THIRD ADDENDUM TO
RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS
IN THE MATTER OF: DOCKET NUMBER: BC-1996-02064
COUNSEL: MR. A. W. WALLUK
HEARING DESIRED: NO
_________________________________________________________________
APPLICANT REQUESTS THAT:
In the applicant’s request for reconsideration, she requests a disability
retirement at a rating of 50 percent, as of the date of her separation.
_________________________________________________________________
STATEMENT OF FACTS:
The applicant’s Total Active Federal Military Service Date (TAFMSD) is 9
May 74. The applicant was honorably discharged in the grade of staff
sergeant (E-5) on 10 May 88 under the provisions of AFR 39-10 (Conditions
that Interfere with Military Service-Not Disability-Character and Behavior
Disorder). She had completed a total of 14 years and 2 days of active duty
service at the time of discharge.
In 1996, applicant applied to the Air Force Board for Correction of
Military Records (AFBCMR) requesting a change to her narrative reason for
separation and separation code. Her application was considered and denied
by the Board on 30 Sep 97. For an accounting of the facts and
circumstances surrounding the applicant’s separation, and, the rationale of
the decision by the Board, see the Record of Proceedings (ROP) at
Exhibit H.
A similar appeal was considered and approved by the Board on 21 Mar 00,
which changed her narrative reason for separation to “Directed by the
Secretary of the Air Force” and her separation code. For an accounting of
the facts and circumstances of this case, and, the rationale of the
decision by the Board, see the Addendum to the ROP at Exhibit M.
In 2001, counsel, on behalf of the applicant, submitted a request for
reconsideration of his client’s application. The reconsideration request
was for a disability retirement at a rating of 50 percent, as of the date
of her separation, based on an earlier Board decision. Her reconsideration
appeal was considered and denied by the Board on 28 Jan 02. A summary of
the evidence considered by the Board and the rationale for its decision is
set forth in the Second Addendum to the ROP at Exhibit R.
In counsel’s most recent request for reconsideration, submitted on behalf
of the applicant, he contends that his client’s diagnoses of unsuiting
conditions were erroneous and that her condition was instead an unfitting
and ratable one that should have resulted in a disability retirement. No
evidence is submitted other than citing the Department of Defense
Instruction (DODI) concerning unsuiting conditions. Counsel’s complete
submission is at Exhibit S.
_________________________________________________________________
AIR FORCE EVALUATION:
Pursuant to the Board’s request, the AFBCMR Medical Consultant reviewed
counsel’s most recent submission and stated that counsel requests
consideration as to whether the applicant’s adjustment disorder diagnosis
could be the basis of a disability discharge, citing Department of Defense
Instruction (DODI) 1332.38, paragraph E5.1.2.1 and E5.1.2.9.4, which states
that an Adjustment Disorder cannot be the basis for a disability discharge
without a finding of another ratable causative disorder. He argues that
there was evidence of “considerable significant other disorders diagnosed”
in the applicant’s case. In support of the contention, he cites the mental
health evaluations from Aug 90 (depression diagnosis), 1 Jul 94 (opinion
that she had a disturbance of mood while on active duty not adequately
treated without specific opinion that the adjustment disorder diagnosis was
in error), and the 1999 evaluation. Counsel contends that the applicant’s
diagnoses were in error and her treatment was inadequate.
The AFBCMR Medical Consultant states that, in order to conclude that the
applicant’s symptoms actually represented an unfitting condition, there
would have to be a preponderance of evidence to conclude that her diagnosis
was something other than adjustment disorder. Alternative diagnoses were
considered and the criteria for diagnosis were not met. There is no reason
to suspect that the different mental health professionals she was evaluated
by while on active duty were all incompetent and unable to properly
diagnose her symptoms. Adjustment Disorder is considered to be the result
of constitutional weakness of coping skills and not a disease. When severe
enough, the condition is considered “unsuiting” for continued military
service and cause for administrative discharge rather than disability
discharge.
Opinions as to whether the applicant had maladaptive personality traits
that met the threshold for diagnosing a personality disorder (Axis II
diagnosis) have varied among the various mental health professionals who
have evaluated her. The Jan 88 VA psychiatry hospitalization rendered a
diagnosis of Histrionic Personality Disorder. Multiple other evaluators
who saw her only one time without the benefit of other sources of
historical information made “no diagnosis” in the Axis II (personality
disorder). However, other evaluators have clearly noted the presence of
maladaptive personality traits contributing to her reduced coping skills.
A specific description of her traits as borderline is consistent with the
previous impression of histrionic traits since both fall into the larger
classification of “Cluster B traits” which includes Borderline, Histrionic,
Antisocial and Narcissistic Personality Disorders. A detailed
psychological evaluation in 1999 that included formal personality testing
was reported to have not identified the presence of a personality disorder.
This apparent discrepancy does not fully contradict the diagnosis of
personality disorder 11 years before as some types of personality disorder,
especially Cluster B disorders, tend to become less evident over time or
remit with age. Histrionic personality disorder is associated with a
higher risk for depressive disorders and the coexisting presence of other
Cluster B traits or disorders. The applicant’s previous several years of
good duty performance and lack of apparent mental health difficulties is
evidence that argues against the presence of a severe personality disorder,
but not the presence of maladaptive traits that do not meet the threshold
for diagnosis. The presence of her adjustment disorder aggravated by
personality traits not meeting the threshold for personality disorder
diagnosis may better account for the difficulties at the time of her
discharge. The applicant’s post-service experience of depression in 1990
and subsequent normal examinations and finding of Posttraumatic Stress
Disorder (PTSD) and Adjustment Disorder do not contradict her diagnoses
while in the service. The difficulties the applicant demonstrated with her
externship in 1989 and 1990 are consistent with the findings of maladaptive
personality traits and personality disorder.
