IN THE CASE OF: BOARD DATE: 15 September 2015 DOCKET NUMBER: AR20140021528 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 the narrative reason for separation be changed from personality disorder to a medical discharge of some sort. 2. The applicant states he has seen a number of psychiatrists in the Department of Veterans Affairs and in the civilian sector. They all said the same thing, that he does not have a personality disorder. 3. The applicant provides his DD Form 214 (Certificate of Release or Discharge from Active Duty). 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 27 April 2004 and he held military occupational specialty 92G (Food Service Specialist). He served in Iraq in support of Operation Iraqi Freedom (OIF) from 20 January 2005 to 30 January 2006. 3. On 18 May 2006, he was evaluated on Ward 3A at Winn Army Community Hospital, Fort Stewart, GA. His Certificate of Psychiatric Examination shows he was diagnosed with an adjustment disorder and personality disorder. He met retention standards and he did not have a psychiatric disease that warranted disposition through medical channels. He was cleared for administrative separation. 4. On 12 June 2006, 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 (Personnel Separations) because of an adjustment disorder and personality disorder. 5. On 12 June 2006, the applicant acknowledged receipt of the notification of separation action, and on 14 June 2006, 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 27 June 2006, 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 14 July 2006, the applicant was discharged accordingly. 8. His DD Form 214 shows he was discharged under the provisions of chapter 5-13 of Army Regulation 635-200 with an honorable character of service. He completed 2 years, 2 months, and 18 days of active service. He was assigned the separation code "JFX." 9. In connection with the processing of this case, an advisory opinion was obtained on 15 July 2015 from the Office of The Surgeon General (OTSG), Director of Health Care Delivery. a. The applicant enlisted in the Army in April 2004. In January 2005, he was activated for a year-long deployment to Baghdad, Iraq in support of OIF. Six months following his return from combat, he was honorably separated from the military under the provisions of Army Regulation 635-200, paragraph 5-13 by reason of personality disorder. He submitted an application requesting the narrative reason for separation on his DD Form 214 be changed from personality disorder to show he received a medical discharge, as he asserts he was being treated for post-traumatic stress disorder (PTSD), depression, insomnia, and anxiety at the time of his discharge from the military. This advisory opinion is based on the available documentation from the applicant's time in active duty service, unless otherwise noted. A panel of three credentialed, doctoral-level behavioral health clinicians reviewed his records to minimize variance and ensure quality of findings. b. He completed the Pre-Deployment Health Assessment in October 2004, prior to deploying to Iraq. At that time, he described his general health as very good and denied any health concerns or medical problems. In December 2005, prior to returning home from Iraq, a Post-Deployment Health Assessment was completed. At that time, he denied experiencing any PTSD symptoms. However, he reported seeking behavioral health care during deployment and expressed interest in receiving help for a stress, emotional, alcohol, or family problem. He also endorsed having been bothered some by the following symptoms over the past two weeks: little interest or pleasure in doing things; feeling down, depressed, or hopeless; thoughts that he would be better off dead or hurting himself in some way. As a result, a referral to behavioral health was initiated. It is unknown whether the Post-Deployment Health Reassessment was completed by the applicant, because it is unavailable for review. c. Based on the information available, he reports his first episode of behavioral health care during active duty service occurred while he was deployed to Iraq. The treatment records for this time period, however, are not available for review. In 2004, the Army had not fully deployed “AHLTA,” the Department of Defense electronic health record, and thus it is possible that hand-written records were created that are now not accessible. The available medical record, which documents behavioral health treatment received by him following his return from theatre, indicates that he was diagnosed with social anxiety while in theatre after repeatedly having difficulty performing tasks in training situations or large groups due to fear of embarrassment. Symptoms for this condition, which began in high school, are documented as having been exacerbated during military service. Following his return from Iraq, he was treated for social phobia, attention deficit hyperactivity disorder, adjustment disorder with anxiety, and insomnia. d. Taking into consideration the available record during his military service, personality disorder is not sufficiently supported by the available medical record in accordance with (IAW) the criteria established by the Diagnostic and Statistical Manual (DSM) of Mental Disorders current at the time of his discharge. However, there is sufficient documentation to conclude that he qualified for a social phobia diagnosis with clinically significant impairment in occupational or other important areas of functioning. Although his condition predated military service, documentation supports it was exacerbated during military service. Consequently, his condition would have warranted referral into the Integrated Disability Evaluation System (IDES) at the time of his discharge. 10. The applicant was provided a copy of the OTSG advisory opinion in order to have the opportunity to respond to or rebut its contents. He responded on 27 July 2015. He stated, in effect: * His lost medical records would have shown that he regularly visited the combat stress team 6 months prior to redeployment * He was on medications and he also suffered from military sexual trauma a week prior to his first visit * He waited for the bruises to heal and did not feel safe talking about this to anyone * He does not have a personality disorder; what he had were symptoms of PTSD and the symptoms were obvious * He continues to receive treatment for PTSD * The memories of sexual trauma continue to haunt him and his response of not reporting the incident was normal then 11. Army Regulation 635-200 (Active Duty Enlisted Administrative Separations) 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. 