DEPARTMENT OF HOMELAND SECURITY
BOARD FOR CORRECTION OF MILITARY RECORDS
Application for the Correction of
the Coast Guard Record of:
BCMR Docket No. 2005-078
XXXXXXXXXXXXXXX
xxxxxxx, AMT3 (former)
FINAL DECISION
Author: Ulmer, D.
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 Chair docketed this
case on March 11, 2005, upon receipt of the applicant’s completed application and
military and medical records.
members who were designated to serve as the Board in this case.
This final decision, dated January 18, 2006, is signed by the three duly appointed
APPLICANT’S REQUEST
The applicant asked the Board to correct his record to show that he was placed
on the permanent disability retired list with a 20% disability rating for lumbosacral
strain under code 5237 of the Veterans Affairs Schedule for Rating Disabilities
(VASRD)1 in addition to the 20% disability rating under VASRD code 7528-78012 that he
received from the Coast Guard, for a combined rating of 40%. The applicant was
discharged by reason of physical disability with severance pay due to "malignant
neoplasm of the genitourinary system, in remission, residuals: scars, other than head,
face, or neck that are deep or that caused limited motion; area exceeding 12 square
1 VASRD is a Manual used by PDES boards to assign codes and percentage of disability for an evaluee
found unfit for duty. See 38 CFR part 4.
2 VASRD code assigned to the applicant for "malignant neoplasm of the genitourinary system, in
remission, residuals: scars, other than head, face, or neck that are deep or that caused limited motion;
area exceeding 12 square inches."
inches" rated as 20% disabling under VASRD code 7528-7801. To be retired by reason of
physical disability, the applicant's disability must be rated at least 30% disabling. The
applicant also complained about the fact that the FPEB considered his disability to be
none combat-related.
ALLEGATIONS
The applicant spent approximately five years on the Temporary Disability
Retired List (TDRL).3 He was subsequently removed from that list, and discharged by
reason of physical disability with severance pay, as mentioned above.
The applicant alleged that in addition to suffering from the debilitating residuals
of malignant neoplasm of the genitourinary system, he also suffered from a
thoracolumbar spine disability, which was not rated by the Formal Physical Evaluation
Board (FPEB).4
The applicant argued that the FPEB's refusal to rate his back/spinal injury
because it found the injury did not exist independently of the reason why he was placed
on the TDRL, or was not sequelae to this injury, constituted a mistake of law. In this
regard, the applicant stated that "the plain language of section 2.C.3.c.(2) of the Physical
Disability Evaluation System (PDES) Manual states that . . . 'findings are . . . required
for any impairment not previously rated.'" The provision further states, "Impairments
not previously rated shall be considered as incurred while entitled to receive basic pay
only when the evidence shows that the condition existed prior to temporary
retirement." The applicant argued that there is no requirement in section 2.C.3.c.(2) of a
nexus between an additional injury (back/spine) and the condition that caused a
member to be placed on the TDRL (malignant neoplasm). He cited Sutherland on
Statutory Construction for the principal that "words should be given their common and
approved usage." The applicant argued that since there is no mention of a sequelae
requirement in Chapter 2.C.3.c.(2) of the PDES Manual, the plain language of the
regulation makes it clear that a member can be assigned a disability rating for a
condition that was incurred prior to being placed on the TDRL irrespective or whether
there is a nexus between the claimed injury and the TDRL injury.
3 The TDRL is a list of members whose disabilities are not yet stable. A member's temporary disability
retired pay terminates at the end of 5 years, unless the member is sooner removed from the list.
4 The FPEB is a fact-finding body, which holds an administrative hearing to evaluate a member's fitness
for duty and to make recommendations consistent with the findings. This hearing is not an adversarial
proceeding, and the implication of litigation must be avoided. See Chapter 5.A.1. of the Physical
Disability Evaluation System Manual (COMDTINST M1850.2C).
In this regard, the applicant asserted that his medical records show that he
suffered from an injury to his back/spine while on active duty and that in January-
February 1998, prior to his cancer surgery, he required medical treatment for the back
injury. The applicant also stated that after cancer surgery he experienced an additional
exacerbation of the spine injury that required treatment on November 20, 1998, as
evidenced by a copy of the medical entry. He further argued that the medical evidence
shows that he is currently experiencing marked limitation of motion secondary to this
injury.
The applicant stated that his health care provider had submitted a narrative
summary showing the direct correlation between the applicant's abdominal scarring
and its exacerbating effect upon his back injury to the FPEB. The applicant also stated
that during the FPEB hearing he presented testimony from an occupational heath
practitioner and a physical therapist that he suffered from restricted range of motion in
the thoracolumbar spine5 of less than 40 degrees on forward flexion. He argued that
the FPEB conceded in its findings that he had exhibited back pain prior to being placed
on the TDRL but still did not find that this injury existed independently of the reason
why he was placed on the TDRL or was sequelae to the TDRL disability.
The applicant submitted a May 27, 2004, letter that his physical therapist
submitted on his behalf to the FPEB. The therapist stated that he had been a therapist
since 1980 and that he had treated the applicant since March 2000. He described the
applicant's physical condition as follows:
[The applicant] was originally referred to physical therapy in March 2000
for hypomobility and weakness of the trunk and pain. With the
progression of trunk exercise, [the applicant] began to experience an
increase in abdominal discomfort and eventual drainage from his
abdominal scar.
[The applicant] demonstrates 40 [degrees] of cervical flexion, 45 [degrees]
of cervical extension, 20 [degrees] of right lateral flexion, 27 [degrees] of
left lateral flexion, 50 [degrees] of right lateral rotations and 59 [degrees] of
left lateral rotation.
In the thoracolumbar spine, [the applicant]
demonstrates 39 [degrees] forward flexion, 18 [degrees] of extension, 23
[degrees] of right lateral flexion, 14 [degrees] of left lateral flexion, 23
[degrees] of right lateral rotation, and 21 [degrees] of left lateral rotation.
