RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS
IN THE MATTER OF: DOCKET NUMBER: BC-2009-01037
COUNSEL:
HEARING DESIRED: YES
___________________________________________________________________
APPLICANT REQUESTS THAT:
1. She be medically retired with a 50 percent disability rating.
2. As an alternatative, she be continued on the Temporary
Disability Retired List (TDRL).
___________________________________________________________________
APPLICANT CONTENDS THAT:
In a 14 page brief, the applicants counsel makes the following key
contentions:
1. The applicant requests to be medically retired under Chapter 61
of Title 10, with a disability rating of 50 percent for a Major
Depressive Disorder and an Eating Disorder. She believes the
opinion of the Formal Physical Evaluation Board (FPEB) that found
her unfit for duty and recommended her for discharge with
10 percent severance pay to be arbitrary, capricious, and contrary
to law and regulation.
2. The applicant was a four-year varsity athlete attending the Air
Force Academy as a cadet who was very impressive; she was on the
Deans List for two of seven semesters and on the Commandants List
for four of seven semesters. Her lifelong dream was to become an
astronaut; however, she began having troubles at the academy when
she found out that she no longer qualified as a pilot, thus,
questioning her self-worth and feeling like she had been abandoned
which led to a cycle of hypomanic periods punctuated at varying
intervals by plummeting depression, which led to serious suicide
ideations.
3. According to her medical records, her eating disorder existed in
a milder form during high school, but was aggravated by her major
depressive disorder.
4. The applicant was formally evaluated by the Cadet Mental Health
Clinic in late 2006 and was found to be suffering from Major
Depressive Disorder, recurrent, moderate. The Medical Evaluation
Board (MEB) found both her military and social impairment to be
rated as considerable. Thus, the MEB placed her on the TDRL with
a 30 percent disability rating. Noted by the applicants counsel,
the doctor who signed off on the diagnosis and who is a
psychiatrist did not conduct a single clinical interview with the
applicant which is in direct contradiction of the governing
regulation.
5. The academy involuntarily hospitalized her right after she was
notified that the MEB found her unfit for duty and recommended her
for discharge. Noting an oversight in processing her for
discharge, the academy forgot that she was a senior cadet who was
entitled to consideration to permit her to graduate if she were
otherwise qualified. This oversight led to a tragic-comical series
of mistakes until she was finally disenrolled from the academy on
26 Jan 07.
6. In 2008, she was reevaluated by an MEB at Dover AFB, DE. She
was found to have Major Depressive Disorder, recurrent, severe, in
full remission. The boards assessment of the chances of
recurrence was 90 percent. The board also concluded the occupation
and social impairment due to mild or transient symptoms would
reduce her work effectiveness only during periods of significant
stress. The applicant appealed to a FPEB which voted 2-1 to
sustain the decision of the reevaluating IPEB that convened on
31 Mar 08.
7. The FPEB found her medically disqualified for service, but only
rated her disability at 10 percent. The decision did not mention
the 90 percent risk of a relapse into suicidal despondency or the
evaluation that rated her with a 50 percent disability rating for
considerable and significant impairment. The physician on the
FPEB recommended continuation on the TDRL stating the applicant
still exhibited occupational and social instability as reflected in
three different occupations, one prolonged travel overseas, and
inability to complete school, all within the current TDRL period
and while taking all her prescribed medications. The physician
concluded by stating she has not stabilized yet and that further
time with her new psychiatry and psychology team should be granted
in order to see if her three Axis I condition[s] have reached a
maintenance therapy stage. The applicant had several episodes of
major depressive acts (see pages 3-5 of her counsels brief) after
receiving the FPEBs decision.
8. The Secretary of the Air Force Personnel Council (SAFPC) adopted
an entirely different rationale for denying the applicants request
which is likewise unsupportable based on an incomplete and
incorrect diagnosis of a borderline personality disorder and is
further an unacceptable supposition that the disabling symptomology
is the product of the personality disorder and not the mood
disorder.
9. Pages 9-13 of her counsels brief supports the reasons she
should be medically retired. Her counsel believes the applicant
was misdiagnosed by the Air Force and she should receive at least a
50 percent medical retirement for Occupational and Adjustment
Disorder.
10. Substantial error has occurred in this case, as neither the
FPEB nor SAFPC ever looked at the applicants medical records which
reflect accredited professional diagnoses.
11. Further specific information can be found in her counsels
brief at Exhibit A.
In support of her request, applicant provides a copy of her
counsels brief and a letter from her psychiatrist.
Her complete submission, with attachments, is at Exhibit A.
