RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2011-03032 COUNSEL: HEARING DESIRED: NO ________________________________________________________________ APPLICANT REQUESTS THAT: His disability discharge be changed to a permanent disability retirement. ________________________________________________________________ APPLICANT CONTENDS THAT: The Physical Evaluation Board (PEB) erred in rating his Bipolar Disorder at ten percent. The medical evidence supported a rating of 50 percent. The PEB also misdiagnosed him with a Personality Disorder. The applicant’s complete submission, with attachments, is at Exhibit A. ________________________________________________________________ STATEMENT OF FACTS: On 24 Mar 92, the applicant commenced his enlistment in the Regular Air Force. On 28 Feb 05, the applicant underwent a Medical Evaluation Board (MEB). The MEB diagnosed him with bipolar disorder, personality disorder, and migraines. The MEB recommended returning the applicant to duty and referred his case to the Informal Physical Evaluation Board (IPEB). On 15 Apr 05, the IPEB reviewed the applicant’s case and recommended discharge with severance pay with a ten percent disability rating for bipolar disorder. On 26 Apr 05, the applicant concurred with the findings and recommendations of the IPEB. On 7 Jun 05, the applicant was honorably discharged for physical disability with severance pay and a ten percent disability rating. He was credited with 13 years, 2 months, and 14 days of total active service. On 13 Oct 11, the applicant’s counsel submitted a request to temporarily withdraw the applicant’s request. On 21 Oct 11, the Board staff informed the applicant and counsel that the applicant’s case had been administratively closed per counsel’s request. The applicant’s counsel later provided rebuttal comments and requested the applicant’s case be reopened. The remaining relevant facts pertaining to this application are contained in the letters prepared by the appropriate offices of the Air Force, which are attached at Exhibits C and H. ________________________________________________________________ AIR FORCE EVALUATION: AFPC/DPSD recommends denial indicating there is no evidence of an error or injustice occurring during the disability process. The IPEB reviewed the applicant’s case and rated his bipolar disorder at 30 percent. The Board deducted 20 percent for the personality disorder per DOD guidance, which resulted in a combined compensable rating of ten percent. DOD and the Department of Veterans Affairs (DVA) disability evaluation systems operate under separate laws. Under Title 10, United States Code (USC), a PEB must determine if a condition renders the service member unfit for continued military service. The fact the member may have a medical condition does not mean that the condition is unfitting for continued military service. To be unfitting, the condition must be such that it alone precludes the individual from fulfilling their military duties. If the board renders a finding of unfit, the law provides appropriate compensation due to the premature termination of their career. Further, it must be noted that the service disability boards must rate disabilities based on the individual's condition at the time of evaluation. The DVA has the responsibility of rating the disabilities from where the AF left off. Furthermore, the DVA may rate any service-connected condition based upon future employability or reevaluate based on changes in the severity of a condition. This often results in different ratings by the DOD and DVA. A complete copy of the AFPC/DPSD evaluation is at Exhibit C. ________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: The evidence indicates at the time of the IPEB the applicant had not received a diagnosis for a personality disorder. The medical note dated 2 Feb 05 does not reflect a diagnosis for Axis II. In subsequent medical notes the Axis II diagnosis either reflects no diagnosis or deferred. The medical records show that two days prior to the MEB the applicant’s diagnosis for Axis II was deferred. All throughout the MEB process the applicant’s medical records shows a consistent Axis II diagnosis of deferred. The IPEB deducted 20 percent from the initial finding due to the assumption the applicant had been diagnosed with a personality disorder. The IPEB was not aware that the MEB repeatedly declined to diagnose the applicant with a personality disorder. Had the IPEB been made aware of the fact the applicant had not received a diagnosis of personality disorder, the results of the proceedings would have called for the case to be returned for clarification. The medical evidence shows the IPEB based its decision on inaccurate information. In support of his response, Counsel provides an expanded statement and copies of documents extracted from the applicant’s military medical records (Exhibit G). ________________________________________________________________ ADDITIONAL AIR FORCE EVALUATION: The AFBCMR Medical Consultant recommends denial noting there is no evidence of an error or injustice. Counsel contends the subsequent medical notes of the clinical psychiatrist would have altered the decision of the IPEB. Although, the clinical psychiatrist referenced Axis II as (deferred), the Medical Consultant opines