BOARD DATE: 20 June 2013 DOCKET NUMBER: AR20120017660 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documents provided, if any). 2. Military Personnel Records and advisory opinions (if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests, in effect, correction of his DD Form 214 (Certificate of Release or Discharge from Active Duty) by changing the narrative reason for separation from personality disorder to medical discharge – post-traumatic stress disorder (PTSD). 2. The applicant states he was diagnosed with PTSD prior to discharge and the Department of Veterans Affairs (VA) has assessed and granted him (service-connected disability compensation) for PTSD. He informed the Army of his PTSD but he was pushed for a chapter 5 personality disorder instead. 3. The applicant provides his VA rating decision. CONSIDERATION OF EVIDENCE: 1. Title 10, U.S. Code, section 1552(b), provides that applications for correction of military records must be filed within 3 years after discovery of the alleged error or injustice. This provision of law also allows the Army Board for Correction of Military Records (ABCMR) to excuse an applicant's failure to timely file within the 3-year statute of limitations if the ABCMR determines it would be in the interest of justice to do so. While it appears the applicant did not file within the time frame provided in the statute of limitations, the ABCMR has elected to conduct a substantive review of this case and, only to the extent relief, if any, is granted, has determined it is in the interest of justice to excuse the applicant's failure to timely file. In all other respects, there are insufficient bases to waive the statute of limitations for timely filing. 2. The applicant's record shows he enlisted in the Regular Army on 1 August 2005 and he held military occupational specialty 74D (Chemical Operations Specialist). He served in Kuwait/Iraq from 1 August 2006 to 17 January 2007. 3. On 20 February 2007, he underwent a mental status evaluation at the Behavioral Health Clinic, Fort Hood, TX. The Mental Status Evaluation form is not completely legible. However, the legible part shows the staff psychiatrist stated: a. His behavior was passive; he was fully alert and oriented, he had a depressed mood, clear thinking process, normal thought content, and good memory. He was mentally responsible, had the capacity to understand and participate in proceedings, and he met the retention standards of chapter 3, Army Regulation 40-501 (Standards of Medical Fitness). He did not require a medical evaluation board (MEB). b. The applicant no longer required inpatient hospitalization and there were no longer any safety concerns to himself or others. He had some depression symptoms but is most concerned with his poor coping skills and characterologic defects that would be unaffected even with early-term management. He may continue to act out in order to get what he wants. He is recommended for paragraph 5-13 separation for Personality Disorder. These traits make him unsuitable for continued service. He should follow at the R/R center and at "DSAS." No weapon or ammunition. Non-deployable at the time. 4. On 1 March 2007, the applicant's immediate commander notified the applicant of his intent to initiate separation action against him under the provisions of paragraph 5-13, Army Regulation 635-200 (Active Duty Enlisted Administrative Separations) because of personality disorder. He had one episode in Iraq in which he had suicidal ideation with intent toward his roommate. He presented a command liability and impaired the overall unit readiness and functioning. He recommended an honorable character of service. 5. On 5 March 2007, after the applicant acknowledged receipt of the notification of separation action, he consulted with legal counsel and was advised of the basis for the contemplated separation and of the rights available to him in connection with the action. Subsequent to receiving legal counsel, the applicant elected not to submit statements in his own behalf. 6. Subsequent to this acknowledgement, the immediate commander initiated separation action against the applicant under the provisions of Army Regulation 635-200, paragraph 5-13, by reason of personality disorder. His intermediate commander recommended approval. 7. On 6 March 2007, the separation authority approved the applicant's separation under the provisions of paragraph 5-13, Army Regulation 635-200, by reason of personality disorder and directed the applicant be issued an honorable characterization of service. On 15 March 2007, the applicant was discharged accordingly. 8. His DD Form 214 shows he was discharged under the provisions of paragraph 5-13 of Army Regulation 635-200 with an honorable character of service. He completed 1 year, 7 months, and 15 days of active service. He was assigned the Separation Code "JFX." 9. On 10 March 2011, the VA awarded him service-connected disability compensation for PTSD at the rate of 30 percent and tinnitus at the rate of 10 percent, both effective 15 September 2010. 10. In connection with the processing of this case, an advisory opinion was obtained on 30 April 2013 from the Office of the Surgeon General (OTSG) Director of Health Care Delivery. The OTSG official states the applicant reported he was diagnosed with PTSD prior to his discharge for personality disorder. Conclusions for this advisory opinion are drawn solely based on available documentation from his time in active service unless otherwise noted. a. Prior to his deployment in October 2006, the applicant self-referred to Behavioral Health for help with depressive and anxiety symptoms, anger, and a belief he was drinking too much alcohol and wanted to stop. He disclosed that prior to entering the Army, he saw a psychiatrist at age 17 when he struggled with his parents' divorce. At that time, he experienced suicidal ideation and was treated with Lexapro for 2 to 3 months with no noticed benefit. At this intake appointment, he received information about the stress/anger management group, how to self-refer to the alcohol program, and a referral for a medication evaluation. He received a diagnosis of adjustment disorder with mixed emotional features. While the duration of this adjustment disorder is not specifically noted, the applicant reported sleep disruption for approximately the prior 6 months, so it was possible he was suffering from chronic adjustment disorder at the time of this diagnosis. The applicant's noncommissioned officer (NCO) accompanied him to his next appointment approximately a week later and expressed concern about the applicant's high level of distress. The applicant reported having problems with authority figures, especially with the yelling and the "put-down attitude." He described feeling rage and indicated he had hit a wall and cut himself. At that time, superficial scratches were observed. He also