___________________________________________________________________
STATEMENT OF FACTS:
The applicant met an IPEB on 13 Nov 06 and was found unfit for duty
and was placed on the TDRL with a 30 percent disability rating for
Major Depressive Disorder, an Eating Disorder not otherwise
specified and an Anxiety Disorder not otherwise specified. The
IPEB recommended her for a 50 percent disability rating, but
deducted 20 percent for an Eating Disorder, which resulted in a 30
percent compensable disability rating. However, after she was
reevaluated, the IPEB found the applicants medical condition had
improved and recommended she be removed from the TDRL and separated
with a 10 percent disability rating with severance pay. The
applicant appealed to the FPEB; however, on 8 Jul 08, the FPEB
agreed with the IPEB findings and upheld the decision to separate
her with a 10 percent disability rating. The applicant appealed
the FPEBs decision to SAFPC which also denied her appeal and
recommended her for separation with severance pay.
___________________________________________________________________
AIR FORCE EVALUATION:
In a four page evaluation, the BCMR Medical Consultant recommends
placing her on the TDRL with a 30 percent disability rating
effective the date of her removal from the TDRL, followed by a
repeat psychiatric evaluation and adjudication through the Military
Disability Evaluation System (MDES). The Medical Consultant
recommends the applicants evaluation be concluded with a V-Axis
diagnostic format and her level of impairment in civilian social
and industrial or occupational adaptability be determined. The
Medical Consultant finds this approach particularly valuable in
correctly diagnosing the applicants medical condition and removing
medications that may have seriously exacerbated her symptoms. If
the applicant actually has a bipolar disorder and not a personality
disorder, it would seem to be unfair to attribute her medical
condition to one disorder that may overlap another disorder.
The Medical Consultants complete evaluation is at Exhibit C.
___________________________________________________________________
APPLICANT'S REVIEW OF AIR FORCE EVALUATION:
The applicants counsel responded by concurring with the Medical
Consultants recommendation to place her on the TDRL for further
evaluation.
Counsels complete rebuttal 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. Sufficient relevant evidence has been presented to demonstrate
the existence of error or injustice warranting a measure of
relief. In this regard, when the applicant was initially placed
on the TDRL her condition was diagnosed with a moderate major
depressive disorder, recurrent, associated with anxiety disorder,
not otherwise specified, which coincides with a 50% disability
rating in accordance with the VASRD; however, her eating disorder
was considered to be EPTS, thus, 20% disability rating was
subtracted from her current rating giving her a 30% combined
compensable disability rating. Upon reevaluation it was
determined by the IPEB and FPEB that her condition was at the
severe level; though, it was noted to be in full remission.
Consequently, her overall rating was reduced to a 10% disability
rating. However, as noted by the BCMR Medical Consultant, the
applicants diagnosis of major depressive disorder stood from 2006
until it was challenged by a board certified psychiatrist in 2008.
The disparity between the determination of the attending
psychiatrist and the FPEB appears to be based upon the fact that
the psychiatrist actually conducted clinical interviews and
testing, resulting in a different diagnosis and treatment. Based
on this, we are unable to ascertain whether or not the severity of
the applicants condition was properly adjudicated during her
reevaluation. It is our opinion that because of the differing
medical opinions, the applicant should have remained on the TDRL
for further observation and evaluation. Restoring the applicants
TDRL status would enable the Air Force to more accurately
reevaluate the diagnosis. Therefore, we recommend her records be
corrected to the extent indicated below.
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 RECOMMENDS THAT:
The pertinent military records of the Department of the Air Force
relating to APPLICANT be corrected to show that:
a. She was not removed from the Temporary Disability
Retirement List (TDRL) and discharged with severance pay on 23 Nov
08, but on that date was continued on the TDRL.
b. A TDRL reevaluation be performed and the results of the re-
evaluation be forwarded to the Air Force Board for Correction of
Military Records at the earliest practicable date so that all
necessary and appropriate actions may be completed.
______________________________________________________________
The following members of the Board considered AFBCMR Docket Number
BC-2009-01037 in Executive Session on 24 Nov 09, under the
provisions of AFI 36-2603:
, Panel Chair
, Member
, Member
All members voted to correct the records, as recommended. The
following documentary evidence for Docket Number BC-2009-01037 was
considered:
Exhibit A. DD Form 149, dated 11 Mar 09, w/atchs.
Exhibit B. Applicant's Master Personnel Records.
Exhibit C. Letter, BCMR Medical Consultant, dated 30 Jun 09.
Exhibit D. Letter, SAF/MRBR, dated 2 Jul 09.
Exhibit E. Letter, Applicants Counsel, dated 16 Sep 09.
Panel Chair
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