RECORD OF PROCEEDINGS
         AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS


IN THE MATTER OF:      DOCKET NUMBER:  97-00995

            COUNSEL:  NONE

            HEARING DESIRED:  NO



APPLICANT REQUESTS THAT:

Her honorable discharge be changed to a medical retirement.


APPLICANT CONTENDS THAT:

Her medical condition was misdiagnosed at the time of her separation.

The applicant states that at the time of her  separation,  she  was  in  the
hospital at Eglin AFB.   At  that  time,  her  condition  was  diagnosed  as
dysthymic disorder;  however,  the  Department  of  Veterans  Administration
(DVA) has diagnosed her condition as bipolar disorder.

In support of the appeal, applicant  provides  statements  from  a  civilian
psychiatrist, civilian psychologist, and copies of the DVA Compensation  and
Pension Exam Report.

The applicant’s complete submission is attached at Exhibit A.


STATEMENT OF FACTS:

On 8 February 1982, the applicant was commissioned as  a  second  lieutenant
and entered extended active duty.

The applicant was considered and not selected for promotion to the grade  of
major by the Calendar Years 1992C and 1993B Central Major Selection Boards.

On  7  August  1994,  the  applicant  was  honorably  discharged  under  the
provisions of AFR 36-12 (Reduction in Force).  She completed 12 years and  6
months of active service.  While on  active  duty,  the  applicant  received
medical  treatment  for  several  conditions   (i.e.,   foot/elbow   injury,
hyperthyroid, depression, miatral valve  prolapse,  obesity,  and  dysthymic
disorder).

On 19 July 1995, the Department of  Veterans  Affairs  (DVA)  diagnosed  the
applicant’s condition  as  dysthymic  disorder  with  major  depression  and
anxiety.  Based on this diagnosis, the DVA awarded her a  disability  rating
of 50%, effective 6 April 1995.

On 16 November 1996, the DVA awarded the applicant  a  combined  compensable
disability rating of 70% (Dysthymic disorder - 50%;  Tempromandibular  Joint
Disease - 20%; Hypothyroidism - 10%; and Degenerative Arthritis - 10%).

A resume of the applicant’s performance reports, since 1987, follows:

       PERIOD ENDING             OVERALL EVALUATION

         30 Mar 87                      1-1-1
         30 Mar 88                      1-1-1
         26 Mar 89 (Referral)     Meets Standards (MS) on
                                  all factors, except
             professional qualities
         26 Mar 90                        MS
         14 Aug 90                        MS
         14 Aug 91                        MS
         17 Jun 92                        MS
         31 Aug 93                        MS


AIR FORCE EVALUATION:

The Chief Medical Consultant, AFBCMR, reviewed this application  and  states
that the evidence of record and medical  examinations  prior  to  separation
indicate the  applicant  was  fit  and  medically  qualified  for  continued
military service or appropriate separation and did not have any physical  or
mental  condition  which  would  have  warranted  consideration  under   the
provisions of AFM 35-4.  Furthermore, the  evidence  of  record  established
beyond all reasonable doubt that the applicant was  properly  diagnosed  and
medically qualified for continued active  duty,  that  the  reason  for  her
separation was proper, and that no error or injustice occurred in the  case.
 The applicant was diagnosed as dysthymic, meaning she was subject  to  mood
swings in response to stressors in her life, and was  discharged  with  this
diagnosis which was not  unfitting  for  continued  military  service.   The
applicant applied to the DVA in December 1994 and  has  continued  to  carry
the diagnosis of  dysthymia  through  her  most  recent  DVA  evaluation  in
November 1996.

The Medical Consultant notes that the reason  why  the  applicant  could  be
declared fit for duty by the Air Force and later be granted a  70%  service-
connected disability by  the  DVA  lies  in  understanding  the  differences
between Title 10, USC, and Title 38, USC.  Title 10, USC, Chapter 61 is  the
Federal statute that charges the Service Secretaries with maintaining a  fit
and vital force.  For an individual to  be  considered  unfit  for  military
service, there must be a  medical  condition  so  severe  that  it  prevents
performance of  any  work  commensurate  with  rank  and  experience.   This
clearly was not the  case  with  the  applicant  whose  performance  reports
showed her capable of performing  her  assigned  duties  in  a  satisfactory
manner.   Congress,  very  wisely  recognized  that  a  person  can  acquire
physical  conditions  which,  although  not  unfitting  at   the   time   of
separation, may later  progress  in  severity  and  alter  the  individual’s
lifestyle and future employability.  With this in mind, Title 38, USC  which
governs  the  DVA  compensation  system  was  written  to   allow   awarding
compensation ratings for conditions that  are  not  unfitting  for  military
service.  This is why an individual can be considered fit for military  duty
up to the day of separation or retirement, and later receive a  compensation
rating from the DVA  for  service-connected,  but  militarily  non-unfitting
condition.  Therefore, the Medical Consultant recommends the application  be
denied.

A complete copy of the Air Force evaluation is attached at Exhibit C.

The Chief, USAF  Physical  Disability  Division,  AFPC/DPPD,  reviewed  this
application and states that the medical aspects of the  case  are  explained
by the Medical Consultant and  they  fully  concur  with  the  comments  and
recommendations.  The medical record clearly shows that while the  applicant
may have been treated for various medical conditions while on  active  duty,
none were serious enough to render her unfit for  further  military  service
under  the  provisions  of  disability  law  and  policy.   Therefore,  they
recommend denial of applicant’s request.

A complete copy of the Air Force evaluation is attached at Exhibit D.


APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

The applicant reviewed the Air Force evaluations and  provided  a  statement
prepared by a civilian psychiatrist and psychologist  which  indicates  that
after reviewing the applicant’s entire military  health  and  mental  health
record, they support  the  applicant’s  contention  that  her  diagnosis  of
bipolar disorder was evident while she was in  the  Air  Force,  and  should
have been diagnosed by Air Force  physicians.   They  note  that  from  1980
through  1994,  the  applicant  sought  help  on  at  least  122   different
occasions.  Furthermore, the  applicant’s  military  mental  health  records
indicate that in 1989, it was suggested that bipolar disorder  be  explored;
however, there was no follow-up.  Although  the  applicant’s  condition  did
not require hospitalization  until  after  she  left  the  military,  it  is
evidence that the bipolar disorder was surfacing for some years  before  her
separation.

The applicant’s complete response, with attachments, is attached at  Exhibit
H.


ADDITIONAL AIR FORCE EVALUATION:

The Chief Medical Consultant, AFBCMR, reviewed this application  and  states
that while the applicant’s problems while serving on active duty  might,  in
retrospect, be seen as fulfilling the criteria  of  a  different  diagnosis,
they were reviewed by numerous competent medical authorities (including  DVA
examiners for 2 years after her  discharge)  as  fitting  the  criteria  for
dysthymia.  Many of the  symptoms  for  dysthymia  mimic  those  of  bipolar
disorder when the two disorders are compared.  The applicant’s disorder  was
not found  unfitting  during  her  military  service,  and  her  performance
reports indicate continued outstanding service in  spite  of  her  problems.
That a different, yet somewhat similar diagnosis should be entertained  some
4 years  after  her  discharge  does  not  disprove  a  diagnosis  that  was
considered valid by  numerous  treating  providers  during  the  applicant’s
period of active duty.  Therefore,  they  recommend  denial  of  applicant’s
requests.

A complete copy of the Air Force evaluation is attached at Exhibit J.


APPLICANT’S REVIEW OF AIR FORCE EVALUATION:

The applicant reviewed the Air Force evaluation and states that in  response
to the advisory opinions  comment  that  her  performance  reports  indicate
continued outstanding service in spite of her problems, she  provides  three
reports that disprove this statement.  The applicant  states  that  she  did
not complete Air Traffic Control training  due  to  a  fear  of  controlling
aircraft.  In addition, she received a referral performance  report  due  to
not meeting Air Force standards  in  the  area  of  professional  qualities.
Furthermore, in the report, closing 14 August  1990,  the  additional  rater
stated,  “If  she  can  overcome  her  medical  and  personal  problems  and
concentrate on applying her  job  knowledge,  she  will  excel  in  her  new
assignment as the wing’s evaluation team chief.”

The applicant’s complete response is attached at Exhibit L.


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 probable error or injustice.  After  thoroughly  reviewing  the
evidence of record and  noting  the  applicant’s  contentions,  we  are  not
persuaded that she has been the victim of an error  or  injustice.  In  this
respect, we note that while the applicant may have been treated for  various
medical conditions while on active duty, none were  serious  enough  at  the
time of her discharge to render her  unfit  for  further  military  service.
The statements provided by the civilian psychologist  and  psychiatrist  are
noted; however, they do not persuade  us  that  the  applicant’s  condition,
while on active duty, fit the criteria for a diagnosis of bipolar  disorder.
 The symptoms for dysthymia mimic those of bipolar disorder  when  compared.
In addition, although it was  suggested,  on  10  July  1989,  that  bipolar
disorder should be explored, it was also indicated  that  it  was  unlikely.
Regardless, prior to her discharge, she was evaluated and treated by  Mental
Health physicians on numerous occasions  with  the  resulting  diagnosis  of
dysthymic disorder.  Although she was diagnosed by  the  Biloxi  VA  Medical
Center on 17 August 1996 as having  Bipolar  Affective  Disorder,  when  she
applied to the DVA for a disability compensation rating  her  condition  was
diagnoses as dysthymic disorder  on  19  July  1995  and  16 November  1996.
Based on  a  preponderance  of  the  evidence  of  record,  we  believe  the
applicant  has  failed  to  meet  her  burden  of  proof  to  overcome   the
presumption of fitness.  Therefore,  in  the  absence  of  evidence  to  the
contrary, we find no compelling  basis  to  recommend  granting  the  relief
sought in this application.


THE BOARD DETERMINES THAT:

The applicant be notified that the evidence presented  did  not  demonstrate
the existence of probable material error or injustice; that the  application
was denied without a personal appearance;  and  that  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 this application in  Executive
Session on 26 January 1999, under the provisions of AFI 36-2603:

                  Ms. Rita S. Looney, Panel Chair
                  Mr. Terry A. Yonkers, Member
                  Ms. Patricia D. Vestal, Member

The following documentary evidence was considered:

      Exhibit A.  DD Form 149, dated 25 Mar 97, w/atchs.
      Exhibit B.  Applicant's Master Personnel Records.
      Exhibit C.  Letter, BCMR Medical Consultant, dated 3 Nov 97.
      Exhibit D.  Letter, AFPC/DPPD, dated 20 Nov 97.
      Exhibit E.  Letter, SAF/MIBR, dated 15 Dec 97.
      Exhibit F.  Letter, Applicant, dated 22 Dec 97.
      Exhibit G.  Letter, AFBCMR, dated 7 Jan 98.
      Exhibit H.  Letter, Civilian Psychologist & Psychiatrist,
                  dated 2 Mar 98, w/atchs.
      Exhibit I.  Letter, AFBCMR, dated 27 Oct 98.
      Exhibit J.  Letter, BCMR Medical Consultant, dated 2 Nov 98.
      Exhibit K.  Letter, AFBCMR, dated 13 Nov 98.
      Exhibit L.  Letter, Applicant, dated 23 Nov 98, w/atchs.




             RITA S. LOONEY
                                  Panel Chair