this is a harmless dictation error and is not an attempt to reverse the diagnosis of a personality disorder. The applicant’s Jan 05 admission notes reflect Axis II as antisocial traits, therefore reinforcing and confirming the diagnosis of a personality disorder. The applicant’s GAF scores at the time of discharge were recorded at 60. A GAF score of 60 is associated with "Moderate symptoms, moderate difficulty in social, occupational or school functioning." This description most closely relates to a Veterans Administration Schedule for Rating Disabilities (VASRD) of "Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication." The VASRD rating would be ten percent, which is consistent with the ten percent rating given by the IPEB. Although the IPEB used a different formula to process the applicant's case the results are the same using two different approaches. The DVA initially rated the applicant at 50 percent and later increased the rating to 70 percent. The DVA, operating under a different set of laws, is empowered to periodically re-evaluate veterans for the purpose of adjusting the disability rating should their degree of impairment vary over time. The DVA is authorized to offer compensation for any medical condition determined service incurred, without regard to its demonstrated or proven impact upon a service member's retainability. A complete copy of the Medical Consultant’s evaluation is at Exhibit H. ________________________________________________________________ APPLICANT'S REVIEW OF ADDITIONAL AIR FORCE EVALUATION: A copy of the AFBCMR Medical Consultant evaluation was forwarded to the applicant on 18 Apr 13, for review and comment within 30 days (Exhibit I). As of this date, no response has been received by this office. ________________________________________________________________ THE BOARD CONCLUDES THAT: 1. The applicant has exhausted all remedies provided by existing law or regulations. 2. The application was not timely filed; however, it is in the interest of justice to excuse the failure to timely file. 3. Insufficient relevant evidence has been presented to demonstrate the existence of an error or injustice. The applicant believes he was misdiagnosed with a personality disorder and this misdiagnosis resulted in him receiving a decreased disability rating for his bipolar disorder which prohibited him from receiving disability retirement. We took notice of the applicant's complete submission, to include the rebuttal response, in judging the merits of the case; however, we agree with the opinion and recommendation of the Air Force office of primary responsibility and the AFBCMR Medical Consultant and adopt their rationale as the basis for our conclusion the applicant has not been the victim of an error or injustice. After thoroughly reviewing the evidence of record and the applicant’s complete submission, we find no errors in the applicant’s disability processing. Based on DOD’s policy at the time, the applicant received reduction in his disability rating due to his non-compensable medical condition (personality disorder). There was no evidence presented which would lead us to believe that the disability rating assigned at final disposition of his case was in error or contrary to the provisions of the governing instruction. Furthermore, the Air Force and the DVA are separate federal agencies and operate under different laws and policies. The Air Force, under Title 10, is tasked to maintain a fit and vital force and assesses a service member's disability with respect to fitness for duty and if found unfit, compensates the member based on the degree of impairment that cut-short their military career. The DVA, however, under Title 38, rates for any and all service-connected conditions, to the degree they interfere with future employability, without consideration of fitness. When combined these two systems provide a continuum of coverage of our veterans. For these reasons, it is not uncommon for the military department and the DVA to issue different ratings. Therefore, after a careful review of all the facts and circumstances of this case, and in the absence of evidence to the contrary, we find no basis to recommend granting the relief sought in this application. ________________________________________________________________ THE BOARD DETERMINES THAT: The applicant be notified the evidence presented did not demonstrate the existence of material error or injustice; the application was denied without a personal appearance; and the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application. ________________________________________________________________ The following members of the Board considered AFBCMR Docket Number BC-2011-03032 in Executive Session on 21 Nov 13, under the provisions of AFI 36-2603: , Panel Chair , Member , Member The following documentary evidence was considered: Exhibit A. DD Form 149, dated 27 Jul 11, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, AFPC/DPSD, dated 26 Aug 11. Exhibit D. Letter, SAF/MRBR, dated 23 Sep 11. Exhibit E. Letter, Counsel, dated 13 Oct 11. Exhibit F. Letter, AFBCMR, dated 21 Oct 11. Exhibit G. Letter, Counsel, dated 3 Dec 12, w/atchs. Exhibit H. Letter, AFBCMR Medical Consultant, dated 15 Apr 13. Exhibit I. Letter, AFBCMR, dated 18 Apr 13. Panel Chair