All of these movements performed to discomfort with repeated measures.
Strength of the abdominal musculature was grossly graded as 3+ to 4/5,
with the erector spinae being 4- to 4/5. In standing posture, [the
5 Thoracolumbar spine pertains to the thoracic and lumbar parts of the spine. See Dorland's Illustrated
Medical Dictionary, 29th edition, p. 1834.
applicant] demonstrates an increase in thoracic kyphosis, abduction of
both scapula and a rounding of both shoulders with a slight head forward
posture.
The applicant's primary care physician since May 2003 submitted a letter to the
FPEB on the applicant's behalf. Dr. F stated that he was board certified in Occupational
and Environmental Medicine and was a senior FAA medical examiner. He offered the
following:
I have reviewed the measurements of the range of motion conducted by
[the applicant's] treating physical therapist . . . and concur with his
observations that [the applicant's] thoracolumbar ROM is restricted to less
than 40 degrees of forward flexions.
In addition to his back injury, [the applicant] also suffers from pain
secondary to the involvement of the abdomen rectus muscle group
regarding his surgical scar.
[The applicant] has actually experienced a reopening of the scar while
attempting to comply with his physical therapy regimen and experiences
ongoing pain at the scar site itself.
However, the point that I would like to make clear is that his pain is due
to damage that extends deeper than the surface wound itself into the
abdomen rectus group, causing him pain and discomfort upon bending,
rotation and extension.
. . . I do not believe [the applicant] is a symptom magnifier.
SUMMARY OF THE RECORD
On November 1, 1994, the applicant enlisted in the Coast Guard. On April 10,
1995, the applicant reported to a medical clinic complaining of neck and back pain.
While the medical note indicated no objective findings, it stated that the applicant was
placed on limited duty for three days.
On June 13, 1995, the applicant reported to the medical clinic complaining of low
back pain that had existed for two weeks. The applicant claimed that the pain radiated
up the center of his spine, but admitted that it varied from day to day. The medical
entry noted that the applicant was a fireman and his work required lifting. The
medical note indicated that there was no history of trauma. The applicant was
diagnosed with a muscle spasm, given medication, and placed on limited duty for
seven days, with no lifting over 25 pounds.
On July 28, 1995, the applicant reported to the medical clinic complaining of low
back pain. The applicant was diagnosed with muscle spasms and given medication.
An x-ray of the lumbar spine was ordered as well as a physical therapy consultation.
The medical note indicated that the applicant was fit for duty.
The x-ray of the lumbar spine was negative. It stated, "The vertebral body
heights, their disc spaces and posterior elements are intact and in normal alignment.
NO compression fracture is identified. There are no pars defects. The sacroiliac joints
are normal."
An August 23, 1995, physical therapy note indicated that the applicant had been
evaluated on July 31, 1995 for spondylosis of the lumbar spine and had had five
subsequent visits. The applicant was placed on a home exercise program.
On January 8, 1998, the applicant reported to the clinic complaining of low back
pain. The applicant denied a recent history of trauma. He was diagnosed with a
mechanical back strain. He was placed on light duty.
On January 14, 1998, the applicant returned to the clinic for follow-up of his back
pain. He was diagnosed with muscle spasms and prescribed medication. He was
found not fit for duty for 48 hours and ordered to return to the clinic in two days.
On January 16, 1998, the applicant returned to the clinic for follow-up, where he
was referred to physical therapy and given light duty for one week with no lifting over
15 pounds. A physical therapy consult was provided this same day.
On January 23, 1998, the applicant reported to the clinic where his pain was
noted as resolving. He was found fit for light duty for 15 days.
On February 5, 1998, the applicant reported to the medical clinic for follow-up
and was found fit for duty.
On February 24, 1998, March 3, 1998, and March 10, 1998, the applicant appears
to have had physical therapy treatments.
On March 19, 1998, the applicant reported to the clinic complaining about a lump
in his testicle.
On April 9, 1998, the applicant underwent a radical orchiectomy,6 and on April
30, 1998, he underwent a left modified nerve sparing retroperitoneal7 lymph node
dissection.
From May through July 21, 1998, the applicant had several limited duty and
medical board evaluations. The July 21, 1998, medical board diagnosed the applicant as
suffering from "Stage T2N1MO Mixed Non-seminomatous germ cell tumor of the
testis." The medical board noted that the applicant had been offered two years of
limited duty for follow-up of his cancer, but now desired a medical board. The medical
board determined that the applicant's condition interfered with the reasonable
performance of his assigned duties and on that basis referred his case to the Coast
Guard reviewing authority for determination. The medical board stated that while
awaiting the results of the Physical Evaluation Board, the applicant would require
monthly follow-ups for two years, but otherwise his physical activities were unlimited.
The medical board noted that if the applicant were retained in the military he would
require an assignment near a major medical center for follow-up appointments.
The applicant's commanding officer (CO), as required by regulation, commented
on the report of the medical board8 and recommended approval. The CO described the
applicant as a conscientious, hardworking member of the unit who is called upon to
serve as an air crewman on local flights and frequent C130 deployments for three to
seven days while not performing C130 aircraft maintenance. The CO stated that the
applicant's duties were consistent with those of his peers, and that prior to and since
recuperation from chemotherapy for his cancer, the applicant had been able to perform
all duties assigned and expected of him. According to the CO, the applicant worked
with his supervisors to meet all expectations, but had encountered some difficulty in
scheduling and meeting follow-up medical appointments. The CO noted that the
applicant had decided to leave the Coast Guard and return to the civilian workforce
and wanted to be discharged on May 1, 1999. The CO recommended favorable
consideration for the applicant's concerns about the inability to obtain medical
insurance once discharged from the Coast Guard.
