway disease, exercise-induced bronchospasm, or asthmatic bron-
chitis, reliably diagnosed at any age.  Reliable diagnostic criteria shall consist of any of 
the following elements.  
 

(1)  Substantiated  history  of  cough,  wheeze,  and/or  dyspnea  which  persists  or 

recurs over a prolonged period of time, generally more than 6 months. 

(2) If the diagnosis of asthma is in doubt, a test for reversible airflow obstruction 
(greater than a 15 percent increase in FEV I following administration of an inhaled bron-
chodilator),  or  airway  hyperreactivity  (exaggerated  decrease  in  airflow  induced  by  a 
standard  bronchoprovocational  challenge  such  as  methacholine  inhalation  or  a  demon-
stration of exercise-induced bronchospasms) must be performed. 

Chapter 3.B.3.d(3) of the Medical Manual provides that during a physical exam-

 

 

ination, “[w]hen the individual is not physically qualified for the purpose of the exam-
ination and a waiver is not recommended, the reviewing authority will arrange for the 
examinee to be evaluated by a medical board and provide administrative action as out-
lined in Physical Disability Evaluation System, COMDTINST M1850.2 (series).” 
 

Chapter  3.B.5.a.  provides  that  “[a]ny  member  undergoing  separation  from  the 
service  who  disagrees  with  the  assumption  of  fitness  for  duty  and  claims  to  have  a 
physical  disability  as  defined  in  section  2-A-38  of  the  Physical  Disability  Evaluation 
System, COMDTINST M1850.2 (series), shall submit written objections, within 10 days 
of signing the Chronological Record of Service (CG-4057), to Commander CGPC.” 
 

Chapter 3.B.6. states that “[w]hen a member has an impairment (in accordance 
with section 3-F of this Manual) an Initial Medical Board shall be convened only if the 
conditions listed in paragraph 2-C-2.(b) [of the PDES Manual] are also met. Otherwise 
the member is suitable for separation.” 
 

Chapter 3.F.1.c. provides that “[m]embers are ordinarily considered fit for duty 
unless they have a physical impairment (or impairments) that interferes with the per-
formance of the duties of their grade or rating. A determination of fitness or unfitness 
depends upon the individual's ability to reasonably perform those duties. Active duty 
or  selected  reserves  on  extended  active  duty  considered  permanently  unfit  for  duty 
shall be referred to an Initial Medical Board for appropriate disposition.” 
 

Chapter 3.F. “lists certain medical conditions and defects that are normally dis-
qualifying. However, it is not an all-inclusive list. Its major objective is to achieve uni-
form disposition of cases arising under the law, but it is not a mandate that possession 
of  one  or  more  of  the  listed  conditions  or  physical  defects  (and  any  other  not  listed) 
means automatic retirement or separation.” 
 

Chapter 3.F.7.b(2) provides that bronchial asthma “[a]ssociated with emphysema 
of sufficient severity to interfere with the satisfactory performance of duty, or with fre-
quent  attacks  not  controlled  by  inhaled  or  oral  medications,  or  requiring  oral  cortico-
steroids more than twice a year” is a disqualifying physical defect. 
 

Chapter  3.F.12.b(4)  provides  that  “[m]otion  that  does  not  equal  or  exceed  the 
measurements listed below” is a disqualifying physical defect.  The measurements for 
hip motion are flexion to 90 degrees and extension to 0 degrees.  
 
PDES Manual (COMDTINST M1850.2C)  
 
 

Chapter 2.C.2. of the PDES Manual states the following: 
 
a. 

The sole standard in making determinations of physical disability as a basis for 

 

the  member,  because  of  disability,  was  physically  unable  to  perform 

retirement or separation shall be unfitness to perform the duties of office, grade, rank or 
rating because of disease or injury incurred or aggravated through military service. … 
 
b. 
The law that provides for disability retirement or separation (10 U.S.C., chapter 
61)  is  designed  to  compensate  members  whose  military  service  is  terminated  due  to  a 
physical disability that has rendered him or her unfit for continued duty.  That law and 
this disability evaluation system are not to be misused to bestow compensation benefits 
on those who are voluntarily or mandatorily retiring or separating and have theretofore 
drawn  pay  and  allowances,  received  promotions,  and  continued  on  unlimited  active 
duty status while tolerating physical impairments that have not actually precluded Coast 
Guard service.  The following policies apply. 
 
Continued performance of duty until a service member is scheduled for separa-
   (1) 
tion or retirement for reasons other than physical disability creates a presumption of fit-
ness for duty.  This presumption may be overcome if it is established by a preponderance 
of the evidence that: 
 
 
adequately in his or her assigned duties; or 
 
acute,  grave  illness  or  injury,  or  other  deterioration  of  the  member’s 
 
physical condition occurred immediately prior to or coincident with processing for sepa-
ration or retirement for reasons other than physical disability which rendered the service 
member unfit for further duty. 
 
    (2)  A  member  being  processed  for  separation  or  retirement  for  reasons  other  than 
physical disability shall not be referred for disability evaluation unless the conditions in 
paragraphs 2.C.2.b.(1)(a) or (b) are met. 
 
