RECORD OF PROCEEDINGS
             AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:      DOCKET NUMBER:  BC-2002-02301
            INDEX CODE:  108.02
            COUNSEL:  Mr. Gary R. Myers

            HEARING DESIRED:  Not Indicated

_________________________________________________________________

APPLICANT REQUESTS THAT:

1.  Her discharge for disability reasons with severance pay  be  changed  to
reflect that she was permanently  retired  for  disability  reasons  with  a
rating of 50%.

2.  In the alternative, her records be corrected to show she was  placed  on
the Temporary Disability Retired List (TDRL) with  a  disability  rating  of
50%.

3.  She receive all back pay an allowances accordingly.

_________________________________________________________________

APPLICANT CONTENDS THAT:

She underwent a Medical Evaluation Board (MEB) on  10  Feb  00.   The  board
practitioner, not versed in psychiatry, relied almost exclusively  upon  the
report of an Air Force clinical  psychologist.   Her  clinical  psychologist
diagnoses were:   Axis  I:  somatization  disorder,  Post  Traumatic  Stress
Disorder (PTSD), depressive disorder; and Axis II: borderline  and  paranoid
personality traits.  A civilian psychiatrist who saw her on 15 Dec 99,  gave
her no diagnosis of Axis II.  Diagnosis of PTSD and depressive disorder  had
been rendered as early as 1995.   The  Informal  Physical  Evaluation  Board
(IPEB) recommended disability with a 30% rating.  However,  the  30%  rating
was reduced to 10% by ascribing 20% to  predisposing  contributing  factors.
These factors were noncompensable personality traits that the  board  opined
affected the severity of  her  condition.   She  accepted  the  results  and
separated in May 2000.  On 31 Jan 02, the  Department  of  Veterans  Affairs
(DVA) awarded  her  a  service-connected  disability  rating  of  50%.   She
applied to the DVA nine days after separation.

Her acceptance of the 10% disability rating was not  an  informed  decision.
Her representative failed to properly advise her of the  highly  speculative
nature of the IPEB decision.  She had nothing to lose by  seeking  a  Formal
PEB.  At no  time  prior  to  7 Feb  00  had  any  practitioner  provided  a
diagnosis on Axis II.  In fact, the diagnosis by the  clinical  psychologist
is a diagnosis of traits without any diagnosis of  a  personality  disorder.
Therefore, up to the MEB there was no mention of Axis II, yet the  IPEB  was
willing to deduct 20% from a diagnosis on AXIS I  that  had  been  diagnosed
since 1995.  It is beyond speculation for the  IPEB  to  say  that  but  for
these "traits" her Axis I conditions would have been mild when there  is  no
factual analysis in the record.  Further, there is no suggestion of  partial
remission of the PTSD in the record.  She was dysfunctional, and  under  the
Veterans Affairs Schedule for Rating Disabilities  (VASRD)  her  dysfunction
was "considerable" at 50%.  When she left  the  Air  Force,  she  could  not
function in her job.  It is a perversion to utilize a last minute  diagnosis
of "traits" to deny her retirement, particularly  when  that  diagnosis  did
not come from a psychiatrist.

In  support  of  her  request,  applicant  provided  her  counsel's   brief,
documentation associated with her disability evaluation  system  processing,
and documentation associated with her DVA rating decision.

_________________________________________________________________

STATEMENT OF FACTS:

Applicant enlisted in  the  Regular  Air  Force  on  21  Jan  94.   She  was
progressively promoted to the grade of senior airman,  having  assumed  that
grade effective and with a date of rank of 21 Jan 97.

An MEB was convened on 1 Feb  00  and  referred  her  case  to  an  Informal
Physical Evaluation Board (IPEB) with a diagnosis of  Axis  I:  somatization
disorder, PTSD, chronic  and  partial  remission,  depressive  disorder  not
otherwise specified;  and  Axis  II:  borderline  and  paranoid  personality
traits.  On 3 Mar 00, the IPEB found her unfit for further military  service
and recommended she  be  discharged  with  severance  pay  with  a  combined
compensable rating of 30%, less predisposing contributing  factors  of  20%,
leaving a rating of  10%.   The  applicant  agreed  with  the  findings  and
recommended disposition of the IPEB.  On 1 May 00, she was  discharged  with
a compensable rating of 10%.  She served 6, years, 3 months, and 11 days  on
active duty.

_________________________________________________________________

AIR FORCE EVALUATION:

The BCMR Medical  Consultant  recommends  denial.   The  Medical  Consultant
states at the time of her discharge she did not require  hospitalization  or
antidepressant  medications;  however,  she  was  experiencing  occupational
difficulty.  Her PTSD had it's roots in her history of  child  abuse  and  a
subsequent physically and emotionally abusive marriage that  began  6  years
before entering active duty and ended  2  years  after  she  entered  active
duty.  There is no documented evidence of PTSD until a year  after  entering
active duty.  Although the severity of her somatization disorder  and  other
conditions  was  determined  to  be  unfitting  at  30%,  the  presence   of
maladaptive personality traits (noncompensable and nonratable) were felt  to
be significant contributors to the severity of  her  primary  diagnoses  and
were the basis for the  reduction  of  her  final  disability  rating.   The
applicant contests the  reduction  contending  the  maladaptive  personality
traits were not diagnosed until October  1999  and  that  these  are  traits
comparable to a normal individual' personality  traits.   She  in  fact  had
maladaptive personality  traits  in  1995  as  listed  on  Axis  II  of  her
psychiatric diagnosis and reflected again in 1997 and  1999.   Although  she
was not diagnosed  with  a  personality  disorder,  the  listed  traits  are
nevertheless abnormal.  The civilian psychiatrist interviewed the  applicant
only once and without the benefit of  having  her  medical  records  or  the
benefit  of  knowledge  of  extensive  occupational  and  social  historical
information available to the Air Force psychologist.  The issue  is  whether
her  abnormal,   maladaptive   personality   traits   were   causative,   or
substantially  contributory  to  the  social  and  industrial   adaptability
impairment  resulting  from  her  total  neuropsychiatric  condition.    Her
maladaptive personality traits are likely inextricably intertwined with  her
PTSD.  Her PTSD represents an existing prior to service  condition  that  in
combination  with  her  maladaptive  personality  traits  is   significantly
responsible for her primary unfitting  diagnosis  of  somatization  disorder
and the social and industrial adaptability.