expressed suicidal ideation as a way to escape his problems. He described mood fluctuations and some compulsive-type behaviors. Two weeks later he reported feeling better, though he indicated he continued to have problems sleeping and other depressive symptoms. The applicant reported using appropriate stress-relieving techniques and stated he had quit drinking on his own. Approximately 2 months later, he was seen in the Emergency Department, for feeling anxious about deploying the next day. He was released with instruction to follow up in theater as needed. There was one available note from his deployment which documented he had delivered a hand-written prescription for Lexapro, which was filled. Also, a later note written upon redeployment indicated he received behavioral health counseling while deployed. b. During his rest and relaxation from deployment, the applicant apparently sought help for depression and was recommended for an administrative separation in accordance with Army Regulation 635-200, paragraph 5-17, though those notes were not available for this opinion. Back at his home station, his command-directed evaluation was performed by a clinical social worker on 8 February 2007. The note stated he received mental health treatment in Iraq with transient improvements in behavior. However, the note indicated he would be unlikely to improve to the level of being able to successfully perform his duties. A paragraph 5-17 administrative separation was recommended for depression. The diagnosis given was depressive disorder not otherwise specified (NOS), and the brief clinical notes from that visit include depressed mood and affect as well as seeking help for depression while on rest and relaxation. Other depressive symptoms were not noted. About 5 days later, he was psychiatrically hospitalized for approximately a week following a suicide attempt after consuming alcohol. In his inpatient Combat Stress Group, one of two available inpatient notes, he stated, "I can't go back to Iraq," and related ongoing problems with anxiety attacks while deployed, feeling paranoid about Iraqis who worked on the base, and emotionally de-compensating. He reported current daily anxiety and panic attacks and he received the diagnosis of anxiety disorder NOS. The other available inpatient note recorded a brief follow-up by the social worker on the day of his discharge, and the note contained no substantive information. His inpatient summary showed the diagnoses of depressive disorder NOS, alcohol abuse, and personality disorder NOS. Unfortunately, additional inpatient notes were not available for review to ascertain the reasoning leading to the diagnoses. Upon his discharge, a Mental Status Evaluation form completed by a psychiatrist noted the applicant had some depressive symptoms but "is most impaired by his poor coping skills and characterologic defects," and recommended a separation under the provisions of Army Regulation 635-200, paragraph 5-13, for personality disorder. His final psychiatry visit followed his discharge from hospitalization. Anxiety and depressive symptoms were noted, with the diagnoses listed as depressive disorder NOS and personality disorder NOS. c. While some of his behaviors and symptoms were consistent with a personality disorder diagnosis, the available record does not provide adequate support for the diagnosis, particularly with the lack of documentation of a long-standing pattern of maladaptive behaviors across a broad range of situations. It is possible the inpatient record, if it were available, would provide that supporting documentation. Additionally, while he may have exhibited a few post-traumatic stress symptoms, there is no evidence he met full criteria for PTSD at the time of his separation and that diagnosis is not recorded in his available record during his time of active service. This does not preclude the possibility he developed PTSD at a later date. His diagnoses of anxiety disorder NOS and depressive disorder NOS, with symptoms exacerbated by military service and with some measure of intractability, did appear to impact his functioning and would have warranted a referral to an MEB to determine his fitness for service. His anxiety and depressive issues evident prior to and exacerbated by deployment interfered with his ability to adapt well to the stressors of deployment, and he was unable to maintain his deployable status. 11. On 30 May 2013, the applicant was provided a copy of the OTSG advisory opinion in order to have the opportunity to respond to or rebut its contents. To date, he has failed to reply. 12. Army Regulation 635-200 prescribes the policy for the administrative separation of enlisted personnel. Paragraph 5-13 provides for separating members by reason of personality disorder (not amounting to disability) that interferes with assignment or with performance of duty. DISCUSSION AND CONCLUSIONS: 1. The applicant's request to change the narrative reason for separation has been carefully considered. However, there is insufficient evidence to support his request. 2. The applicant underwent a mental status evaluation that led to a diagnosis of a personality disorder. Accordingly, his chain of command initiated separation action against him. His separation processing was accomplished in accordance with the applicable regulation. All requirements of law and regulation were met and the rights of the applicant were fully protected throughout the separation process. 3. The evidence of record contains a mental status evaluation completed on the applicant that confirmed a diagnosis of personality disorder not amounting to disability was made by proper medical authority. The record is void of any clear indication that the applicant was suffering from an unfitting PTSD condition at the time of his discharge. As confirmed by the OTSG advisory opinion, it is possible he may have developed PTSD at a later date, there is no evidence he met full criteria for PTSD at the time of his separation and that diagnosis is not recorded in his available record during his time of active service. There is insufficient medical evidence to support an unfitting PTSD finding at the time of discharge. 4. In view of the foregoing, absent any evidence of error or injustice in the separation process or medical evidence confirming the applicant was suffering from an unfitting PTSD condition at the time of his discharge, there is an insufficient evidentiary basis to support granting the requested relief. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING __X___ ___X_____ __X______ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. ___________X______________ CHAIRPERSON I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. ABCMR Record of Proceedings (cont) AR20120017660 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20120017660 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1