Chapter  3.D.7.  states  that  a  “member  who  is  being  processed  for  separation … 
shall  not  normally  be  referred  for  physical  disability  evaluation.  Unless  previously 
retained on active duty [with a waiver], absence of a significant decrease in the level of 
a member’s continued performance up to the time of separation or retirement satisfies 
the presumption that the member is fit to perform the duties of his or her office, grade, 
rank or rating. (see paragraph 2.C.2.).”  However, Chapter 3.D.8. provides that an IMB 
shall be convened “[i]n any situation where fitness for continuation of active duty is in 
question.”  
 

(a) 

(b) 

Chapter  3.F.1.  provides  that  an  IMB  “considers  and  reports  upon  any  evaluee 
whose case has been referred for consideration.  It conducts a thorough physical exam-
ination to evaluate the member’s general health.  Additionally, all impairments noted 
shall be separately evaluated … .  It shall obtain and examine available records to for-
mulate a conclusion regarding the member’s present state of health and the recommen-
dations required.”  Chapter 3.F.2. states that an IMB “presents a clear medical picture of 
the  case  in  question  making  all  pertinent  diagnoses/prognoses  and  giving  a  medical 
opinion  as  to  the  evaluee’s  fitness  for  duty  and  recommendations  for  future  action.”  
Chapter  3.G.3.  states  that  the  IMB’s  Narrative  Summary  shall  include  a  “summary  of 
the  pertinent  data  concerning  each  complaint,  symptom,  disease,  injury  or  disability 

 

presented  by  the  evaluee,  which  causes  or  is  believed  by  the  medical  board  to  cause 
impairment of the evaluee’s physical condition.”  Chapter 3.G.4. states that if a member 
is found medically unfit for duty, the IMB may refer the member to a Central Physical 
Evaluation Board (CPEB) for further processing under the PDES.  Chapter 3.G.6. pro-
vides that the IMB also makes findings as to whether conditions were incurred in the 
line of duty, whether they pre-existed the member’s enlistment, and whether such pre-
existing conditions were aggravated during the member’s active duty. 

 

FINDINGS AND CONCLUSIONS 

 
 
The  Board  makes  the  following  findings  and  conclusions  on  the  basis  of  the 
applicant's military record and submissions, the Coast Guard's submissions, and appli-
cable law: 
 

1. 

The  Board  has  jurisdiction  concerning  this  matter  pursuant  to  10  U.S.C. 

§ 1552.  The application was timely. 

 
2. 

3. 

The applicant requested an oral hearing before the Board.  The Chair, act-
ing pursuant to 33 C.F.R. § 52.51, denied the request and recommended disposition of 
the case without a hearing.  The Board concurs in that recommendation. 
 
 
The  record  indicates  that  on  August  14,  2001,  after  the  applicant  had 
undergone a physical examination in preparation for her release from active duty, she 
had  a  motor  vehicle  accident  that  resulted  in  significant  injuries  to  her right  hip.  The 
physical  examination  report,  which  was  approved  on  August  8,  2001,  did  not  cover 
these injuries and was never amended or redone to account for the injuries.  In addition, 
there is no evidence in the record that the applicant was ever allowed to object to the 
report of her physical examination by signing a CG-4057, as required by Article 12.B.6. 
of the Personnel Manual and Chapter 3.B.5.a. of the Medical Manual.  
 

4. 

The preponderance of the evidence indicates that although the applicant 
underwent surgery and months of physical therapy after the accident, in April 2002— 
just two months before her release from active duty—she still walked with a significant 
lurch.    Moreover,  she  was  strongly  advised  never  to  run  again  because  such  “impact 
activities” could accelerate the applicant’s development of arthritis and the need for a 
hip  replacement,  which  were  anticipated  by  her  doctors.    Although  gaits  are  not 
included in Chapter 3.F. of the Medical Manual as standards of impairment, the Coast 
Guard has admitted, and the Board agrees, that the restrictions on the applicant’s gait 
likely rendered her unfit for continued service in the Coast Guard.  Chapter 3.D.8. of the 
Medical Manual provides that an IMB shall be convened “[i]n any situation where fit-
ness for continuation of active duty is in question.”  
 
 

Chapter 3.B.6. of the Medical Manual provides that, when a member has a 

5. 

 

disqualifying  impairment,  an  IMB  shall  be  convened  only  if  the  conditions  listed  in 
Chapter 2.C.2.(b) of the PDES Manual are met.  That chapter provides that “[c]ontinued 
performance of duty until a service member is scheduled for separation or retirement 
for reasons other than physical disability creates a presumption of fitness for duty.  This 
presumption may be overcome if it is established by a preponderance of the evidence 
that:  …  acute,  grave  illness  or  injury,  or other  deterioration of  the  member’s  physical 
condition occurred immediately prior to or coincident with processing for separation or 
retirement for reasons other than physical disability which rendered the service mem-
ber unfit for further duty.”  The Board finds that although the applicant was presump-
tively fit for duty until August 2001, when she was being processed for separation, the 
injuries she incurred in the motor vehicle accident were sufficient to overcome that pre-
sumption. 
 