The Medical Consultant evaluation is at Exhibit C.

AFPC/DPPD recommends denial.  DPPD  states  she  is  using  the  DVA  rating
decision as justification for a higher  rating  and  disability  retirement.
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.   The  mere  presence  of  a  medical
condition does not qualify a member for  disability  discharge,  retirement,
or compensation.  Once an individual has been declared  unfit,  the  service
Secretaries are required by law to rate the condition based upon the  degree
of disability at the time of permanent disposition.  The DVA  may  rate  any
service-connected  condition  based  on  the  seriousness  of  the   medical
conditions throughout her life span.  This  is  why  the  services  and  DVA
ratings may disagree.  The  applicant  was  treated  fairly  throughout  the
military DES process,  she  was  properly  rated  under  federal  disability
guidelines at  the  time  of  her  evaluation,  and  she  was  afforded  the
opportunity for further review as provided by federal law and policy.

The DPPD evaluation is at Exhibit D.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Counsel states the distinction between the DVA and military  rating  systems
is  irrelevant  in  this  case.   The  diagnostic  elements  of   somataform
disorder, chronic depression  and  PTSD,  which  gives  rise  to  disability
ratings of 30% or above, do not change between the  DVA  and  the  military.
She received 30% for Axix I, which was reduced to 10%  by  the  PEB  due  to
contributions from a personality disorder on Axis II.  She was  actually  at
50% on the date of her PEB.  The 30% was  actually  too  low  based  on  the
clinical data.  Contrary to the advisory opinion there was no  evidence  she
got worse from her date of separation of 3 Mar 00, to her first DVA exam  on
14 Apr 01.  Medication use is not an indication of  a  worsening  condition,
rather it is within physician discretion.  The DVA effective date is  2  May
00 and PTSD and somataform disorder were also  part  of  the  diagnoses  and
were independent of depression.  The issue is how much  do  you  deduct  for
the personality disorder after giving effect to the actual rating for  PTSD,
somataform disorder and depression.  Fifty percent  is  an  accurate  value.
If 20% reduction is appropriate for the  personality  disorder,  that  still
leaves  a  30%  disability.   How  much  an  Axis  II  personality  disorder
quantatively contributes to an Axis I condition is at best  a  guess.   What
is certain is that the Axis I conditions were, upon her  discharge,  ratable
at 50%.  Counsel's response is at Exhibit
F.

_________________________________________________________________

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  error  or  injustice.   We  took  notice  of  the  applicant's
complete submission in judging the merits of the case; however, we  are  not
persuaded by the applicant's contentions that the disability  processing  or
the rating she received at final disposition of her case were  in  error  or
contrary to the governing Air Force regulations, which  implement  the  law.
After a thorough review of  the  evidence  of  record  and  the  applicant's
submission,  we  are  not  persuaded  by  counsel's  contentions  that   the
applicant's condition at final disposition warranted a rating higher than  a
rating of 30%.  With respect  to  the  issue  of  the  applicant's  assigned
rating as compared to the  rating  assigned  by  the  DVA,  we  feel  it  is
important to note that the services assign ratings based on  the  degree  of
impairment of performance or duties at the time of  disposition,  while  the
DVA  rates  service-connected  conditions  on  the  basis  of   social   and
industrial adaptability.   Therefore,  it  is  entirely  possible  that  the
applicant's unfitting condition was  rated  at  30%  while  she  received  a
higher rating from the DVA.  We agree with the Air Force offices of  primary
responsibility  that  the  applicant  was  properly  rated   under   federal
disability guidelines and  adopt  their  rationale  as  the  basis  for  our
conclusion that the applicant has  not  been  the  victim  of  an  error  or
injustice.  In the absence of persuasive 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 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 AFBCMR Docket Number  BC-2002-
02301 in Executive Session on 16 Mar 04, under the  provisions  of  AFI  36-
2603:

      Ms. Olga M. Crerar, Panel Chair
      Mr. James W. Russell III, Member
      Mr. James A. Wolfe, Member

The following documentary evidence was considered:

    Exhibit A.  DD Form 149, dated 19 Jul 02, w/atchs.
    Exhibit B.  Applicant's Master Personnel Records.
    Exhibit C.  Letter, BCMR Medical Consultant, dated 24 Feb 03.
    Exhibit D.  Letter, AFPC/DPPD, dated 4 Apr 03.
    Exhibit E.  Letter, SAF/MRBR, dated 11 Apr 03.
    Exhibit F.  Letter, Counsel, dated 25 Jun 03.




                                   OLGA M. CRERAR
                                   Panel Chair