`                       RECORD OF PROCEEDINGS
         AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:      DOCKET NUMBER:  BC-2003-03834


      XXXXXXX    COUNSEL:  NONE

      XXXXXXX    HEARING DESIRED: YES

_________________________________________________________________

APPLICANT REQUESTS THAT:

His diagnoses of Anxiety Disorder and Narcissistic Personality  Traits
for separation be removed from his records in order to allow him to be
eligible to return to active duty.

_________________________________________________________________

APPLICANT CONTENDS THAT:

His prior psychologist stated that his condition  was  corrected  more
than two months prior to his medical evaluation board  (MEB)  meeting.
The psychologist at the VA Medical Center in Cheyenne, WY stated after
his evaluation, he should had never been  diagnosed  with  an  Anxiety
Disorder.  He is currently attending a graduate school full time.   He
would like to return to active duty and/or allowed  to  serve  in  the
active Reserves or Air National Guard.  Please  note  his  outstanding
final OPR and comments from his squadron commander.

In support of his appeal, the applicant has provided copies  of  OPRs,
training reports, Findings  and  Recommendation  Disposition  of  USAF
Physical Evaluation Boards, MPT Training Report Reviews, USAF  Fitness
Program Reports, Award Submissions, Letters of Appreciation, Statement
of Medical Condition,  Field  Observations,  Formal  Evaluation  Board
Reports, Medical  Evaluation  Board  Reports,  MEB  audio  tapes,  and
letters of support.

Applicant’s complete submission, with attachments, is at Exhibit A.

_________________________________________________________________

STATEMENT OF FACTS:

The applicant completed ROTC,  was  commissioned,  entered  active  on
September 25, 1999, and served as missile combat crew in the grade  of
2nd lieutenant.   In  April  2002,  he  presented  with  complaint  of
increasing anxiety resulting in  decertification  from  the  Personnel
Reliability Program (PRP) and subsequent  disability  discharge.   The
applicant was disability discharged with severance pay on May 2,  2003
after 3 years, 7 months and 8 days on active duty.

While an ROTC Cadet, the applicant worked with the Air Force  Tops  in
Blue tours over the course of two years prior to  his  graduation  and
commissioning.  Following his commissioning,  the  applicant  attended
missile training and was  assigned  to  F.E.  Warren  Air  Force  Base
beginning July 2000. His excellent work with Tops In Blue resulted  in
an invitation for him to continue to participate  with  Tops  In  Blue
tours while on active duty, however, his requests to participate  with
Tops In Blue were denied in 2000 and 2001.   On  an  August  14,  2001
periodic  health  assessment  questionnaire,  the   applicant   wrote,
“Anxious to cross train into Tops in Blue.”  The  applicant’s  request
to participate with the tour in 2002 was  again  denied  around  April
2002 (according to a letter dated December 10, 2002 in  the  discharge
package).

The applicant was seen initially in the  Life  Skills  Clinic  (mental
health clinic) on April 16, 2002 and given a preliminary diagnosis  of
anxiety disorder.  There was no prior history of psychiatric  illness.
He was temporarily decertified from  missile  duty  and  entered  into
psychotherapy. Personnel records show  he  performed  his  non-missile
duties in an exemplary fashion and did well in training  (a  simulator
ride and 2 tests). His diagnosis in  the  April  24,  2002  entry  was
listed as “Adjustment Disorder with Anxiety,  R/o  anxiety  disorder.”
The applicant’s duty limiting symptoms persisted through June  and  he
was  referred  by  his  psychologist  for  further   evaluation   with
psychological  testing  and  evaluation   by   a   psychiatrist.   The
psychiatrist evaluated the applicant on July  22,  2002  and  rendered
diagnoses  of  Anxiety   Disorder   not   otherwise   specified,   and
narcissistic personality traits, commenting,” Patient  has  manifested
clear symptoms of anxiety in the face of mild to moderate job  stress.
It seems that his narcissistic personality traits may  interfere  with
his ability to accept a  job  that  he  feels  is  ill-suited  to  his
nature.”  On a July  31,  2002  health  questionnaire,  the  applicant
endorsed symptoms of being bothered by feeling down, helpless, panicky
or anxious.  On July 31, 2002, the mental  health  clinic  recommended
permanent decertification from the Personnel Reliability Program  (and
therefore missile duty) subsequently triggering a  Medical  Evaluation
Board.