On October 5, 1998, the applicant submitted a rebuttal to the finding of the
medical board, expressing concern about the need for ongoing medical treatment and
the unlikelihood of obtaining health insurance once he was out of the Service. The
6 Orchiectomy is the excision of one or both testes. See Dorland's Illustrated Medical Dictionary, 29th
Edition, p. 1274.
7 Retroperitoneal means external to or posterior to the peritoneum. Id. at 1568. The peritoneum is the
serous membrane lining the abdominopelvic walls. Id. at 1358.
8 Apparently a medical board was held in June 1998 on which the applicant's CO provided comment.
Apparently this medical board had recommended placing the applicant on limited duty, after which he
was expected to be fit for full duty.
medical board referred the applicant's case to the Central Physical Evaluation Board
(CPEB).
On February 8, 1999, the CPEB diagnosed the applicant as suffering from
"Malignant Neoplasm of the Genitourinary System Rated as Renal Dysfunction." It
recommended that the applicant be temporarily retired with a 30% disability rating. On
March 15, 1999, the applicant accepted the findings of the CPEB, and he was
subsequently placed on the TDRL.
On November 11, 1999, a medical note indicated that the applicant complained
about low back pain. The doctor prescribed medications and exercise for the applicant
and placed him on light duty, with no lifting greater than 20 pounds.
On October 25, 2000, the applicant underwent his first TDRL periodic
examination.9 The TDRL report stated that the applicant reported no current
complaints. The physician recommended that the applicant be continued on the TDRL
and noted no significant change in the applicant's condition since his initial placement
on the TDRL. The physical examination revealed the following:
Patient is a healthy appearing 25-year-old Caucasian male in no acute
distress. Neck is supple without adenopathy or bruits. Lungs are clear to
auscultation bilaterally. Cardiovascular exam shows a regular rate and
rhythm without murmurs, rubs or gallops. Back is without CVA or spinal
tenderness. Abdominal exam shows a well-healed midline abdominal
incision. Patient has normoactive bowel sounds and has no palpable
abdominal masses. The patient also has a left inguinal incision. The
patient has normal phallus. His left testicle is surgically absent. His right
testicle is normal without evidence of mass. His extremities are without
clubbing, cyanosis or edema. His neurological examination is grossly
non-focal. [Emphasis added.]
In February 2003, the applicant underwent a second TDRL medical examination.
The medical report dated February 28, 2003, noted that the applicant had no complaints,
weight loss, or constitutional symptoms. The medical report stated that the applicant
was "approaching five year disease free interval from nonseminomatous germ cell
tumor with evidence of recurrence."
9 A member on the TDRL must undergo periodic physical examinations and CPEB review to determine
if the member's condition has stabilized sufficiently to adjudicate the case. An examination is required (1)
at least once every 18 months; (2) not less than 12 months prior to the termination of 5 years from the date
the member was first placed on the TDRL; and or (3) at any other time as specified by appropriate
authority. See Chapter 8.C. of the Physical Disability Evaluation Manual.
The applicant's record also contains an April 8, 2003, letter from a physical
therapy rehabilitation clinic, which stated that during March and April 2000, the
applicant was a patient following a motor vehicle accident. It stated the following:
[The applicant] was a patient in our physical therapy clinic during March
and April of 2000, following a motor vehicle accident. With the treatment
progression associated with his low back pain, we initiated trunk
strengthening. During trunk strengthening, [the applicant] experienced
both subjective discomfort and eventual objective drainage from his
abdominal scar. This occurred with abdominal strengthening. In his
chart on 4/05/2000, the subjective complaint of abdominal discomfort is
noted. To the best of my recollection, by decreasing his abdominal
strengthening, [the applicant's] discomfort resolved.
In or around February 2004, the applicant underwent a third TRDL examination.
The medical report notes that the applicant complained about occasional back pain.
Upon physical examination, the doctor reported that the applicant was alert and
oriented; that he had no cervical or supraclavicular adenopathy; that his abdomen was
without palpable mass; that he had a 21 cm midline scar 1 cm in width, mildly tender;
that his right testicle was without mass; that his left testicle was absent; and that he had
flexion and extension of the back, was nontender, and no limited motion on exam.
On March 3, 2004, the applicant underwent a retirement/medical board physical
The applicant was found not qualified for service during this
examination.
examination. The medical report did not clearly state why the applicant was found not
fit for duty, but the President of the CPEB (discussed later) attributed the finding to the
applicant's tender scar that partially impeded the applicant's mobility.
After approximately five years on the TDRL, the CPEB met and found the
applicant unfit for duty because of "malignant neoplasm of the genitourinary system, in
remission, residuals: rated as scar, superficial on examination." The CPEB rated the
applicant's disability as 10% disabling and recommended his discharge with severance
pay. The President of the CPEB attached an amplifying statement noting that the
applicant's cancer was in full remission and that a loss of one testicle was not an
unfitting condition. The amplifying statement noted that the applicant did not pass a
flight physical on March 3, 2004, due to a tender scar that partially impeded his
mobility, which was a ratable residual of the original unfitting condition. On May 26,
2004, the applicant rejected the findings of the CPEB and demanded a hearing before
the FPEB.
On June 17, 2004, the FPEB agreed that the applicant was unfit for duty due to
"malignant neoplasm of the genitourinary system, in remission, residuals: scars, other
than head, face, or neck that are deep or that cause limited motion; area exceeding 12
square inches" and rated his disability as 20% disabling under VASRD code 7528-7801.