The Board agrees with the Coast Guard and the applicant that her com-
 
mand erred in releasing her from active duty without ordering a new physical exami-
nation for separation after her motor vehicle accident and without convening an IMB to 
evaluate her hip condition and to determine whether she should be referred to a CPEB.  
Therefore,  the  Board  shall  order  the  Coast  Guard  to  convene  an  IMB  to  evaluate  the 
applicant regarding her fitness for duty at the time of her release from active duty in 
accordance with Chapter 3 of the PDES Manual. 
 
 
The  applicant  and  the  Coast  Guard  disagree  as  to  whether  the  Board 
should  order  the  IMB  to  consider  the  applicant’s  asthma  as  a  potentially  unfitting 
impairment.  As the Coast Guard argued, the applicant stated that her health was good 
on her Report of Medical History dated June 29, 2001, and there is no indication that her 
asthma worsened during the year prior to her release.  In addition, there is no evidence 
in the record that the applicant’s asthma caused her to be unable to perform the duties 
of  her  rank  and  rating,  which  is  the  sole  standard  for  unfitness,  pursuant  to  Chapter 
2.C.2.a. of the PDES Manual.  Moreover, there is substantial evidence in the record that 
the applicant’s asthma pre-existed her enlistment. 
 
 
As stated in finding 3, above, however, there is no evidence that the appli-
cant was given an opportunity to object on a form CG-4057 to her doctor’s finding that 
she was fit for separation on the Report of Physical Examination that was approved on 
August  8,  2001,  as  required  by  Article  12.B.6.  of  the  Personnel  Manual  and  Chapter 
3.B.5.a. of the Medical Manual.  Furthermore, as the applicant argued, the PDES Manual 
does  not  limit  the  conditions  that  an  IMB  should  consider  to  those  that  have  already 
been found to be potentially unfitting by a doctor.  Chapter 3.F.1. of the PDES Manual 
provides  that  an  IMB  “considers  and  reports  upon  any  evaluee  whose  case  has  been 
referred for consideration.  It conducts a thorough physical examination to evaluate the 
member’s  general  health.    Additionally,  all  impairments  noted  shall  be  separately 
evaluated.”    Chapter  3.G.3.  states  that  the  IMB’s  Narrative  Summary  shall  include  a 
“summary of the pertinent data concerning each complaint, symptom, disease, injury or 

7. 

6. 

8. 

 

disability presented by the evaluee, which causes or is believed by the medical board to 
cause impairment of the evaluee’s physical condition.”  
 

9. 

The  Board  has  already  found  that  the  applicant  was  erroneously denied 
an IMB, under Chapter 3.D.8. of the Medical Manual and Chapter 2.C.2.b. of the PDES 
Manual.  If the applicant had been evaluated by an IMB prior to her release from active 
duty,  she  would  certainly  have  been  entitled  to  present  the  issue  of  her  asthma,  in 
accordance with Chapter 3.G.3. of the PDES Manual.  If she had, the IMB would have 
been free to decide whether or not her asthma was a disqualifying and unfitting condi-
tion and to make findings and recommendations accordingly.  Although the applicant 
has not proved by a preponderance of the evidence that her asthma rendered her unfit 
for duty, the BCMR is not a medical board, and it will not limit the IMB’s discretion in 
deciding what conditions, if any, rendered her unfit to perform the duties of her rank 
and rating prior to July 1, 2002. 
 
 
10.  Accordingly,  relief  should  be  granted  by  ordering  the  Coast  Guard  to 
convene an IMB to evaluate the applicant and determine whether she was unfit for duty 
prior  to  her  release  from  active  duty  on  July  1,  2002.    Based  upon  the  findings  and 
recommendation  of  the  IMB,  the  Coast  Guard  should  further  process  her  case  in 
accordance with the provisions of the PDES Manual. 
 
 

[ORDER AND SIGNATURES APPEAR ON NEXT PAGE]

 

 

ORDER 

The  application  of  xxxxxxxxxxxxxxxxxxxxxxxxx,  USCGR,  for  correction  of  her 

 
 
military record is granted as follows: 
 
 
The  Coast  Guard  shall  convene  an  Initial  Medical  Board  to  evaluate  her  and 
determine whether she was unfit for duty prior to her release from active duty on July 
1, 2002, because of physical impairment.  Based upon the findings and recommendation 
of  the  IMB,  the  Coast  Guard  shall  further  process  her  case  in  accordance  with  the 
provisions of the PDES Manual.   
 

 

 

 

 

 

 

 
 

 
 

 
 

 
 

 
 

 
 

 
 Philip B. Busch 

The Coast Guard shall correct her record as necessary to reflect the outcome of 
this PDES processing and shall pay her any amount she may be due as a result of such 
correction of her record. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 Harold C. Davis, M.D. 

 

 
 George A. Weller