MEMORANDUM OF CONSIDERATION

	IN THE CASE OF:   

	BOARD DATE:           25 April 2002                   
	DOCKET NUMBER:   AR2001064676

	I certify that hereinafter is recorded the record of consideration of the Army Board for Correction of Military Records in the case of the above-named individual.

	Mr. Carl W. S. Chun		Director	
	Mrs. Nancy Amos		Analyst	

  The following members, a quorum, were present:

	Ms. Joann Langston		Chairperson	
	Mr. George D. Paxson		Member	
	Mr. Charles Gainor		Member	

	The Board, established pursuant to authority contained in 10 U.S.C. 1552, convened at the call of the Chairperson on the above date.  In accordance with Army Regulation 15-185, the application and the available military records pertinent to the corrective action requested were reviewed to determine whether to authorize a formal hearing, recommend that the records be corrected without a formal hearing, or to deny the application without a formal hearing if it is determined that insufficient relevant evidence has been presented to demonstrate the existence of probable material error or injustice.

	The applicant requests correction of military records as stated in the application to the Board and as restated herein.

	The Board considered the following evidence:

	Exhibit A - Application for correction of military 
                records
	Exhibit B - Military Personnel Records (including
	            advisory opinion, if any)

APPLICANT REQUESTS:  That all references to the psychiatric diagnosis regarding the cause of his headaches be deleted and that he be awarded the Purple Heart.

APPLICANT STATES:  That his medical records clearly show that he contracted Dengue Fever when he was on Saipan but the Army doctor ignored this fact and made an incorrect diagnosis in his case.  The diagnosis contained gross errors and was extremely prejudicial against him.  He volunteered for the Air Force Reserve after his Army discharge and volunteered for overseas duty in the Korean War while in the Air Force Reserve.  This refutes the psychiatrist’s claim that he applied for Officer Candidate School (OCS) just to get back to the States. He later earned a Doctor of Optometry degree, became a member of the Texas House of Representatives, served as a Regional Administrator during the Bicentennial Celebration, and served as the U. S. Representative to the Annual Festivities of the launch of Christopher Columbus’ voyage to discover the Americas in Spain.  He was nominated to serve as U. S. Ambassador to Belize and to Guyana and served as the Ambassador to the Kingdom of Lesotho.  These achievements refute the Army’s diagnosis that he had an Adult Situational Maladjustment.  He was not shown his medical records at the time of his discharge.  He does not know if that is routine or not.  Had he seen the faulty diagnosis he would have objected vigorously.  He was on the verge of being commissioned when he was discharged for having enough points to qualify for separation.  He was shocked when he saw this diagnosis years later, because of his later achievements and because he was still a minor at the time, not yet an adult. It is a matter of record that he was given every known test in an attempt to diagnose the cause of his headaches but they could not find any physical cause. Although the true effects of Dengue Fever were not well known at that point in time, it is well established now that Dengue Fever can cause headaches for an undetermined length of time.

He provides two articles describing Dengue Fever.  One article is from a graduate of the University of Wisconsin Medical School, with specialty training in internal medicine, who had to be alerted to the disease by a person who lived in a Dengue Fever part of the world.  After contracting the disease herself, she notes that headaches are a characteristic of the disease, headaches that cause the head to throb all the time.  Another article states that symptoms appear five to eight days after a bite by an infected mosquito and include fever, rash, severe joint and muscle pains and headache.  Full recovery may take several weeks.  If the Army psychiatrist had not been asleep on the back row of his tropical disease course in medical school, he would not have had to dream up the diagnosis of Simple Adult Maladjustment.

An addendum to his records would not be acceptable as such letters are often lost or misplaced, leaving him with the incorrect record to pass to his descendants.  As for the Purple Heart, he was wounded on Saipan in December 1944 from bomb shrapnel from a Japanese aircraft.  No report was made of this wound due to the fact the injury occurred in a remote foxhole where no medical facility was available.  The injury is noted in his Army Discharge Record.

EVIDENCE OF RECORD:  The applicant's military records are not available.  Information contained herein was obtained from alternate sources to include copies of extracts from his service record provided by the applicant.

He was born on 23 July 1924.  He was inducted into the Army on 16 February 1943 and entered active service on 23 February 1943.  He arrived in the Pacific Theater of Operations on 30 September 1943 where he apparently served as a radar operator.  His Report of Physical Examination of Enlisted Personnel Prior to Discharge, Release from Active Duty or Retirement, WD AGO Form 38, item 11 shows he had Dengue Fever in September 1944 while on Saipan.  He departed the Theater on 22 April 1945 apparently enroute to OCS at Fort Benning, GA.  