The FPEB also attached an amplifying statement, which contained the following in
pertinent part:
In considering this case, the [FPEB] did review evidence concerning [the
applicant's] claim of spine impairment. The [FPEB] did find evidence in
the record that [the applicant] had experienced back pain and that his pain
was documented prior to his being placed on the TDRL in February of
1999. However, the [FPEB] determined from the medical evidence that
the back pain existed independent of his reasons for being placed on the
TDRL and furthermore, was not sequalae, while on TDRL, to the reason
for his being placed on the TDRL. The [FPEB] determined that [the
applicant's] disability was not incurred during combat and was not the
result of an instrumentality of war.
On June 30, 2004, the applicant submitted a rebuttal to the findings and
recommendations of the FPEB. He argued then as he argues before this Board that the
FPEB's failure to rate his thoracolumbar spine injury was a mistake of law and that it
should have rated the applicant's spine injury as 20% disabling.
On July 8, 2004, the President of the FPEB denied the applicant's rebuttal. The
President of the FPEB stated the following, in pertinent part:
The [FPEB] considered your claim that [it] made a mistake of law . . . in its
finding of June 17, 2004 . . . Title 10 USC Chapter 61, Sec 1210 . . . required
the Secretary to make a final determination in TDRL cases on the physical
disability(s) "for which the member's name was carried on the temporary
disability retired list." Your interpretation of [Section 2.C.3.c.(2) of the
PDES Manual] inappropriately expands the law . . . and this is not
permitted. The aforementioned section of [the PDES Manual] as written,
pertains to entitlement to receive basic pay if the disability existed prior to
retirement. The [FPEB] does recognize you had a pre-existing back
impairment at the time of your separation for TDRL. However, the record
does not support your claim that this was an unfitting condition.
The [FPEB] then considered your claim that other services making TDRL
final determinations allow for disabilities that were not part of the original
TDRL finding. The other services subject to Title 10 USC Chapter 61 make
allowances for these disabilities if they are documented prior to the
member being separated and if they are deemed unfitting. Once again,
the [FBEP] reviewed the medical evidence in this case and found that your
back condition taken independently at the time of your temporary
retirement, would not have made you permanently unfit for duty at that
time.
The [FPEB] considered additional medical evidence provided by Dr. [F]
regarding his opinion of the nexus between your existing back condition
and the possible worsening of this condition by the existence of your
abdominal scar . . . The Board recognizes Dr. ]F's] opinion. However, the
preponderance of the evidence in this case shows you never claimed your
back condition as being disabling or making you unfit for duty, even
though you had several opportunities to do so both prior to your going on
the TDRL and during your TDRL period (all while your scar was healing).
More significantly the record shows your back condition only became an
issue after (and in direct response to, given the medical treatment sought)
you had a motor vehicle accident during the course of your five-year
TDRL period. The evidence shows it was this incident, if any, and not
your scar, that exacerbated your back condition. Based on the above, your
back condition is not sequelae to the condition for which you were placed
on the TDRL. Furthermore your back condition at the time you were
placed on the TDRL did not make you unfit for duty, independently of
your testicular cancer condition.
On September 7, 2004, the PRC reviewed the findings of the FPEB and found no
errors in the findings of the FPEB and concurred with the findings and disposition. On
September 23, 2004, the Judge Advocate General found the PEB proceedings to be in
accepted form and technically correct, the findings to be supported by the evidence of
record, and the recommended disposition to be supported by the evidence of record.
On September 27, 2004, the Deputy, Coast Guard Personnel Command directed
that the applicant's name be removed from the TDRL and that he be separated from the
Coast Guard with severance pay.
Decision of the Department of Veterans Affairs (DVA)
On or about September 9, 1999, the DVA rated the applicant as being 10%
disabled due to Tender Abdominal Scar, 10% disabled for low back strain, and 10%
disabled due to Tender Testicular Scar for a combined disability rating of 30%. The
applicant underwent a DVA compensation and pension examination on August 3, 1999,
approximately three months after his discharge from the Coast Guard. The physical
examination of the applicant's abdomen and musculoskeletal areas revealed the
following pertinent information:
ABDOMEN: There is a surgical scar . . . [which] is slightly hypertrophic
. . . Very light stroking causes discomfort along the scar. Any deeper
palpation in the scar area at all, is reported as a deep aching sensation.
We find no organomegaly. Bowel sounds are normal.
MUSCULOSKELETAL: He undresses with no difficulty. He stands erect
with the shoulders and pelvis level. With straight knees, he can bend
forward getting his fingertips within about 2 inches from the toes and can
return to the upright position with no difficulty. In the seated position, he
will flex forward getting his shoulders down as far as his knees. He will
extend about 15-20 degrees. He complains of mild generalized low back
pain on extension movement, but not on flexion. He will rotate the trunk
bilaterally about 80 degrees and side bend bilaterally about 40 degrees
without any pain or discomfort. In the cervical area, he will flex the head
forward about 50 degrees, extend it about 50 degrees, rotate bilaterally 85
degrees, and side bend bilaterally about 40 degrees without pain or
discomfort.
On or about November 3, 2004, the DVA increased the applicant's disability
rating to 20% for Tender Abdominal Scar, and 20% due to low back strain. The DVA
did not increase the applicant's 10% rating for Tender Testicular Scar. The DVA
assigned the applicant a combined DVA rating of 40%. To obtain an increase in his
disability rating, the applicant underwent a physical examination on July 20, 2004,
approximately five years after his placement on the TDRL. X-rays of the lumbar spine
were taken and revealed "normal alignment of the lumbosacral vertebrae. The disc
spaces are preserved. No bony or joint abnormality is seen." The radiologist's
impression was that of a "normal . . . lumbosacral spine." The physician stated that the
applicant's rectus abdominis muscle contracted normally in all of the tested maneuvers
and there was no evidence of diastasis recti. The physician noted that the applicant
stated that he had been told that his rectus abdominis muscle did not work properly,
which was related to his pain and back pain. However, this doctor stated that he could
not confirm the applicant's statement in this regard because the applicant had normal
rectus abdominis muscle function at that time. The physician further stated that the
applicant's "subjective complain[t]s far outstrips any objective findings on today's
examination."