12. Army Regulation 635-5-1 (Separation Program Designator (SPD) Codes) states that the SPD codes are three-character alphabetic combinations, which identify reasons for and types of separation from active duty. The "JFX" SPD code is the correct code for members separating under the provisions of paragraph 5-13 of Army Regulation 635-200 by reason of personality disorder. 13. Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) establishes the Army Physical Disability Evaluation System (PDES) (now called IDES) and sets forth policies, responsibilities, and procedures that apply in determining whether a Soldier is unfit because of physical disability to reasonably perform the duties of his or her office, grade, rank, or rating. In each case, it is necessary to compare the nature and degree of physical disability present with the requirements of the duties the Soldier reasonably may be expected to perform because of his or her office, grade, rank, or rating. Separation by reason of disability requires processing through the PDES. 14. Army Regulation 635-40, chapter 4, contains guidance on processing through the PDES, which includes the convening of a Medical Evaluation Board (MEB) to document a Soldier's medical status and duty limitations insofar as duty is affected by the Soldier's status. If the MEB determines a Soldier does not meet retention standards, the case will be referred to a Physical Evaluation Board (PEB). The PEB evaluates all cases of physical disability equitably for the Soldier and the Army. The PEB investigates the nature, cause, degree of severity, and probable permanency of the disability of Soldiers whose cases are referred to the board. It also evaluates the physical condition of the Soldier against the physical requirements of the Soldier's particular office, grade, rank, or rating. Finally, it makes findings and recommendations required by law to establish the eligibility of a Soldier to be separated or retired because of physical disability. DISCUSSION AND CONCLUSIONS: 1. The applicant was discharged from active duty on 14 July 2006 by reason of a personality disorder. He completed the Pre-Deployment Health Assessment in October 2004, prior to deploying to Iraq. At that time, he described his general health as very good and denied any health concerns or medical problems. 2. The available medical records, which document behavioral health treatment received by him following his return from the theatre, indicate that he was diagnosed with social anxiety while in theatre after repeatedly having difficulty performing tasks in training situations or large groups due to fear of embarrassment. Symptoms for this condition, which began in high school, are documented as having been exacerbated during military service. Following his return from Iraq, he was treated for social phobia, attention deficit hyperactivity disorder, adjustment disorder with anxiety, and insomnia. 3. The advisory opinion states personality disorder is not sufficiently supported by the available medical records in accordance with the criteria established by the DSM in effect at the time of his discharge. However, there is sufficient documentation to conclude that he qualified for a social phobia diagnosis with clinically significant impairment in occupational or other important areas of functioning. Although his condition predated military service, the medical documents support that it was exacerbated during military service. Consequently, his condition would have warranted referral into the IDES at the time of his discharge. He may have had traits of an adjustment disorder; however, the record does not support full criteria meeting this diagnosis. An MEB would likely have been appropriate. 4. Therefore, it is clear that the applicant may have had a mental disorder that could have failed retention standards and there are some indications that his mental disorder may have interfered with the performance of his duties. Although it is premature to determine if these symptoms fell below retention standards and/or were unfitting, as a matter of equity the applicant should have his records considered by an MEB to make this determination. His records should be corrected as recommended below. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ___x____ ___x____ ____x___ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ________ ________ ________ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: 1. The Board determined that the evidence presented was sufficient to warrant a recommendation for partial relief. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by: * having the Office of The Surgeon General contact the applicant and arrange a physical evaluation via appropriate medical facilities and, if appropriate, referral to an MEB * directing the Office of The Surgeon General to issue appropriate invitational travel orders to the applicant to accomplish the physical evaluation and, if appropriate, the MEB * directing the Office of The Surgeon General to issue appropriate invitational travel orders to the applicant to prepare for and participate in consideration of his case by a PEB in the event that a PEB becomes necessary * In the event a PEB finds that the individual concerned has a medically unfitting condition and it is compensable, action will be taken to correct his records to show he was appropriately separated or retired effective 14 July 2006 2. The Board further determined the evidence presented is insufficient to warrant a portion of the requested relief. As a result, the Board recommends denial of so much of the application that pertains to medical discharge at this time. _______ _ 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) AR20140021528 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20140021528 7 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1