RECORD OF PROCEEDINGS
         AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:      DOCKET NUMBER:  BC-2005-01789
            INDEX NUMBER:  108.00
      XXXXXXX    COUNSEL:  NONE

            HEARING DESIRED:  No


MANDATORY CASE COMPLETION DATE:  2 Dec 06


_________________________________________________________________

APPLICANT REQUESTS THAT:

Her disability discharge with severance pay be changed to a disability
retirement.

_________________________________________________________________

APPLICANT CONTENDS THAT:

She  was  diagnosed  with  thyroid  cancer,  which  provided  clinical
evidence that she  had  a  real  medical  problem  that  produced  the
symptoms and conditions used to suggest the diagnosis of Dysthymia and
Personality Disorder.

The physical and psychological effects of thyroid disorders  were  the
obvious causation factor for the mood changes and major depression she
suffered, but was misdiagnosed or ignored by Air force personnel.

Due to an objective and  complete  evaluation  by  the  Department  of
Veterans Affairs (DVA), it  was  determined  that  the  cause  of  her
problems were in fact due to a medical problem, but was not determined
soon enough to prevent the total removal of her  thyroid  gland.   She
was diagnosed with thyroid cancer only four months after her discharge
from the Air Force.  She believes the cancer should have been detected
while she was on active duty.

The two different versions of her psychological  evaluation  while  on
active duty suggest there was misdirection on the part of  the  staff.
A  close  examination  of  the  evaluation  will  reveal   conflicting
statements and a lack of empirical supporting evidence that she had  a
preexisting personality disorder.

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

_________________________________________________________________

STATEMENT OF FACTS:

The applicant entered active duty in the Air Force on 1 Jun 98.  On 17
Oct 02, a medical evaluation board (MEB) convened and recommended  the
applicant be referred to an informal physical evaluation board  (IPEB)
based on the following diagnoses:

        a. Irritable Bowel Syndrome.

         b.  Chronic  constipation  status  post  multiple   abdominal
surgeries with adhesions.

        c.  Gastro esophageal Reflux Disease.

        d.  Seasonal Allergic Rhinitis.

        e.  Dysthymic Disorder, late onset.

        f.  Partner Relational Problems.

         g.   Personality  Disorder,  not  otherwise  specified,  with
borderline and self-defeating features (principal diagnosis).

On 18 Nov 02, an  IPEB  convened  and  recommended  the  applicant  be
discharged with severance pay with a  compensable  rating  of       10
percent based  on  a  diagnoses  of  Dysthymia  Disorder,  social  and
industrial adaptability impairment definite.   The  rating  of      10
percent was derived from a rating of 30 percent minus 20  percent  for
the applicant’s diagnosis of Personality Disorder.  The applicant  was
also diagnosed with the following conditions that could  be  unfitting
but were not found to be compensable or ratable at the time:

        a.  Irritable Bowel Syndrome.

        b.  Gastro esophageal Reflux Disease.

        c.  Seasonal Allergic Rhinitis.

The applicant was also diagnosed with Personality Disorder, which  was
not considered separately unfitting or compensable or ratable.

On 26 Nov 02, the applicant indicated  on  AF  Form  1180,  Action  on
Physical Evaluation Board Findings and Recommended  Disposition,  that
she did not agree with  the  IPEB  findings  and  recommendations  and
demanded a formal hearing.

On 30 Jan 03, a Formal Physical Evaluation Board (FPEB)  convened  and
concurred and upheld the findings of the IPEB.   On  30  Jan  03,  the
applicant indicated on the AF Form  1180  her  disagreement  with  the
findings and recommended disposition of the FPEB hearing and indicated
she would submit  a  rebuttal  to  the  Secretary  of  the  Air  Force
Personnel  Council  (SAFPC).   The  applicant’s  counsel  submitted  a
statement to SAFPC challenging the deduction of      20  percent  from
the applicant’s disability rating for  the  diagnosis  of  Personality
Disorder.  On 7 Apr 03, the SAFPC considered the applicant’s  rebuttal
and directed her discharge with severance pay based  on  a  disability
rating of 10 percent.  The applicant was discharged from the Air Force
on 2 Jun 03 with disability  severance  pay  based  on  a  10  percent
disability rating.  Additional facts pertinent to this application are
contained in the evaluation prepared by the  BCMR  Medical  Consultant
found at Exhibit C.