VIEWS OF THE COAST GUARD
On March 28, 2005, the Judge Advocate General (JAG) of the Coast Guard
submitted an advisory opinion recommending that the Board deny the applicant’s
request.
The JAG argued that the applicant failed to show by a preponderance of the
evidence that that the Coast Guard committed legal error by not rating his back
condition. The JAG stated that the only evidence submitted by the applicant to prove
his allegation is his reference to Article 2.C.3.c.(2) of the PDES Manual which states in
part: ". . . Impairments not previously rated shall be considered as incurred while
entitled to receive basic pay only when the evidence shows that the condition existed
prior to temporary retirement." The JAG also noted that Article 2.C.3.C(3) of the PDES
Manual states that "An impairment incurred after temporary retirement shall be found
"Not incurred while entitled to receive basic pay."
The JAG noted that the FPEB reviewed evidence concerning the applicant's spine
and found that the back pain existed independently of his reason for being placed on
the TDRL and was not sequalae to the reason for the applicant's placement on the
TDRL.
The JAG stated that the applicant has the burden of proving error or injustice,
but failed to do so in this case. He argued that absent strong evidence to the contrary,
it is presumed that Coast Guard officials carried out their duties lawfully, correctly, and
in good faith. See Arens v. United States, 969 F. 2d 1034, 1037 (D.C. Cir. 1990).
The JAG stated that the DVA rating for the applicant's low back strain is not
persuasive that the Coast Guard committed an error or injustice by not rating the back
condition given the different standard employed by the DVA. In this regard, the JAG
argued that the DVA rating is not determinative of issues involved in military disability
cases. The JAG stated that the DVA determines to what extent a veteran’s civilian
earning capacity has been reduced as a result of physical disabilities. In contrast, the
Coast Guard determines if a member is unfit to perform his military duties and then
rates the extent to which the unfitting medical condition prevents the member from
performing his duties. He further stated as follows:
The procedures and presumptions applicable to the DVA evaluation
process are fundamentally different from, and more favorable to the
veteran than those applied under the PDES (Coast Guard’s Physical
Disability Evaluation System). The DVA is not limited to the time of
Applicant’s discharge. If a service-connected condition later becomes
disabling, the DVA may award compensation on that basis.
The DVA's finding that the Applicant was 40% disabled is not relevant to
the Coast Guard's finding that he was 20% disabled based solely on the
conditions that rendered him unfit for continued service at the time of his
separation. The sole standard for a disability determination in the Coast
Guard is unfitness to perform duty . . . In any event any long-term
diminution in the Applicant's earning capacity attributable to his military
service is properly a matter of the DVA, not the Coast Guard or the
BCMR.
The JAG attached comments from the Commander, Coast Guard Personnel
Command (CGPC), as Enclosure (1) to the advisory opinion. CGPC stated that the
applicant was afforded all of his due process rights with respect to the processing of his
case through the PDES. He stated he found no error in the process or the decision of the
FPEB. Moreover, he stated that the preponderance of the evidence in the case shows
the applicant never claimed that his back condition was disabling or made him unfit for
duty until he had a motor vehicle accident during the course of his five-year TDRL
period.
APPLICANT’S RESPONSE TO THE COAST GUARD’S VIEWS
On September 6, 2005, the Board received the applicant's response to the views of
the Coast Guard. The applicant stated that the Coast Guard's position that his back
condition was not sequelae to the condition that placed him on the TDRL is incorrect.
In this regard, he noted the following:
a. There is no dispute that the [applicant] suffered a lumbar spine injury
while on active duty that required him to seek medical treatment in
January to February 1998 time period, a time frame approximately two
months prior to the surgery for testicular cancer that would eventually
place him on the TDRL.
b. Likewise there is no dispute that he experienced an exacerbation of this
injury after his cancer surgery in the fall of 1998, a period of time that was
several months after the two surgical procedures to treat his testicular
cancer.
c. Where the agency's analysis of the sequelae issue falls short is in its
failure to produce any evidence refuting the medical opinion establishing
a causal nexus between [the applicant's] abdominal surgery to treat his
cancer and his back injury.
d. [T]he board-certified occupational health provider who has been
treating the [applicant] since placement on the TDRL stated that the
scarring on the [applicant's] abdominus rectus muscle group secondary to
the surgeries performed in 1998 caused additional strain on his back and
aggravated his previous back injury.
The applicant also argued that the Coast Guard is incorrect in its assertion that
his back injury was not separately unfitting at the time that he was placed on the TDRL.
In this regard, he noted that the Coast Guard conceded that the applicant suffered a
spine injury prior to being placed on the TDRL. The applicant stated that the medical
evidence shows that the injury was exacerbated in January-February 1998 and in
November 1998, a period of time after the surgeries. Therefore, he argued that a nexus
is established between the surgeries and the aggravation of the applicant's spine.
SUMMARY OF APPLICABLE LAW
Disability Statutes
Title 10 U.S.C. § 1201 provides that a member who is found to be “unfit to per-
form the duties of the member’s office, grade, rank, or rating because of physical dis-
ability incurred while entitled to basic pay” may be retired if the disability is (1) perma-
nent and stable, (2) not a result of misconduct, and (3) for members with less than 20
years of service, “at least 30 percent under the standard schedule of rating disabilities in
use by the Department of Veterans Affairs at the time of the determination.” Title 10
U.S.C. § 1203 provides that such a member whose disability is rated at only 10 or 20
percent under the VASRD shall be discharged with severance pay. Title 10 U.S.C.
§ 1214 states that “[n]o member of the armed forces may be retired or separated for
physical disability without a full and fair hearing if he demands it.”
