DEPARTMENT OF HOMELAND SECURITY 

BOARD FOR CORRECTION OF MILITARY RECORDS 

 
Application for Correction of 
the Coast Guard Record of: 
 
                                                                                     BCMR Docket No. 2002-169 
 
XXXXXXX, Xxxxxx X. 
xxx xx xxxx, XXXXX 
   

 

 
 

FINAL DECISION 

 
GARMON, Attorney-Advisor: 
 
 
This is a proceeding under the provisions of section 1552 of title 10 and section 
425 of title 14 of the United States Code.  It was docketed on September 16, 2002, upon 
the BCMR’s receipt of the applicant’s request for correction.  On July 24, 2003, the Board 
issued  an  Interim  Decision  directing  several  corrections  to  the  disputed  OER  for  the 
period  June  1,  19xx  to  April  30,  20xx.    However,  the  Board  held  a  single  matter  in 
abeyance for further consideration:  whether the applicant has proved that his diabetes 
played a detrimental role in his performance of assigned duties during the evaluation 
period for the disputed OER.  The Interim Decision is incorporated as part of this Final 
Decision and is attached below. 
 
 
members who served as the Board in this case on July 24, 2003. 
 

This final decision, dated October 22, 2003, is signed by the three duly appointed 

SUMMARY OF THE APPLICANT’S MEDICAL RECORD  

 

In  accordance  with  the  Board’s  Order,  dated  July  24,  2003,  the  Coast  Guard 
submitted the applicant’s original and complete medical record on August 18, 2003.  It 
is summarized, in pertinent part, as follows:   
 

On  November  12,  19xx,  the  applicant  was  evaluated  by  Physician’s  Assistant 
(PA)  R  at  a  military  medical  facility  for  diabetic-type  symptoms.    He  complained  of 
“frequency in urination” and reported that “diabetes runs in [his] family.”  The medical 
notes indicate that PA R reviewed the applicant’s laboratory (lab) results and ordered a 
series of lab testings.  The applicant was assessed as having “DM [diabetes mellitus].”   

 
 
On the 11th, 14th, and 29th of December 19xx, the applicant underwent repeated 
lab tests.  His blood glucose levels were reported at 347,1 372, and 350, respectively.  He 
was advised to continue his prescribed diabetes medication therapy.2   
 

On January 7 and 14, 19xx, the applicant underwent more lab tests.  His blood 

glucose levels were reported at 267 and 306, respectively. 
 
 
On February 11, 19xx, the applicant was seen in follow-up by PA R, who noted 
that the applicant’s diabetes needed better control, as he was still experiencing blurred 
vision.  The PA’s notes also indicate that the applicant reported improved fatigue, less 
frequent urination, and feeling well.  He underwent more lab tests and was given refills 
of his medication.  PA R found the applicant fit for full duty. 
 

On February 19, 19xx, PA R contacted the applicant regarding his lab results of 
February 11, 19xx, wherein his blood glucose level was reported at 303.  The applicant 
was advised to increase his dosage of Micronase, continue with  his other medication, 
and have more lab tests in one week.   

 
On March 19, 19xx, the applicant underwent lab tests.  His test results indicated a 

blood glucose level of 210.   

 
On March 21, 19xx, the applicant was seen in follow-up for his diabetes mellitus.  
According to PA R’s medical notes, the applicant reported feeling well, and his diabetes 
was  assessed  as  “improved.”    PA  R  recommended  that  the  applicant  increase  his 
dosage of Glucophage and return for re-evaluation in two weeks.   The applicant was 
found fit for full duty.   
 

On  April  6,  19xx,  the  applicant  was  seen  in  follow-up  by  PA  R.    The  medical 
notes  indicate  that  the  applicant  was  “feeling  improved.”    PA  R  also  noted  that  the 
applicant’s  “DM  [diabetes  mellitus]  control  [had]  improved.”    The  plan  of  treatment 
was to perform more lab tests and increase the applicant’s dosage of Micronase if his 
condition was not well controlled.  He was found fit for full duty.   

 

                                                 
1 The normal range for blood glucose is between 70 mg/dl (mg/dl means milligrams of glucose in 100 
milliliters  of  blood)  and  110  mg/dl.    Each  elevated  blood  glucose  range  carries  a  degree  of  risk  for 
developing complications.  The risk of complications is considered low for the 110 mg/dl to 180 mg/dl 
range; moderate for the 180 mg/dl to 250 mg/dl range; high for the 250 mg/dl to 400 mg/dl range; and 
very high for the 400 mg/dl to 800 mg/dl range. 
 