The Medical Evaluation Board (MEB) narrative  summary  dated    August
18, 2002 indicated that the applicant reported difficulties  with  job
stress while performing missile duties since his arrival and  reported
“angered and resentment over  “doing  wrong  job”  and  being  “better
suited elsewhere in USAF.”  His symptoms had worsened markedly in  the
month preceding his April  2002  presentation  to  the  mental  health
clinic.  His symptoms included depressed mood,  insomnia,  generalized
anxiety associated with nervousness,  sweaty  palms,  increased  heart
rate, shortness of breath, and white knuckles.   He  reported  feeling
trapped inside the missile capsule.  Following  removal  from  missile
duty, his symptoms improved.  The narrative report  noted  personality
traits (not to the level of a personality disorder) that were felt  to
have contributed significantly to his difficulty adapting to  the  job
he found very distressing and anxiety provoking.  The formal diagnoses
were, Anxiety  Disorder  not  otherwise  specified,  and  Narcissistic
personality traits with a social and industrial  impairment  of  mild.
The narrative summary concluded.

An October 6, 2002 update  to  the  narrative  summary,  states,  “His
condition remains unchanged since the MEB began.  His anxiety symptoms
resolved  completely  with  his  withdrawal  from  his  stressful  job
environment.  Psychological testing was consistent with the  diagnosis
of  an  anxiety  disorder.   He  would  likely  deteriorate  again  if
reassigned to missileer  duties.   Job  stress  and  frustration  were
central to the etiology of his  psychiatric  symptoms  and  poor  work
performance. He will likely experienced significant  problems  in  any
situation in which he was stressed over his military job  assignment.”
The psychiatrist recommended disability discharge from the military.

The commander’s letter to the  Physical  Evaluation  Board  (undated),
states that since April 2002, the applicant had been assigned  various
jobs within the wing.   “He  has  the  capability  to  be  an  average
crewmember, but his negative attitude  towards  that  duty  holds  him
back.  His inability to cope with stress of crew duty  causes  him  to
question his ability to deal with any situation  or  career  field  he
doesn’t like.  The training difficulties we’ve had with the  applicant
and his inability to deal with the stress of a  job  he  doesn’t  like
cause him to question  his  ability  to  succeeded  as  an  Air  Force
officer.”

The applicant requested retention on active duty with  cross  training
into another career field and submitted  several  letters  of  support
including  coworkers,  trainers,  and  supervisors  attesting  to  his
character and excellent qualities desirable of an Air  Force  officer.
Also present are two letters from Air  Force  Tops  In  Blue  civilian
officials extolling his abilities and performance while  working  with
that organization.  A November 13, 2002  memorandum  for  the  Medical
Evaluation Board by the applicant’s  psychologist  indicated  complete
resolution of symptoms and  estimated  his  prognosis  for  continuing
health as good.

The Informal Physical  Evaluation  Board  recommended  discharge  with
severance pay stating, “Member’s medical condition is  not  compatible
with the rigors of military service as evidenced by his susceptibility
to relatively minor stressors which  may  be  present  even  in  other
career  fields.”   The  applicant  appealed  to  the  Formal  Physical
Evaluation Board (FPEB).  The FPEB, on  January  10,  2003  found  the
applicant unfit and recommended discharge with severance pay (10%) for
Anxiety Disorder Not Otherwise Specified.

The decision of the FPEB was upheld by the Secretary of the Air  Force
Personnel Council on March 12, 2003,  citing  the  opinion  of  mental
health professionals indicating a high  likelihood  of  recurrence  of
symptoms, under similar stressful situations.

