Dresen v. United States, 14-1102

Background

Daniel Dresen, a California Army National Guard member, was separated in 2014 after a March 2013 diagnosis of Crohn's disease and sought medical severance ($33,500) or retirement and an E-5 promotion.
The CAARNG and the Army Board for Correction of Military Records (ABCMR) found Crohn's was not incurred while Dresen was on active duty for more than 30 days and thus denied military retirement/severance and correction of records.
The government originally argued Crohn's existed before service; the Court remanded for clarification on whether Crohn's is hereditary/genetic and when symptoms first manifested.
On remand medical advisers (Drs. Salinas and Twillie) reported: Crohn's etiology is uncertain; "genetic predisposition" ≠ proven hereditary disease; objective diagnosis required colonoscopy/biopsy, which occurred in March 2013.
Medical records showed rectal bleeding/anal fissures in 2007–08 attributed to constipation, no documented abdominal pain until 2013, and genetic testing in 2012 did not establish a diagnosis while Dresen was on active duty.
The Court reviewed the administrative record and granted the government's motion for judgment, concluding the ABCMR decisions were supported by substantial evidence and not arbitrary or contrary to law.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Eligibility for medical retirement/severance under 10 U.S.C. §§1201, 1203	Dresen contends Crohn's was service-incurred/aggravated and he is entitled to retirement or severance and back pay	Government: disease either preexisted service or was not incurred while on qualifying active duty; diagnosis confirmed in March 2013 after qualifying service ended	Court held ABCMR supportably found disease not incurred while on active duty >30 days; denied relief
Whether Crohn's is hereditary/genetic such that presumption of service-incurred applies	Dresen implied a hereditary origin (arguing preexisting condition or service link)	Government: "genetic predisposition" does not equate to proven hereditary disease; Crohn's etiology uncertain and objective diagnostic criteria required	Court accepted medical advisory finding that predisposition ≠ proof of pre-service disease; no basis to reverse ABCMR
Whether earlier symptoms or treatments (2007–08 surgeries) establish earlier onset	Dresen argued earlier rectal symptoms and surgeries indicated disease during service	Government: earlier symptoms were attributed to constipation and were self-limiting; no medical notes indicating Crohn's until 2013	Court found substantial evidence supports conclusion disease not diagnosed/established during qualifying service
Whether procedural or record-correction errors occurred (NDR-PEB reconvening, PEB referrals, promotion denial, anthrax vaccine causation)	Dresen raised multiple procedural and causation claims, promotion to E-5, and vaccine causation	Government: regulations followed; no record evidence of error; VA rating does not compel Army correction; no established link between anthrax vaccine and Crohn's	Court held ABCMR's denial of correction and findings on each contention were not arbitrary or unsupported and denied relief

Key Cases Cited

Chambers v. United States, 417 F.3d 1218 (Fed. Cir. 2005) (federal court reviews military disability retirement decisions for arbitrary, capricious, or unsupported-by-substantial-evidence error)
Wollman v. United States, 108 Fed. Cl. 656 (Fed. Cl. 2013) (remand for medical-origin inquiry where etiology unclear)
Bannum, Inc. v. United States, 404 F.3d 1346 (Fed. Cir. 2005) (standard for judgment on the administrative record)
Gossage v. United States, [citation="394 F. App'x 695"] (Fed. Cir. 2010) (substantial-evidence standard described)
Heisig v. United States, 719 F.2d 1153 (Fed. Cir. 1983) (court will not reweigh evidence before military board)