2 The applicant was prescribed Micronase, Glucophage, and Glucotrol—all three of which are oral anti-
diabetic medications used for the control of hypoglycemia and its associated symptoms in patients with 
non-insulin dependent diabetes mellitus type II.   

On  April  7,  19xx,  the  applicant  underwent  more  lab  tests.    His  blood  glucose 

level was reported at 218.   

 
On  April  8,  19xx,  the  applicant  had  more  lab  tests  done,  wherein  his  blood 

glucose level was reported at 264. 

 
On  May  3,  19xx,  the  applicant  was  referred  to  a  naval  diabetic  clinic  for 
evaluation.  Lab tests revealed a highly elevated blood glucose level of 406.  According 
to the notes of CDR J, a medical officer in the endocrinology department, the applicant 
“admit[ted]  to  poor  dietary  compliance  and  [a  low  level  of]  exercise.”    The  applicant 
also stated that he may have had  symptoms of polyuria,3 polydipsia,4 blurred vision, 
and  weight  loss  since  April  19xx.    The  applicant  was  provided  a  glucometer5  with 
instructions and supplies (test strips), underwent more lab work, and was scheduled for 
a nutritional evaluation.   

 
On May 4, 19xx, the applicant met with a registered nurse to discuss exercise, as 

part of his outpatient diabetes education program. 

 
On  May  6,  19xx,  the  applicant  had  an  eye  examination  with  a  civilian 
optometrist.  According to CGPC, during that examination, the optometrist noted that 
the  applicant’s  new  medication—though  not  identified  by  name—had  affected  his 
vision.   
 
On  June  1,  19xx,  the  period  of  the  disputed  OER  began.    During  this  period, 
which lasted through April 30, 20xx, the applicant served as a xxxxxxxxxxxxxx for xx 
months  and  then  as  a  xxxxxxxxxxxx  officer  for  xx  months  at  a  Coast  Guard  marine 
safety office (MSO).   

 
On June 8, 19xx, the applicant had an appointment with a registered nurse at a 
military  facility  to  discuss  “stress  management,”  as  part  of  his  outpatient  diabetes 
education program. 

 
On  June  16,  19xx,  the  applicant  met  with  a  registered  dietician  at  a  military 
nutrition  clinic  to  discuss  an  appropriate  calorie  range  and  diet,  goals  of  medical 
nutrition  therapy,  and  healthy  eating  habits.    The  appointment  was  part  of  the 
applicant’s outpatient diabetes education program. 

                                                 
3 “Polyuria” is defined as “the passage  of a large volume of urine in a given period, a characteristic  of 
diabetes.”  Dorland’s Illustrated Medical Dictionary, 1436 (29th ed. 2000) (hereinafter “Dorland’s”). 
 
4 “Polydipsia” is defined as “chronic excessive thirst and intake of fluid; it may  have an organic cause, 
such as the dehydration of diabetes mellitus ….”  Id., 1430. 
 
5 A glucometer is an instrument for home blood glucose testing.   

 
On  July  1,  19xx,  the  applicant  was  evaluated  by  CDR  J  of  the  endocrine 
department  in  the  diabetic  clinic.    According  to  the  medical  notes,  the  applicant 
appeared “clinically stable” and denied having “polyuria, polydipsia, polyphagia,6 … 
[or] fatigue.”  CDR J’s plan of treatment was to renew the applicant’s medication and 
order lab tests.  He recommended that the applicant follow-up in two to three months.   

 
On July 6 and 27, 19xx, the applicant met with a registered nurse practitioner to 
discuss  “sick  day  management”  and  “foot  care,”  respectively,  as  part  of  his  ongoing 
outpatient diabetes education program.   

 
In  Xxxxxx  and  Xxxxxx  of  19xx,  the  applicant  underwent  cataract  removal 
surgeries.    The  applicant  had  a  period  of  convalescence  after  each  surgery,  and 
according  to  CGPC,  a  number  of  post-operative  follow-up  visits  in  evaluation  of  his 
condition.   

 
On April 4, 20xx, the applicant was seen by PA R for a swollen left ring finger, 
which the applicant reported was injured while playing basketball in March 20xx.  The 
medical  notes  indicate  that  the  applicant  had  decreased  grip  strength  and  increased 
pain with palpitation of the finger but no problems with circulation.  He was diagnosed 
with a “finger strain/sprain,” provided a finger splint, prescribed Ibuprofen, (an anti-
inflammatory drug), and found fit for full duty.   

 
On November 17, 20xx, the applicant was seen at a military facility, complaining 
of soreness in his left ring finger that had not resolved since injuring it in March 20xx.  
He reported that he was only recently able to “remove his wedding ring” and “that the 
joint [was] tender to the touch.”  He was assessed with “possible arthritic changes” in 
the finger and advised to return if he experienced any new or worsening of symptoms.   