The AFBCMR Medical Consultant concludes that evidence of the record
supports the original diagnoses of Adjustment Disorder and Personality
Disorder that led to the applicant’s discharge and that no change in the
records is warranted. Action and disposition in this case are proper and
equitable reflecting compliance with Air Force directives that implement
the law. A complete copy of this evaluation is at Exhibit T.
_________________________________________________________________
APPLICANT'S REVIEW OF AIR FORCE EVALUATION:
Having been provided the advisory opinion, the applicant submitted a
personal statement indicating that her counsel would be preparing a
response to the advisory opinion (Exhibit V).
The applicant, through congressional channels, has apparently submitted her
response to the advisory opinion for the Board’s review. She does not
believe that the AFBCMR Medical Consultant is fully cognizant that the
Board removed personality disorder from her records. She would also like
to note that he is not a psychiatrist. Since then, she has obtained a
letter from a psychologist (Dr. H---) and a letter from a psychiatrist
(Dr. G--). She indicated that they both agreed with the Board’s decision
to remove the diagnosis of Personality Disorder from her records and that
her release from active duty was due to emotional problems due to a mental
condition (Axis I disorder), diagnosed a generalized Anxiety Disorder on 5
Nov 87. She has been unemployed since her discharge.
The congressional inquiry and the applicant’s submission, with attachments,
are at Exhibit W.
Having been provided the advisory opinion, counsel submits his statement
indicating that the point of this reconsideration is that the previous
advice that the Board adopted was incorrect. All three Air Force
evaluations contain axis one diagnoses that qualify for the exception in
the DoD Instruction. The applicant’s medical problems were well documented
while she was on active duty and they continued causing her problems from
immediately following her discharge to the present day. She served over 13
years and was improperly discharged, as the Board earlier determined, with
no benefits. She should have been processed through the Air Force
disability system that would have resulted in a retirement of at least 30
percent, but more likely 50 percent.
Counsel’s submission, with attachments, is at Exhibit W.
_________________________________________________________________
THE BOARD CONCLUDES THAT:
1. After reviewing the documents presented for our review with the
applicant’s request for reconsideration along with the prior evidence of
record, we are unconvinced that, at the time of her administrative
separation, the applicant had a medical condition that warranted her
referral to the Disability Evaluation System for processing. We therefore
believe the earlier decision in this case should be affirmed based on the
following considerations.
2. It should be noted that then, as now, an individual’s condition at the
time of separation or final disposition governs whether or not the member
is referred for disability processing. In order to be referred for
disability processing, the member’s fitness for worldwide duty must be seen
as questionable. Decisions of this nature are based on accepted medical
principles. While the applicant’s behavior was case for referral for
mental health evaluations, it was the determination of health care
providers that her condition at that time was not unfitting, but rather,
was cause for the initiation of administrative separation action.
3. This Board has been presented with the assertion that the applicant had
conditions that were unfitting in accordance with the governing DoD
Instruction. We disagree. Prior to her separation, it appears that the
applicant underwent extensive evaluation and treatment, including a period
of inpatient hospitalization at a VA medical facility. In the main, her
condition was diagnosed as an Adjustment Disorder. Beginning approximately
two years after the applicant’s separation, she was diagnosed, variously,
as having Major Depression, Generalized Anxiety Disorder and Depressive
Neuroses, Adjustment Disorder, and PTSD. Notwithstanding the views of
various mental health specialists who have evaluated her over the years
since her separation, we remain unpersuaded that the assessments of her
condition prior to her discharge were erroneous, contrary to sound medical
principles or based on factors other than the state of her condition at
that time. It is interesting to note that the DVA has determined that she
does not possesses a psychiatric disability that is compensable under the
VASRD. The applicant’s case has undergone an exhaustive review by the BCMR
Medical Consultant and there is nothing in the evidence provided by the
applicant that would overcome his assessment of the case.
4. Accordingly, in view of the above and based on our finding that there
is no evidence in the available record that establishes to our satisfaction
that the applicant’s separation from the Air Force in 1988, as corrected by
this Board, is erroneous or unjust, we have no basis to favorably consider
the applicant’s request for additional relief in the form of a retirement
because of physical disability.
_________________________________________________________________
THE BOARD DETERMINES THAT:
The applicant be notified that the evidence presented did not demonstrate
the existence of 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 11 September 2003 under the provisions of AFI 36-2603:
Mr. Richard A. Peterson Panel Chair
Ms. Brenda L. Romine, Member
Ms. Carolyn B. Willis, Member
The following documentary evidence was considered:
Exhibit R. Second Addendum to the Record of Proceedings,
dated 15 February 2002, with Exhibits.
Exhibit S. Counsel’s letter, dated 19 August 2002, with
with attachments.
Exhibit T. Letter, BCMR Medical Consultant, dated
14 November 2002.
Exhibit U. Letter, AFBCMR, dated 15 November 2002.
Exhibit V. Applicant’s letter, dated 5 December 2002.
Exhibit W. Letter from a Member of Congress, dated
28 July 2003, with Applicant’s 30 June 2003
letter, with attachments, and Counsel’s
letters, dated 18 August 2003,
with attachments, and 5 September 2003.
RICHARD A. PETERSON
Panel Chair
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