Provisions of the PDES Manual (COMDTINST M1850.2C)
The PDES Manual governs the separation of members due to physical disability.
Chapter 3 provides that an IMB of two medical officers shall conduct a thorough medi-
cal examination, review all available records, and issue a report with a narrative
description of the member’s impairments, an opinion as to the member’s fitness for
duty and potential for further military service, and if the member is found unfit, a refer-
ral to a CPEB. The member is advised about the PDES and permitted to submit a
response to the IMB report.
Chapter 3.I.7. provides that before forwarding an IMB report to the CPEB, the
member’s CO shall endorse it “with a full recommendation based on knowledge and
observation of the member’s motivation and ability to perform.” The endorsement
must include a summary of the duties normally associated with the member’s grade or
rating and a statement regarding the member’s ability to perform those duties.
Chapter 4 provides that a CPEB, composed of at least one senior commissioned
officer and one medical officer (not members of the IMB), shall review the IMB report,
the CO’s endorsement, and the member’s medical records. Chapter 4.A.5.7. provides
that if the CPEB finds that the evidence is insufficient for a proper determination, it will
return the case to the member’s command for a Disposition Medical Board (DMB) to
amplify the record.
Chapter 2.C.2.a. provides that the “sole standard” that a CPEB or FPEB may use
in “making determinations of physical disability as a basis for retirement or separation
shall be unfitness to perform the duties of office, grade, rank or rating because of dis-
ease or injury incurred or aggravated through military service.”
Chapter 2.C.3.a.(3)(a) provides that, if a CPEB (or subsequently an FPEB) finds
that the member is unfit for duty because of a permanent disability, it will
propose ratings for those disabilities which are themselves physically unfitting or which
relate to or contribute to the condition(s) that cause the evaluee to be unfit for continued
duty. The board shall not rate an impairment that does not contribute to the condition of
unfitness or cause the evaluee to be unfit for duty along with another condition that is
determined to be disqualifying in arriving at the rated degree of incapacity incident to
retirement from military service for disability. In making this professional judgment,
board members will only rate those disabilities which make an evaluee unfit for military
service or which contribute to his or her inability to perform military duty. In accordance
with the current VASRD, the percentage of disability existing at the time of evaluation,
the code number and diagnostic nomenclature for each disability and the combined per-
centage of disability will be provided.
Chapter 9.A.8. provides that if “a medical condition which causes or contributes
to unfitness for military service is of such mild degree that it does not meet the criteria
even for the lowest rating provided in the VASRD … [a] zero percent rating may be
applied in such cases.”
Chapter 9.A.1.c. states that there is no legal requirement, in making disability
retirement determinations, to rate a physical condition, not in itself considered to be
disqualifying for military service, along with another condition that is determined to be
disqualifying, in arriving at the rated degree of incapacity incident to retirement from
military service for disability. This section further states that "except [for rating
residuals] board members will not rate those disabilities neither unfitting for military
service nor contributing to the inability to perform military 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 section 1552 of
title 10 of the United States Code. The application was timely.
2. The applicant failed to prove that the Coast Guard committed an error by not
rating his back condition prior to his removal from the TDRL and discharge with
severance pay by reason of physical disability due to "malignant neoplasm of the
genitourinary system, in remission, residuals: scars, other than head, face, or neck that
are deep or that caused limited motion; area exceeding 12 square inches" rated as 20%
disabling. The applicant is correct that under Chapter 2.C.3.c.(2) of the PDES Manual,
an impairment that is unfitting for duty should be rated during the physical disability
evaluation process whether or not it resulted from or is related to the reason for the
applicant's placement on the TDRL. Chapter 2.C.3.c.(2) of the PDES Manual states when
the CPEB (or FPEB) reviews the case of a member on the TDRL findings are required for
any impairment not previously rated. This provision further states that "[i]mpairments
not previously rated shall be considered as incurred while entitled to receive basic pay
only when the evidence shows that the condition existed prior to temporary
retirement." [Emphasis in regulation.]
3. Whether or not the FPEB's basis for refusing to rate the applicant's
back/spinal injury contained in its amplifying statement constitutes a mistake of law is
subject to interpretation. The questionable statement was " the [FPEB] determined from
the medical evidence that the back pain existed independent of his reasons for being
placed on the TDRL and furthermore, was not sequalae, while on TDRL, to the reason
for his being placed on the TDRL." However, the Board finds that if such statement in
the amplifying comments constituted a mistake, it was cured by the FPEB's reply to the
applicant's rebuttal. The reason offered by the FPEB in its reply for not rating the
applicant's alleged back/spinal injury is in accord with law and regulation. The FPEB
stated in its reply to the applicant's rebuttal that although there was evidence in the
record that the applicant had a back/spinal injury prior to placement on the TDRL, the
record did not support a finding that such injury caused the applicant to be unfit for
military duty, nor did it contribute to the applicant's unfitness for duty caused by his
testicular cancer.
4. Other provisions of the PDES Manual support the FPEB's interpretation of the
regulation as put forth in its reply to the applicant's rebuttal. Chapter 2.C.2.a. of the
PDES Manual states that the sole standard in making determinations of physical
disability as a basis for retirement or separation shall be unfitness to perform the duties
of one's rank or rating. In addition, Chapter 2.C.3.a.(3)(a) of the PDES Manual states
that the CPEB rates only “those disabilities which make an evaluee unfit for military
service or which contribute to his or her inability to perform military duty.” Last,
Chapter 9.A.1.c. of the PDES Manual states that there is no legal requirement, in making
disability retirement determinations, to rate a physical condition, not in itself
considered to be disqualifying for military service, along with another condition that is
determined to be disqualifying, in arriving at the rated degree of incapacity incident to
retirement from military service for disability. This section further states, "except [for
rating residuals] board members will not rate those disabilities neither unfitting for
military service nor contributing to the inability to perform military duty."