_________________________________________________________________

AIR FORCE EVALUATION:

The BCMR Medical  Consultant  recommends  denial  of  the  applicant’s
requests.  The applicant was disability discharged with severance  pay
for  Dysthymic  Disorder  and  Personality  Disorder,  Not   Otherwise
Specified.  Because the personality disorder was  determined  to  have
contributed  significantly  to  her  overall  impairment,   a   rating
deduction was applied resulting  in  a  rating  of  10  percent.   The
applicant requests disability retirement  contending  thyroid  cancer,
undiagnosed while on active duty caused her emotional  and  behavioral
difficulties diagnosed as personality disorder.

While  significant  under  or  over  production  of  thyroid   hormone
associated with thyroid diseases may be  associated  with  psychiatric
symptoms   (including   depression,    irritability    or    cognitive
disturbances), a review of the applicant’s service medical records  as
well as DVA records shows no evidence of under or over  production  of
thyroid hormone associated with  her  thyroid  disease.   Her  service
medical records show documentation of normal thyroid function  in  Dec
01 and Mar 02.  DVA records show normal thyroid function in Aug 03 and
Nov 03.  Although the applicant’s  thyroid  cancer  may  have  existed
while  she  was  on  active  duty,  it  was  not  the  cause  of   her
disqualifying symptoms diagnosed as Dysthymia and personality disorder
and is, therefore, not eligible  for  consideration  in  the  military
disability  evaluation  system.   The   development   and   successful
treatment for thyroid cancer while on active duty is not an  automatic
basis for disability discharge and an individual in the nursing career
specialty would clearly be retained.

Personality disorders themselves are not  medically  disqualifying  or
unfitting and are not ratable or compensable under the  rules  of  the
disability system.  However, a personality  disorder  may  render  the
individual unsuitable for further military service and  may  be  cause
for administrative action by the individual’s unit commander.  When  a
personality disorder contributes to the severity  of  the  social  and
industrial adaptability impairment associated with an unfitting mental
illness, DoD policy provides for a rating deduction to account for the
relative contribution of the non-ratable, non compensable  personality
disorder.  The BCMR Medical Consultant concludes that the  applicant’s
diagnosis of personality disorder is supported by the preponderance of
the evidence and  that  there  is  no  evidence  of  abnormal  thyroid
function that would have caused her symptoms.

The complete evaluation is at Exhibit C.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

In her response to the BCMR Medical Examiner’s  evaluation,  applicant
states that great  emphasis  is  made  to  point  the  finger  at  her
personally and asks if there might not have possibly  been  any  other
“forces or dynamics” at play that could not have been directly related
to  her  alleged  late  onset  personality  disorder.   The  applicant
provides comments  on  several  of  the  issues  brought  out  in  the
evaluation.   The  applicant  provides  an  excerpt  from  an  article
published by an authority on cancer that  indicates  that  cancer  may
develop as a result of stress.  She also states that the hypothesis of
maladaptive behavior focuses on the effect  and  totally  excuses  the
cause giving it cultural support and credence.  She opines  that  this
hypothesis can not possibly hold as much weight as the empirical  fact
that in the height of her Army military career, she rose to  the  rank
and position of Chief Nurse of the Ohio State National Guard.   Before
entering the Air Force, she held a civilian  position  as  coordinator
for a busy cardiovascular operating room, averaging four to  six  open
heart cases per day.  She states that  the  inherent  stress  of  this
previous military position and civilian job  had  already  tested  her
coping ability much more than a simple tour of hospital duty.

In further support of her appeal,  she  provides  a  letter  from  her
present psychiatrist and  copies  of  her  medical  records  from  the
Department of Veterans Affairs  since  her  separation  from  the  Air
Force.

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

_________________________________________________________________

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 opinion  and  recommendation  of  the  BCMR
Medical Consultant and adopt  his  rationale  as  the  basis  for  our
conclusion that the applicant has not been the victim of an  error  or
injustice.  Additionally, after  reviewing  the  applicant’s  evidence
submitted in rebuttal, we did not find it sufficient to  overcome  the
findings  contained  in  the  BCMR  medical  Consultant’s  evaluation.
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 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 Docket  Number  BC-2005-
01789 in Executive Session on 28 September 2006, under the  provisions
of AFI 36-2603:

      Mr. James W. Russell, III, Panel Chair
      Mr. Alan A. Blomgren, Member
      Mr. Grover L. Dunn, Member

The following documentary evidence was considered:

    Exhibit A.  DD Form 149, dated 30 May 05, w/atchs.
    Exhibit B.  Applicant's Master Personnel Records.
    Exhibit C.  Memorandum, BCMR Medical Consultant,
                dated 3 Aug 06.
    Exhibit D.  Letter, SAF/MRBR, dated 4 Aug 06.
    Exhibit E.  Letter, Applicant, dated 7 Sep 06, w/atch.




                                   JAMES W. RUSSELL, III
                                   Panel Chair