 
The  applicant’s  medical  record  contains  no  further  entries  until  approximately 

fifteen months later in February 20xx.   
 

SUMMARY OF THE APPLICANT’S RELEVANT SUBMISSIONS 

On  June  30,  2003,  the  applicant  submitted  a  signed  affidavit  from  Dr.  H,  his 

 
 
current endocrinologist, which, in pertinent part, states the following: 
 

Upon review of his outpatient health record, [the applicant] was definitively diagnosed 
with diabetes mellitus type 2 in Mar[ch 19]XX following an initial evaluation by his [U.S. 
Coast Guard] primary care provider in Nov[ember 19]XX.  Initial symptoms did include 
blurred vision, and frequent urination.  The frequent urination particularly at night made 

                                                 
 
6 “Polyphagia” is defined as “excessive eating; gluttony.”  Dorland’s, 1434.   

getting  the  proper  amount  of  sleep  difficult  leading  to  fatigue,  another  common 
symptom of many due to an abnormal elevation in blood sugar.  [The applicant] reported 
a family history notable for diabetes mellitus type 2, a fact placing him at increased risk 
of disease development.  Following initial diagnostic testing and therapy, [the applicant] 
was  subsequently  referred  to  an  endocrinologist  at  [a  naval  medical  center]  and 
completed initial specialty consultation in May [19]XX. 
 
It  is  probable  that  [the  applicant]  suffered  from  a  temporary  strain  associated  with 
adjusting  to  the  diagnosis  of  diabetes  type  2  and  the  life  long  requirement  for  daily 
therapy.  It is also probable that the temporary strain and the physiological changes in his 
body impacted his occupational performance in a negative fashion. 

On August 4, 20xx, the applicant’s XXXXXXXX (XXX) selection board convened.  

 
 
The applicant was not selected for promotion to the next higher rank of XXX.   
 
By memorandum dated September 17, 20xx, the applicant requested the removal 
 
of his failure of selection by the 20xx XXX selection board, should the Board decide to 
remove the disputed OER in its entirety. 
 
 

APPLICABLE LAW 

 
Personnel Manual (COMDTINST M1000.6A) 
 
 
Article  7.A.2.e.  of  the  Personnel  Manual  defines  “sick  leave”  as  the  “period  of 
authorized absence granted to persons while under medical care and treatment.  Article 
7.A.5.F. provides that “[s]ick leave is granted for illness, injury, and convalescence.”   
 
Medical Manual (COMDTINST M6000.1B)  
 
Article 1.A.1.a. of the Medical Manual sets forth the mission of the Coast Guard 
 
Health Service Program.  It provides that “[t]he Health Services Program supports the 
Coast  Guard  missions  by  providing  quality  health  care  to  maintain  a  fit  and  healthy 
active duty corps ….” 
 
Article  1.B.1.  provides  that  “[t]he  principal  duty  of  medical  officers  is  to 
 
understand and support the operational missions of the Coast Guard.  Medical Officers 
include Physicians, Physician Assistants …, and Nurse Practitioners ….” 
 

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 submission, and appli-
cable law: 
 

1. 

2. 

3. 

4. 

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

 
§ 1552.  The application was timely. 
 
In the Board’s Interim Decision issued in this matter on July 25, 2003, all 
 
dispositive issues were addressed and decided, with the exception of one regarding the 
applicant’s  medical  condition.    The  sole  issue  now  before  the  Board  is  whether  the 
applicant has proved that his diabetes played a detrimental role in his performance of 
assigned duties during the evaluation period for the disputed OER.   
 
 
According to the applicant’s medical record, he was first diagnosed with 
and treated for diabetes mellitus type II in November 19xx.  The record further indicates 
that, on various occasions, the applicant experienced health problems associated with 
his condition.  However, during the June 1, 19xx through April 30, 20xx period of the 
disputed OER, the objective medical evidence showing that his diabetes detrimentally 
affected  his  performance  of  duties  is  slim.    The  record  contains  a  statement  from  his 
current endocrinologist who opined that “[i]t is probable that [the applicant] suffered a 
temporary  strain  associated  with  adjusting  to  the  diagnosis  of  diabetes  …”  and  that 
such  strain  and  “the  physiological  changes  in  his  body  impacted  his  occupational 
performance in a negative fashion.”  However, the applicant’s medical record contains 
no  evidence  of  his  taking  any  sick-in-quarters  days  or  being  found  unfit  during  the 
evaluation  period.    Moreover,  according  to  medical  notes  made  on  July  1,  19xx,  the 
applicant  stated  that  he  had  no  complaints  of  polyuria,  polydipsia,  polyphagia,  or 
fatigue—all  symptoms  which  he  claimed  had  a  negative  impact  on  his  health  and 
ability  to  work—and  was  found  to  be  “clinically  stable”  by  the  examining  medical 
officer.   
 
