RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2012-05354 COUNSEL: NONE HEARING DESIRED: NO ________________________________________________________________ APPLICANT REQUESTS THAT: 1. His diagnosis of anxiety, depression, and post-traumatic stress disorder (PTSD) be included in the list of unfitting conditions described on his AF IMT Form 618, Medical Board Report, and the AF Form 356, Recommended Findings and Disposition of Informal or Formal Physical Evaluation Board. 2. His PTSD diagnosis be designated as a combat-related illness. 3. His disability rating with the Department of Defense (DoD) be changed from 20 percent to 100 percent and, as a result, his records be corrected to reflect he was permanently retired for physical disability instead of being discharged with entitlement to severance pay. _________________________________________________________________ APPLICANT CONTENDS THAT: He was misled by his Physical Evaluation Board Liaison Officer (PEBLO) to believe that he could only put one condition on his Medical Evaluation Board (MEB) Report for review. According to his narrative summary, the Department of Veteran’s Affairs (DVA) retroactively upgraded his diagnosis of anxiety and depression to PTSD since his date of separation (DOS). The applicant’s complete submission, with attachments, is at Exhibit A. _________________________________________________________________ STATEMENT OF FACTS: The applicant’s military personnel records indicate he enlisted in the Regular Air Force on 26 Feb 02. On 16 Sep 05, the applicant was honorably discharged with a narrative reason for separation of “Disability with Severance Pay” and was credited with 3 years, 6 months, and 21 days of total active service. According to information provided by the applicant, on 16 Mar 06, the DVA evaluated the applicant’s diagnosis of dysthymia with anxious and granted him a 30 percent disability rating. On 9 Oct 08, the DVA reevaluated the applicant’s claim and retroactively upgraded his diagnosis of anxious mood to PTSD and increased the disability rating to 70 percent. The remaining relevant facts pertaining to this application are contained in the letters prepared by the appropriate offices of the Air Force, which are at Exhibits C and F. _________________________________________________________________ AIR FORCE EVALUATION: AFPC/DPFD recommends denial indicating there was no evidence of an error or injustice that occurred during the disability process or at the time of separation. The applicant’s military personnel records indicated that the Informal Physical Evaluation Board (IPEB) did not consider the applicant for PTSD and his exception letter only described all the back pain experienced during his time in the military. The applicant concurred with the recommendation of the board, and on 16 Sep 05, was honorably discharged from the Air Force. The DoD and DVA disability evaluation systems operate under separate laws. Title 10 USC states that Physical Evaluation Boards (PEB) determine if a member’s condition renders them unfit for continued military service. A diagnosed medical condition does not necessarily mean that the condition is unfitting for continued military service. To be unfitting, the condition alone must preclude the member from fulfilling their military duties. The USAF disability boards must rate disabilities based on the member’s condition at the time of evaluation. The DVA picks up where the AF must, by law, leave off. Under Title 38 USC, the DVA determines and reevaluate service-connected conditions. Often times, the results are different ratings by the two agencies. The applicant had an opportunity to appeal for a Formal Physical Evaluation Board and appeal their findings to the Secretary of the Air Force Personnel Council, but chose not to exercise either of those rights. A complete copy of the AFPC/DPFD evaluation is at Exhibit C. The AFBCMR Medical Consultant recommends denial indicating the applicant has not met the burden of proof of error or injustice that warrants the desired change of his record. In accordance with Title 38, Code for Federal Regulations (CFR), Section 4.13, repercussions should be kept in mind when considering changing a current service connection rating. When any change in evaluation is to be made, there should be an assurance that there has been a change in the conditions, for better or worse. According to 38 CFR, Section 4.125, as it pertains to mental disorders, if the diagnosis does not conform to DSM-IV or is not supported by the findings on the examination report, it shall be returned to the examiner for substantiation. Also, if the diagnosis is changed, the rating agency shall determine whether the new diagnosis represents progression, correction of an error, or development of a new and separate condition. If it is not clear, it shall be returned to the examiner for a determination. No evidence or proof has been provided to determine that the applicant’s diagnosis