_________________________________________________________________

AIR FORCE EVALUATION:

The BCMR Medical Consultant recommended denial and stated  action  and
disposition in this case is proper and equitable reflecting compliance
with Air Force directives that implement the law.  The  applicant  was
disability discharged with severance  pay  for  Anxiety  Disorder  not
otherwise specified that developed in the setting of  job  stress  and
dissatisfaction with the career field that the Air Force had  assigned
him.  Following the disappointment of being denied the opportunity  to
tour with Tops In Blue, he presented to the mental health  clinic  and
reported a 2 year history of  symptoms  that  had  recently  worsened.
Based on the applicant’s report of symptoms, severity and duration, he
was properly diagnosed by his psychologist and psychiatrist.  Although
his symptoms  improved  gradually  following  removal  from  missileer
duties,  both  his  psychologist  and  psychiatrist   attributed   the
development  of  his  symptoms  to  characterological   features   and
expressed the opinion that recurrent symptoms were highly likely under
similar circumstances  of  occupational  dissatisfaction  and  stress.
Based on  these  opinions  the  Physical  Evaluation  Boards  and  the
Secretary of the Air Force Personnel Council determined the  applicant
was not fit for continued military service.

The situational and  transient  nature  of  the  applicant’s  symptoms
diagnosed as anxiety disorder also suggested the earlier diagnosis  of
Adjustment Disorder.  Members diagnosed with Adjustment Disorder  that
interferes with duty are considered unsuited for military duty and are
subject to administrative discharge by their commanders.  Although the
symptoms of Adjustment Disorder improve with relief of the  stressors,
recurrence under similar stressful circumstances is likely  especially
with the co-morbid maladaptive  coping  associated  with  narcissistic
personality  traits.  Regardless  of  which  diagnosis  was  the  most
accurate, Adjustment Disorder or Anxiety Disorder, past experience  is
predictive of an  increased  risk  for  recurrence  of  duty  limiting
anxiety and or Adjustment Disorder if re-exposed to the unique demands
of military training and service.
BCMR Medical Consultant’s complete evaluation is at Exhibit C.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

A copy of the Air Force evaluation was forwarded to the  applicant  on
21 May 2004 for review and comment within 30 days.  As of  this  date,
no response has been received by this office.

_________________________________________________________________

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 agree with the BCMR  Medical  Consultant’s  recommendation
and adopt his rationale that the applicant has not been the victim  of
an error or injustice and the narrative reason for separation in  this
case is appropriate.  In this respect, we noted the  findings  of  the
MEB and PEB that indicated the applicant’s medical  condition  is  not
compatible with the rigors of military service  as  evidenced  by  his
susceptibility to relatively minor stressors,  which  may  be  present
even  in  other  career  fields.   Accordingly,  in  the  absence   of
persuasive evidence to the contrary, we find  no  basis  to  recommend
granting the relief sought in this application.

4.  The applicant's case is adequately documented and it has not  been
shown  that  a  personal  appearance  with  or  without  counsel  will
materially  add  to  our  understanding  of   the   issues   involved.
Therefore, the request for a hearing is not favorably considered.

_________________________________________________________________

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-
2003-03834 in Executive  Session  on  14  September  2004,  under  the
provisions of AFI 36-2603:

                 Ms. Olga M. Crerar, Panel Chair
                 Mr. James W. Russell III, Member
                 Mr. John B. Hennessey, Member

The following documentary evidence was considered:

    Exhibit A.  DD Form 149, dated 10 Nov 03, w/atchs.
    Exhibit B.  Applicant's Master Personnel Records.
    Exhibit C.  Letter, BCMR Medical Consultant, dated 17 May 04.
    Exhibit D.  Letter, SAF/MRBR, dated 21 May 04.




                                   OLGA M. CRERAR
                                   Panel Chair