 
Given  the  above  evidence,  the  record  fails  to  indicate  that,  during  the 
evaluation  period,  the  applicant’s  diabetes  either  limited  his  physical  or  mental 
capabilities,  or  had  more  than  a  minimal  effect  on  his  ability  to  perform  his  assigned 
duties.  Although the treating endocrinologist concluded that the applicant underwent 
strain  upon  being  diagnosed  with  diabetes,  he  said  that  the  strain  was  temporary.  
According to the medical record, the diagnosis of diabetes was rendered in November 
19xx—nearly seven months prior to the commencement of the period of the disputed 
OER.  The Board therefore finds insufficient evidence to conclude that the applicant’s 
temporary strain associated with his diagnosis of diabetes had a significant effect on his 
ability 
the 
endocrinologist’s  opinion,  the  applicant  submitted  no  statements  or  other  credible 
evidence to support his contentions regarding physical manifestations of the symptoms 
he  claims  to  have  detrimentally  affected  on  his  performance  during  the  evaluation 
period.  Consequently, the applicant has not proven by a preponderance of the evidence 
that  his  diabetes  detrimentally  interfered  with  his  ability  to  perform  assigned  duties 
between June 1, 19xx and April 30, 20xx.  
 

  Moreover,  aside 

to  work  during 

the  evaluation  period. 

from 

5. 

 
With respect to the applicant’s Xxxxxx and Xxxxxx 19xx cataract surgeries 
and the periods of convalescence leave associated therewith, he was granted sick leave 
and  excused  from  duty  in  accordance  with  applicable  Coast  Guard  regulations.    See 
Articles 7.A.2.e. and 7.A.5.f. of the Personnel Manual.  The days of leave during which 
the  applicant  was  not  observed  were  not  factored  into  his  performance  evaluation 
during the period of the disputed OER, and therefore, had no bearing on the marks or 
comments he received. 
 
 
Furthermore,  the  record  fails  to  support  a  finding  that  the  Coast  Guard 
unfairly  failed  to  accommodate  his  condition.    See  Article  10.A.2.b.2.i.(2)  of  the 
Personnel  Manual.    The  applicant  argued  that  because  the  symptoms  associated  with 
his condition had a “negative impact on [his] ability to sit, view the computer monitor[,] 
and  focus  on  his  work,”  the  Coast  Guard  should  have  changed  his  duties  in  such  a 
manner to enable him to perform well.  However, the record fails to show any evidence 
that the applicant ever announced to Coast Guard officials, medical or otherwise, that 
he  was  unable  to  continue  to  perform  his  assigned  duties  because  of  his  diabetes.  
Without  substantial  evidence  that  the  applicant’s  diabetes  was  hindering  his 
performance or that he ever complained that it was hindering his performance during 
the evaluation period, the Board cannot find either that the Coast Guard had a duty to 
adjust his duties to accommodate his condition or that it unreasonably failed to do so. 
 
 
Lastly,  in  his  response  to  the  memorandum  from  CGPC,  the  applicant 
argued that the Board should remove the disputed OER from his record based on his 
contention  that  the  Coast  Guard  provided  inadequate  medical  treatment  for  his 
diabetes, which resulted in his diminished performance of assigned duties.  However, 
to  be  entitled  to  such  relief,  the  applicant  must  overcome  the  strong  but  rebuttable 
presumption  that  Coast  Guard  medical  officers  have  acted  correctly,  lawfully,  and  in 
good faith in executing their duties of “providing quality health care to maintain a fit 
and healthy active duty corps ….”  See Arens v. United States, 969 F.2d 1034, 1037 (Fed. 
Cir. 1992); Sanders v. United States, 594 F.2d 804, 813 (Ct. Cl. 1979); Articles 1.A.1.a. and 
1.B.1. of the Medical Manual.  The applicant may rebut this presumption only with clear 
and persuasive evidence to the contrary.   
 
To prove that the treatment of his condition was inadequate, the applicant 
 
relies heavily on his own complaints regarding his care and on the fact that his care was 
transferred to a naval medical facility in May 19xx.  While this evidence may indicate 
that  the  applicant  was  displeased  with  his  treatment,  it  does  not  substantiate  the 
applicant’s  contentions  that  he  received  improper  medical  care  or  treatment  from  the 
Coast Guard.   
 