5. Taking into consideration the provisions just discussed, it is the applicant's
burden to prove that conditions other than those identified as disabling by the FPEB
caused him to be unfit or contributed to his unfitness for military duty, i.e. unable to
perform the duties of his office, grade, rank, or rating. Chapter 2.A.38 defines physical
disability as any manifest or latent physical impairment that separately makes or in
combination make a member unfit for continued duty. Chapter 2.A.50. defines unfit for
continued duty as the status of a member who is unable to perform the duties of office,
grade, rank, or rating because of a physical disability. Chapter 2.C.2.f.i. makes clear that
a member may have physical impairments ratable in accordance with the VASRD, but
such impairments may not necessarily render the member unfit for military duty.
6. The Board finds that the applicant did not prove that his back/spinal
condition caused him to be unfit to perform the duties of rate or rating. In this regard,
the Board finds no medical statement that the applicant was rendered unfit for duty as a
result of his back/spinal injury. The medical board report that referred the applicant's
case to the CPEB did not mention or diagnose the applicant as suffering from back
pain/injury. In fact, the medical board report of July 21, 1998, noted that the applicant
was a well-developed, well-nourished male in no acute distress. Even the applicant's
CO stated that the applicant had been able to perform all duties assigned and expected
of him prior to and since his recuperation from chemotherapy. Chapter 2.C.2.a. states
that the CO's statement is critical in determining how the applicant's conditions affected
his ability to do his job. The evidence further shows that the applicant was placed on
the TDRL on March 15, 1999 due to "malignant neoplasm of the genitourinary system"
with a 30% disability rating and that no other disabilities were rated by the CPEB at that
time. The applicant accepted the findings of the 1999 CPEB and was placed on the
TDRL with a 30% disability rating.
7. In addition, the applicant was on the TDRL for approximately five years and
had three periodic TDRL examinations during that time. The medical reports for the
first two examinations did not mention a back/spinal injury or back pain. The first
periodic examination occurred on or about October 25, 2000, and the medical report
stated that the applicant had no complaints and noted that his "back is without CVA or
spinal tenderness." The second periodic examination occurred in February 2003, and
the medical report stated that the applicant had no complaints, weight loss, or
constitutional symptoms."
8. The third periodic examination occurred in February 2004, and the medical
report noted that the applicant had some back pain, but it also stated that the applicant
had flexion and extension of the back, was nontender, and had no limited motion on
exam.
9. The applicant argued that the evidence from a physical therapist and Dr. F
proves that his back injury is secondary to his testicular cancer surgery to his abdomen.
The physical therapist states in his May 27, 2004 letter to the FPEB that the applicant
was originally referred to physical therapy in March 2000 for hypomobility and
weakness of the trunk and pain. However, the therapist failed to state, as he did in an
earlier April 8, 2003, letter, that the applicant had been in an automobile accident for
which he received physical therapy treatments in March and April of 2000. This 2003
letter also stated that the applicant experienced discomfort and drainage from the
abdominal scar during the trunk strengthening exercises. Therefore, it appears to the
Board that the applicant's physical therapy treatments and back pain were attributable
at that time to injuries caused by the automobile accident.
10. Dr. F stated in his May 28, 2004, letter to the FPEB that the applicant had
suffered a reopening of the surgical scar while attempting to comply with his physical
therapy regimen. However, the Board notes that the physical therapist's letter of April
8, 2003, indicated that the physical therapy treatments that resulted in the reopening of
the applicant's scar were prescribed after the applicant was involved in an automobile
accident and appeared to have nothing to do with the cancer treatment or surgeries.
Therefore, the Board is not persuaded that the physical therapy treatments were related
to any condition that the applicant had prior to his placement on the TDRL. Nor is the
Board persuaded by Dr. F's statement that the applicant suffered pain secondary to the
involvement of the abdomen rectus muscle group resulting from his surgical scar. In
contrast, the Board notes that the DVA's medical examination of the applicant on July
20, 2004, approximately two months later, revealed, "normal rectus abdominis muscle
function." During the five years that the applicant was on the TDRL, he did not
complain about pain in his abdomen rectus muscle group until his time on the TDRL
was about to expire. Here, it is important to note that Dr. F did not state that the
applicant's back/spine injury caused him to be disabled or unfit to perform the duties
of his rate. As stated above, a member may have physical impairments ratable in
accordance with the VASRD, but such impairments may not necessarily render the
member unfit for military duty. To be rated for a back disability while in the Coast
Guard, the applicant must prove that he incurred the disability while entitled to basic
pay and that it rendered him unfit or contributed to his unfitness to perform the duties
of his rate or rating. The applicant has not met his burden of proof on this issue.
11. Although the applicant submitted evidence showing that the DVA has
determined that he is 40% percent disabled, such evidence does not establish error by
the Coast Guard. This Board has consistently held that a higher disability rating from
the DVA does not of itself establish that the Coast Guard committed an error or
injustice by assigning a lower disability rating. In Lord v. United States, 2 Cl. Ct. 749,
754 (1983), the Court of Federal Claims stated "[d]isability ratings by the Veterans
Administration [now the Department of Veterans Affairs] and by the Armed Forces are
made for different purposes. The Veterans Administration determines to what extent a
veteran's earning capacity has been reduced as a result of specific injuries or
combination of injuries. [Citation omitted.] The Armed Forces, on the other hand,
determine to what extent a member has been rendered unfit to perform the duties of his
office, grade, rank, or rating because of a physical disability. [Citation omitted.]
Accordingly, Veterans' Administration ratings are not determinative of issues involved
in military disability retirement cases."