of Adjustment Disorder was an error or the newly diagnosed PSTD should have been the correct diagnosis. The fact that the applicant was given a different diagnosis by the DVA provider is insufficient to invalidate the conclusions reached by competent military mental health authorities at the time of his military service. Military medical officials have been recently reminded that a “Chronic” Adjustment Disorder (lasting more than six months) is a compensable medical condition under the Veterans Affairs Schedule for Rating Disabilities (VASRD) and may warrant MEB processing, if it is the cause for career termination. The evidence presented does not reflect the applicant’s Adjustment Disorder was chronic or an independent cause for career termination. A complete copy of the AFBCMR Medical Consultant’s evaluation is at Exhibit F. _________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: The applicant reiterates that he was misled by his PEBLO that he could only list one condition on his MEB Report and that was his lower back pain. He was hesitant but decided to trust her and followed her instructions. He contends that his diagnosis of “moderate” Dysthymia with Anxious Mood on 15 Sep 05, was borderline serious and if he put the symptoms on his MEB, he would have obtained the proper diagnosis and counseling from the military psychologist and psychiatrist. Additionally, his condition was documented in the VA report as 30 percent disabling, the day after his discharge. On 20 Oct 08, the VA found that his diagnosis of PTSD with Dysthymia and Anxious Mood was disabling and prorated his disability compensation back to 17 Sep 05, the day after his discharge from the military. His case should have been denied or sent back for a review of the mental impact on his job. All he is requesting at the very least is 30 percent, recognized service in the form of a sensible retirement, health insurance for his nine year old son and wife, who is a cancer survivor and need regular checkups, and the ability to proudly state that he sacrificed himself and his body for his country instead of just a VA identification card. The applicant provided a signed statement from his ex-wife, dated 14 Apr 08 indicating, she was married to the applicant from 22 Dec 03 to 21 Sep 07. She stated that she noticed a change in the applicant’s personality when he returned from his deployment to Pakistan. She indicated that he was more withdrawn, and at times would struggle with low self-esteem, depression, and anxiety. She didn’t see these extremes before his deployment. He talked more in his sleep and was very restless. His symptoms continued to worsen when they moved to New Jersey. When they left McGuire AFB, NJ, the applicant had a stable job and was able to somewhat manage his depression and anxiety. However, his symptoms worsened toward the end of 2006. He was complaining of trouble sleeping, focusing, concentration problems, nightmares, and anger and frustration issues. This eventually led to them deciding on divorce. When she met the applicant, he was a good guy with an even temperament. She definitely witnessed a huge psychological change in him after his deployment to Pakistan. __________________________________________________________________ THE BOARD CONCLUDES THAT: 1. The applicant has exhausted all remedies provided by existing law or regulations. 2. The application was timely filed. 3. Insufficient relevant evidence has been presented to demonstrate the existence of an error or injustice. We took notice of the applicant’s complete submission in judging the merits of the case; however, we agree with the opinions and recommendations of the Air Force offices of primary responsibility (OPR) and adopt their rationale as the basis for our conclusion the applicant has not been the victim of an error or injustice. The applicant’s contentions are duly noted; however, we do not find these assertions, in and by themselves, sufficiently persuasive to override the evidence of record or the rationale provided by the AFBCMR Medical Consultant and other pertinent advisory. We are not persuaded by the evidence that the applicant’s diagnosis of PTSD warrants a change in his disability rating, consideration for the permanent disability retired list or designated as a combat-related injury. Therefore, 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-2012-05354 in Executive Session on 25 Jun 13, under the provisions of AFI 36-2603: , Panel Chair , Member , Member Although chaired the panel, in view of her unavailability, has signed as Acting Panel Chair. The following documentary evidence was considered: Exhibit A. DD Form 149, dated 30 Aug 13, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, AFPC/DPFD, dated 19 Feb 13. Exhibit D. Letter, SAF/MRBR, dated 24 Feb 13. Exhibit E. Letter, SAF/MRBC, dated 12 Aug 13. Exhibit F. Letter, BMCR Medical Consultant, dated 12 Aug 13. Exhibit G. Letter, Applicant, dated 13 Aug 13, w/atchs. Acting Panel Chair 5