RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2014-00602 XXXXXXXXXXXX COUNSEL: NONE HEARING DESIRED: NO APPLICANT REQUESTS THAT: His discharge be changed to a medical retirement. APPLICANT CONTENDS THAT: While he was active duty, he developed depression, migraine headaches, tension headaches, bilateral tinnitus and left/ right medial tibial stress syndrome. He has been unable to run since leaving the military. He was discharged with a narrative reason of personality disorder. The applicant’s complete submission, with attachments, is at Exhibit A. STATEMENT OF FACTS: The applicant entered the Regular Air Force on 6 January 2009. On 13 January 2012, his commander notified him that he was recommending him for discharge after being diagnosed with a personality disorder, which was so severe that his ability to function effectively in the military environment was significantly impaired. The applicant acknowledged receipt of the notification of discharge. He was advised of his right to consult with legal counsel and submit statements in his own behalf. The applicant consulted counsel; however, he waived his right to submit statements. On 23 January 2012, the base legal office reviewed the case and found it legally sufficient to support separation. On 27 January 2012, the discharge authority approved the separation and directed the applicant be discharged with an honorable service characterization. He was discharged on 1 February 2012. His narrative reason for separation was listed as personality disorder. He was credited with 3 years and 28 days of active duty service. The remaining relevant facts pertaining to this application are contained in the memoranda prepared by the Air Force offices of primary responsibility (OPRs), which are attached at Exhibits C,D and F. AIR FORCE EVALUATION: AFPC/DPSOR recommends denial. The applicant's SPD code and narrative reason for separation are correct as indicated. AFI 36-3208, Administrative Separation of Airmen, paragraph 5.11.9 states "A recommendation for discharge under this provision must be supported by a report of evaluation by a psychiatrist or clinical psychologist that confirms the diagnosis of a disorder listed below, as contained in the Diagnostic and Statistical Manual of Medial Disorders (DSM-IV)." The commander received such a report from a qualified medical professional and provided the documented evidence to the discharge authority with a recommendation for discharge. This was done correctly and in accordance with the discharge instruction. The applicant's character of service is correct as indicated on the DD Form 214, Certificate of Release or Discharge from Active Duty. Both the commander and the discharge authority determined the applicant's character of service warranted an Honorable discharge. The discharge, to include the SPD code, narrative reason for separation and character of service were consistent with the procedural and substantive requirements of the discharge regulation. There was no evidence provided by the applicant to show an error or injustice occurred in the processing of his discharge. The complete AFPC/DPSOR evaluation is at Exhibit C. The BCMR Medical Consultant recommends denial. On 21 October 2011, the results of a mental health evaluation conducted by a psychiatrist, was addressed to his commander. The report indicated that antidepressants were initiated during the hospitalization and at follow-up at the military facility, but "were not effective as it was believed that the Service member's underlying personality disorder likely contributed to these symptoms." The report also indicated that the applicant was seen for 23 sessions until 8 September, at which time treatment was terminated after achieving "maximal medical benefit," but that occupational/interpersonal difficulties continued, to include following military customs and courtesies, and problems with command and authority." The concluding diagnostic arrangement included: Axis I: Depression, not otherwise specific, in remission, and Axis II: Personality Disorder, not otherwise specified. The applicant's intervening separation history and physical [DD Form 2697, Report of Medical Assessment], initiated on 13 January 2012, on which the evaluating provider noted: "PT [patient] has no current health complaints and migraine HA [headaches] are stable on current medications. He has been evaluated by mental health and cleared from any threatening disorders, but has personality disorder conflicting with military lifestyle and regulations. Clear for separation. Follow-up care as needed with civilian PCM, mental health, [and] neurology if needed for headaches.” On 23 July 2013, a rating decision was dispatched from the Department of Veterans Affairs (DVA), assigning the applicant a 50% disability rating for migraine and tension headaches, a 10% disability rating for depression, not otherwise specified, a 10% rating for bilateral tinnitus, and a 0% [zero] rating each for left and right tibial stress syndrome. Zero percent ratings are assigned by the DVA when there is no current demonstrable functional impairment, albeit acknowledged as service-connected. In the rationale for the rating decisions, the VA examiner also noted the applicant's "Personality Disorder, not otherwise specified" and acknowledged that "Personality Disorder is not recognized as a disability for VA purposes." Addressing the applicant's expressed desire for a medical retirement, the military Disability Evaluation System (DES), established to maintain a fit and vital fighting force, can by law, under Title 10, United States Code (U.S.C.), only offer compensation