The  medical  record  establishes  that  when  the  applicant  first  sought 
 
treatment  in  November  19xx,  he  was  diagnosed  with  diabetes  mellitus  type  II  and 
immediately  prescribed  anti-diabetic  medications  based  on  the  clinical  findings  from 

7. 

6. 

8. 

9. 

laboratory  tests  ordered  by  Coast  Guard  medical  officers.    During  the  course  of  his 
treatment, the applicant’s condition was frequently monitored through laboratory tests 
performed  to  check  his  blood  glucose  levels  on  more  than  fifteen  different  occasions, 
and  his  anti-diabetic  medications  were  adjusted  based  on  those  clinical  findings.  
Moreover, the Coast Guard’s initial diagnosis of diabetes mellitus type II has remained 
unchanged  to  the  present  day.    In  view  of  the  foregoing,  the  Board  cannot  find  any 
persuasive  evidence  in  the  record  to  support  the  applicant’s  allegation  that  the  Coast 
Guard  provided  him  improper  medical  treatment.    Nor  does  the  Board  find  that 
adjustments made to the applicant’s anti-diabetic medication amounted to a failure to 
correctly treat the applicant’s condition.  Instead, it appears that medical officers were 
making  reasonable  modifications  to  the  applicant’s  medication  in  response  to 
fluctuations in his condition.  In the absence of objective evidence which shows that the 
medical  treatment  provided  by  Coast  Guard  officials  was  in  some  way  flawed  or 
unsound, the Board must presume regularity. 
 
 
10.  Moreover, contrary to the case in BCMR Docket No. 66-80, the instant case 
presents no medical evidence indicating that the Coast Guard failed to “diagnose [his 
condition] promptly and correctly.”  Although BCMR Docket No. 66-80 sets forth that 
the  Coast  Guard’s  improper  diagnosis  and  treatment  of  a  “physical  illness  beyond  [a 
member’s]  control  …  could  easily  have  a  nonspecific,  depressing  impact”  on  the 
performance of a member’s duties, the applicant has not presented credible evidence to 
satisfy  this  standard.    In  BCMR  Docket  66-80,  the  Board  found  that  the  Coast  Guard 
committed an error and an injustice which diminished the applicant’s physical capacity 
to  perform  his  duties.    In  this  case,  however,  the  medical  evidence  presented  by  the 
applicant does not establish that his diabetes was misdiagnosed or improperly treated 
or that it negatively affected his job performance during the evaluation period.  Because 
the applicant’s  contentions are not adequately substantiated to support a finding that 
his case is factually similar to BCMR Docket No. 66-80, his reliance on that BCMR case 
is misplaced.  The applicant has not proven by a preponderance of the evidence that the 
Coast Guard’s treatment of his diabetes had a “nonspecific depressing impact” on his 
performance of duty during the period of the disputed OER.   
 

11. 

Based on his contention that the disputed OER prejudiced his chances of 
selection, the applicant requested the removal of his failure of selection by the 20xx XXX 
selection  board.    In  determining  whether  a  nexus  exists  between  the  errors  and  the 
applicant’s failure to be selected, the Board applies the standards set forth in Engels v. 
United  States,  230  Ct.  Cl.  465  (1982)  by  answering  two  questions:    “First,  was  [the 
applicant’s] record prejudiced by the errors in the sense that the record appears worse 
than  it  would  in  the  absence  of  the  errors?    Second,  even  if  there  was  some  such 
prejudice, is it unlikely that [the applicant] would have been promoted in any event?”  
However,  the  Board  finds  that  because  the  Interim  Decision  issued  on  July  24,  2003 
removed  the  inappropriate  comments  erroneously  included  in  the  disputed  OER  and 
the  reply  and  endorsements  thereto,  the  applicant’s  record  was  correct  when  it  was 

reviewed  by  the  20xx  XXX  selection  board.    Consequently,  there  is  no  need  for  an 
Engels analysis.  
 

12. 

The Board finds no basis in the record for granting the applicant’s request 
that  the  disputed  OER  be  removed  from  his  record  in  its  entirety.    Accordingly,  no 
further relief should be granted.   
 

[ORDER AND SIGNATURES APPEAR ON NEXT PAGE]

ORDER 

 
 

 
 

 
 

 
 

 

 

 
 

 
 
Julia Andrews 

 
 
The  application  of  XXXX  Xxxxxxx  X.  Xxxxxx,  xxx  xx  xxxx,  USCG,  for  the 
correction of his military record is granted only as required by the Order of this Board 
issued in its Interim Decision on July 24, 2003.  No other relief is granted.   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
Nancy Lynn Friedman 

 

 
George J. Jordan