12. The applicant has not shown by preponderance of the evidence that he
suffered a back/spinal injury that caused him to be unfit for duty at the time he was
placed on the TDRL or contributed to his unfitness due to testicular cancer and
surgeries while on the TDRL. The applicant received all due process to which he was
entitled under the Physical Disability Evaluation System and has failed to prove that the
Coast Guard committed an error or injustice in his case. The Board would note that the
CPEB, FPEB, PRC, and the JAG reviewed the applicant's case, and none found that his
back/spine injury was unfitting for military service or contributed to his unfitness due
to his testicular cancer and surgeries.
13. The applicant complained about the FPEB's finding that his disability was
not combat-related but provided no argument or evidence to show that the FPEB
committed an error or injustice by making such a finding or that the finding was
erroneous. The Board has consistently held that a mere allegation is insufficient to
prove error or injustice. Therefore, the Board will not disturb the finding of the FPEB in
this regard.
14. Accordingly, the applicant’s request for relief should be denied.
[ORDER AND SIGNATURES APPEAR ON NEXT PAGE]
The application of former AMT3 Xxxxxxxxxxxxxxxxxxx, USCG, for correction of
ORDER
his military record is denied.
Toby Bishop
J. Carter Robertson
Eric J. Young
CG | BCMR | Disability Cases | 2002-175
On April 7, 1992, he enlisted in the Coast Guard and served on active duty until May 5, 199x, the dated he was placed on the temporary disability retired list (TDRL) 3 with a 30% disability rating for pain and limitation of motion associated with degenerative disease of the cervical and thoracic spine. On March 31, 199x, the FPEB met and found the applicant unfit to perform the duties of his rate due to severe pain and degenerative disc disease of the thoracic and cervical spine and...
CG | BCMR | Disability Cases | 2003-069
This final decision, dated December 18, 2003, is signed by the three duly APPLICANT’S REQUEST AND ALLEGATIONS The applicant, a former xxxxxxxxxxxxxxxxxxxx, asked the Board to correct her record to show that she was medically retired from the Coast Guard on January 9, 2002, with a 30% combined disability rating, including a 10% rating for neuritis of the left external popliteal nerve and a 20% rating for lumbar spondylosis, in accordance with the Veterans’ Affairs Schedule for Rating...
This final decision, dated December 18, 2003, is signed by the three duly APPLICANT’S REQUEST AND ALLEGATIONS The applicant, a former xxxxxxxxxxxxxxxxxxxx, asked the Board to correct her record to show that she was medically retired from the Coast Guard on January 9, 2002, with a 30% combined disability rating, including a 10% rating for neuritis of the left external popliteal nerve and a 20% rating for lumbar spondylosis, in accordance with the Veterans’ Affairs Schedule for Rating...
CG | BCMR | Disability Cases | 2003-133
The patient is currently without any other complaints at this time.” The doctor noted that the applicant had “chronic hepatitis-C with a histologic response to combination therapy, but the patient is unable to tolerate therapy long term due to side effects” and that he and another doctor had recommended a full year of treatment with pegylated Interferon and Rebetron. CGPC also alleged that “the medical findings and recommendations of each of the Applicant’s CPEBs were based on an...
CG | BCMR | Disability Cases | 2006-112
The record indicates that the CPEB’s findings and recom- mendations were reasonable and appropriate.” CGPC stated that the applicant has based his claim on a single clinical finding, whereas the FPEB “determined the percent- age of disability awarded based upon the overall evidence of record (i.e., MRI findings, neurosurgical consults, physical therapist findings, and expert testimony during the FPEB).” CGPC pointed out that the applicant received and exercised his full due process rights...
CG | BCMR | Disability Cases | 2003-087
He stated that on May 17, 2002, the Department of Veterans Affairs (DVA) rated his condition as 40% disabling under the Veterans Administration Schedule for Rating Disabilities (VASRD) 2 code 5293 (Intervertebral Disc Syndrome) based on the same medical evidence the Coast Guard used for its 10% disability rating under VASRD code 5295. Article 9.A.14 of COMDTINST M1850.2C (Physical Disability Evaluation System (PDES) Manual) instructs participants in the PDES to use great care in selecting a...
CG | BCMR | Disability Cases | 2002-140
On October 28, 199x, the CPEB reviewed the applicant’s case and recommended that he receive a 20-percent disability rating for his chronic lower back pain, which it analogized to VASRD codes 5299 and 5293.3 The CPEB recommended that he be sepa- rated with severance pay.4 On November 12, 199x, the applicant was informed of the CPEB’s findings and recommendation. He also stated that at the time of the FPEB, only the applicant’s back condition made him unfit for duty and so only the back...
CG | BCMR | Disability Cases | 2005-001
On December 19, 2002, the applicant’s podiatrist reported that the surgeries had been successful and that the applicant was “stable and fixed.” He stated that it was “difficult to tell if [the applicant’s foot problem was] a natural progression or if being on his feet for prolonged periods of time [as a cook for the Coast Guard] aggravated the pre-existing condition and allowed the bunions to get worse, causing pain and the necessity for surgery.” On February 6, 2003, a hand specialist...
CG | BCMR | Disability Cases | 2000-095
This final decision, dated March 7, 2001, is signed by the three duly appointed REQUEST FOR RELIEF The applicant, a former xxxxxxx in the Coast Guard, asked the Board to correct his military record to show that he was medically retired from the Coast Guard with a 50-percent disability rate on xxxxxxx, instead of being separated from the Coast Guard with severance pay due to a 10-percent disability rating. If the member fails to do so within 15 working days from the date of written...
CG | BCMR | Disability Cases | 2008-020
§ 1201 provides that a member who is found to be “unfit to perform the duties of the member’s office, grade, rank, or rating because of physical disability incurred while entitled to basic pay” may be retired if the disability is (1) permanent and stable, (2) not a result of misconduct, and (3) for members with less than 20 years of service, “at least 30 percent under the standard schedule of rating disabilities in use by the Department of Veterans Affairs at the time of the determination.”...