for those service incurred diseases or injuries which specifically rendered a member unfit for continued active service and were the cause for career termination; and then only for the degree of impairment present at the lime of separation and not based on future occurrences. Also acknowledging the applicant's other reported medical conditions, no evidence is supplied to indicate that either of these conditions interfered with his ability to perform his military duties to the extent or duration that warranted an alternative separation under AFI 36- 3212, Physical Evaluation for Retention, Retirement, and Separation, as would be reflected on AF Forms 422s [e.g., "P4" or "L4" profiles]. AF Forms 469, Duty Limiting Conditions Reports, or service narrative summaries that indicate the existence of a medical condition that prohibits deployment and warrants MEB/PEB processing. On the other hand, operating under a different set of laws (Title 38, U.S.C.), with a different purpose, the DVA is authorized to offer compensation for any medical condition determined service incurred, without regard to [and independent of] its demonstrated or proven impact upon a service member's fitness for continued service or narrative reason for release from military service; nor the intervening or transpired period since the date of separation. With this in mind, Title 38, U.S.C., which governs the DVA compensation system, was written to allow awarding compensation ratings for any condition with a nexus with military service. This is the reason why an individual can be found fit for release from active military service for one reason and yet thereafter receive compensation ratings from the DVA for medical conditions found service- connected, but which was not proven militarily unfitting during the period of active service. The DVA is also empowered to conduct periodic re-evaluations for the purpose of adjusting the disability rating awards (increase or decrease) as the level of impairment from a given service connected medical condition may vary (improve or worsen, affecting future employability) over the lifetime of the veteran. The complete BCMR Medical Consultant’s evaluation is at Exhibit D. APPLICANT'S REVIEW OF AIR FORCE EVALUATION: A copy of the Air Force evaluation and the BCMR Medical evaluation were forwarded to the applicant on 22 September 2014 for review and comment within 30 days (Exhibit E). As of this date, no response has been received by this office. ADDITIONAL AIR FORCE EVALUATION: The AFBCMR Clinical Psychology Consultant recommends denial. The Clinical Psychology Consultant is familiar with the requirements used when determining whether a Service member suffers from a mental health condition that calls into question fitness or suitability for continued military service, and recognizes that a Service member suffering from multiple mental health conditions may simultaneously be potentially unfitting and unsuiting. In the case at hand, the applicant was diagnosed with personality disorder not otherwise specified and depression not otherwise specified. The former relates to his suitability for continued military service and the latter to his fitness. This Consultant reminds the applicant the mere existence of a diagnosis does not automatically trigger a recommendation for either a medical evaluation board (MEB) or administrative separation. When a condition precludes satisfactory performance of duty or worldwide assignability or deployment, a Service member is scrutinized for processing via disability evaluation system or administrative channels, as delineated by AFI 48-123 and DODI 1332.38 (versions in use at time of applicant’s discharge). A review of the materials associated with this case did not produce a compelling causal link between depression and the behavior that ultimately led to his discharge. The applicant is advised that the VA’s determination of service connection for a mental health condition is not confirmation that the diagnosis was unfitting at the time of discharge from military service. The complete AFBCMR Clinical Psychology Consultant’s evaluation is at Exhibit F. APPLICANT'S REVIEW OF AIR FORCE EVALUATION: A copy of the AFBCMR Clinical Psychology Consultant evaluation was forwarded to the applicant on 29 May 2015 for review and comment within 30 days (Exhibit G). 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 timely filed. 3. Insufficient relevant evidence has been presented to demonstrate the existence of error or injustice. We took notice of the applicant’s complete submission in judging the merits of the case; however, we are not persuaded by the evidence submitted in this appeal that a change in the record is warranted. Therefore, we agree with the opinion and recommendation of the Air Force office of primary responsibility, the BCMR Medical Consultant and the BCMR Clinical Psychology Consultant and adopt their rationale as the basis for our conclusion that the applicant has not been the victim of an error or injustice. 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-2014-00602 in Executive Session on 7 July 2015 under the provisions of AFI 36-2603: The following documentary evidence pertaining to AFBCMR Docket Number BC-2014-00602 was considered: Exhibit A. DD Form 149, dated 1 Feb 14, w/atchs. Exhibit B. Applicant's Master Personnel Record Excerpts. Exhibit C. Letter, AFPC/DPSOR, dated 7 Mar 14. Exhibit D. Letter, BCMR Medical Consultant, dated 13 Aug 14. Exhibit E. Letter, SAF/MRBR, dated 22 Sep 14. Exhibit F. Letter, AFBCMR Clinical Psychology Consultant, dated 20 May 15. Exhibit G. Letter, SAF/MRBR, dated 29 May 15.