The applicant arrived at OCS on or about 18 June 1945.  He was hospitalized on 26 June 1945 with complaints of severe headaches.  The History of the Present Illness form indicates his symptoms of frontal and right parietal headaches dated to childhood.  About the age of 7 he was taken to the Mayo Clinic for a study of his headaches.  The applicant did not know the details or diagnosis of that study. He thereafter continued to have mild frontal and right parietal headaches from time to time, never severe or incapacitating and apparently related to strenuous exertion.  After contracting Dengue Fever, which from the applicant’s description was unusually protracted, he remained ill for over one month.  Since that time the headaches were increasingly severe.  He apparently sought treatment from his dispensary but after being told he would have to be sent to a psychiatrist he dropped the matter until he arrived at OCS.  Until he arrived for pre-OCS, he was almost constantly aware of the headaches but it was not sufficiently severe to be more than a minor annoyance.  With the strenuous exertion of his pre-OCS training, he found that his headaches became very severe and related symptoms increased to the point he was unable to continue and he was hospitalized.  

On 4 July 1945, the applicant was evaluated for a complaint of continuous prefrontal and temporal headaches.  His physical examination was completely negative.  A consultant could find no ocular pathology and no significant abnormality of the upper respiratory passages.  Laboratory studies revealed a routine blood count; urinalysis and Kahn were negative.  X-ray of the skull and sinuses were negative.  A neuropsychiatric consult was requested.  The examiner indicated that he did not believe there was any organic basis for the headaches, believed the applicant would not do well in OCS, and believed that he really had headaches.  

A 5 July 1945 neuropsychiatric consultation history sheet was annotated by the examiner that the applicant stated he got his headaches with physical activity in the sun.  They were worse since he had Dengue Fever.  He did not want to lose out on OCS as he feared this would send him back overseas sooner (the applicant is refuting this statement).  It was noted the applicant married on 5 May 1945.  The examiner went on to comment that he believed the applicant had a functional headache which was increased by the stress of OCS.  He did not believe he would be good officer material.  He suspected very strongly that the applicant applied for OCS to get back to the States.  He could see no medical reason why the headaches should keep him from being a full duty enlisted man.  The applicant was diagnosed as having Simple Adult Maladjustment, Situational, manifested by headaches.  It was recommended he be released from OCS and reassigned to full duty as an enlisted man.  

The applicant was returned to duty on 12 July 1945.  He was discharged from the Army on 19 November 1945.  His WD AGO Form 38, items 11 and 15 show that he injured his right knee in December 1944 on Saipan and that he had laceration scars on his right knee.  

Dorland’s Illustrated Medical Dictionary, 26th edition states that Dengue is an infectious, eruptive, febrile disease, marked by severe pains in the head, eyes, muscles, and joints, sore throat, catarrhal symptoms, and sometimes a cutaneous eruption on and painful swellings of the parts.  The disease comes on suddenly after an incubation period of from three to six days.  The symptoms increase in severity for two or three days, then decrease somewhat, only to increase again on the fourth or fifth day, at which time the eruption appears.  

Army Regulation 40-105 dated 14 October 1942 governed the standards of physical examination for commissioning in the Regular Army, National Guard of the United States, Army of the United States, and Organized Reserve.  Under Nervous and Mental Disorders, it stated that other organic or severe functional diseases of the nervous system were causes for rejection.  

Army Regulation 40-501 is the current regulation that governs medical fitness standards for enlistment and appointment, retention and separation.  Paragraph 2-28 governs enlistment and appointment standards for neurological disorders.  It states that recurrent headaches of all types if they are of sufficient severity or frequency to interfere with normal function is a cause for rejection.  Paragraph   3-30 governs retention and separation standards for neurological disorders.  It states that migraine, tension, or cluster headaches, when manifested by frequent incapacitating attacks, are causes for referral to a medical evaluation board.

Army Medical Department authorities have researched the term/description of Simple Adult Maladjustment, Situational.  It was discovered that the Diagnostic and Statistical Manual of Mental Disorders, 1st edition (DSM I) issued in 1952, used a lot of the terms in vogue during World War II.  There was a DSM I diagnosis called “Adult Situational Reaction” which was changed to “Adjustment Reaction of Adult Life” in DSM II.  These were both transient disturbances that were situationally based.  

DSM-II dated 1968 described Transient Situational Disturbances as a more or less transient disorder of any severity that occur in individuals without any apparent underlying mental disorders and that represent an acute reaction to overwhelming environmental stress.  A diagnosis in this category should specify the cause and manifestations of the disturbance so far as possible.  If the patient has good adaptive capacity his symptoms usually recede as the stress diminishes.  Disorders in this category were classified according to the patient’s developmental stage:  Adjustment reaction of infancy, of childhood, of adolescence, of adult life, and of late life.

Army Regulation 600-8-22 provides, in pertinent part, that the Purple Heart is awarded for a wound sustained as a result of hostile action.  Substantiating evidence must be provided to verify that the wound was the result of hostile action, the wound must have required treatment by a medical officer, and the medical treatment must have been made a matter of official record.

DISCUSSION:  Considering all the evidence, allegations, and information presented by the applicant, together with the evidence of record, applicable law and regulations, it is concluded:

1.  In order to justify correction of a military record the applicant must show to the satisfaction of the Board, or it must otherwise satisfactorily appear, that the record is in error or unjust.  The applicant has failed to submit evidence that would satisfy this requirement.

2.  The Board is cognizant of the fact that psychiatric terms, definitions, and descriptions change over the years.  It appears that the DSM-I description of “Adult Situational Reaction,” the DSM II description of “Adjustment Reaction of Adult Life” in DSM II, and the DSM-II description of Transient Situational Disturbances are very similar to the applicant’s circumstances at pre-OCS in 1945.  His headaches were a more or less transient disorder without any apparent underlying mental disorders and represented an acute reaction to the overwhelming environmental stress of the heat and physical activity of pre-OCS at Fort Benning, GA in the summertime.  The applicant was not a minor in the eyes of the Army and presumably was not an adolescent or child in his own eyes; therefore, it appears likely that the disorder was classified based upon his presumed adulthood.  He was an adult and his headaches were a result of his simple maladjustment to the physically stressful environment of his situation, i.e., pre-OCS.  The Board also notes that the applicant was not “on the verge” of being commissioned.  He had not started the regular OCS course yet and was still in pre-OCS.

3.  The applicant has provided no evidence to show that his headaches were the result of his contracting Dengue Fever nine months previously.  The doctors who examined him did not ignore this fact; it was mentioned in his medical writeups.  It was also noted that he had a history of headaches dating to childhood.  As the applicant acknowledges, he was given every known test in an attempt to diagnose the cause of his headaches and no physical cause could be determined.  The articles on Dengue Fever he provides do not state that Dengue Fever can cause headaches for an undetermined length of time.  The first article only noted that headaches are a characteristic of the disease.  The second article noted the characteristics of the disease -- fever, rash, severe joint and muscle pains, and headache – and noted that full recovery may take several weeks.  Neither of these two articles indicated the headaches last for an undetermined length of time and do not indicate that they last for as long as nine months.  Based upon the facts known at the time and known now about Dengue Fever, it appears reasonable that the Army would have looked for a psychiatric reason for the applicant’s headaches.  

4.  The Board will not change comments made in a psychiatric report.  Unlike a doctor who treats the physical aspects of a patient’s body, a psychiatrist must consider a noncorporeal entity – the mind.  Almost by definition he must note personal impressions rather than physical conditions in making a diagnosis.  Therefore, the Board finds no reason to change any of the neuropsychiatrist’s comments.  As to the applicant contending he did not make the comment that he didn’t want to lose out on OCS as he feared this would send him back overseas sooner, at this point in time the Board presumes regularity and that the examiner entered what he heard the applicant say.  

5.  In addition, the Army has an interest in promoting the reliability of its medical records.  Alteration of a diagnosis in those records after the fact may lead to fundamental questions about the veracity of the records in this case and generally.  For these reasons, the Board declines to alter a diagnosis in the applicant’s medical records.  The Secretary’s interest is in ensuring an orderly system in which a physician makes certain observations and recording them faithfully in the medical records at the time.  It would take an extraordinary showing for the Board to alter such a diagnosis.  In this case, the applicant’s physician made a diagnosis in good faith and based upon accepted medical principles at the time.  That observation was duly recorded in the applicant’s medical records and he has not presented sufficient reason to alter that observation.

6.  In the absence of evidence to the contrary, the Board finds no error in the applicant’s diagnosis.  The diagnosis obviously was not extremely prejudicial to him as he went on to a successful Air Force career and a successful civilian and diplomatic life.  There was no error in finding him unfit for appointment to be an officer but finding him fit for duty as an enlisted soldier.  Medical appointment standards are higher than retention standards and are so for the physical welfare of the soldier due to the extra physical and mental stress of going through either enlisted basic training or OCS.

7.  It is normal for a soldier not to be shown his medical records.  They are not subject to a periodic review as are personnel records as they are not usually used in determining personnel actions such as assignments, training (except when high standards of medical fitness must be considered, such as for flight training), or promotions.  

8.  The Board appreciates the applicant’s service in the Pacific during World War II but there is no evidence of record and he provides none to show he 
received the laceration scars on his right knee as noted on his WD AGO Form 38 in a combat injury.  Further, as noted by the applicant, the wound did not require treatment by a medical officer and accordingly no official record of medical treatment was completed.  Therefore, the regulatory requirements for award of Purple Heart were not met.

9.  In view of the foregoing, there is no basis for granting the applicant's request.

DETERMINATION:  The applicant has failed to submit sufficient relevant evidence to demonstrate the existence of probable error or injustice.

BOARD VOTE:

________  ________  ________  GRANT

________  ________  ________  GRANT FORMAL HEARING

__jl____  __gdp___  __cg____  DENY APPLICATION

		    Carl W. S. Chun
		    Director, Army Board for Correction
    of Military Records

INDEX

CASE ID	AR2001064676	
SUFFIX		
RECON		
DATE BOARDED	20020425	
TYPE OF DISCHARGE		
DATE OF DISCHARGE		
DISCHARGE AUTHORITY		
DISCHARGE REASON		
BOARD DECISION	(DENY)	
REVIEW AUTHORITY		
ISSUES         1.	107.0015	
2.	124.01	
3.		
4.		
5.		
6.