RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2013-01627
		
		COUNSEL:  NONE

		HEARING DESIRED:  NO


_________________________________________________________________

APPLICANT REQUESTS THAT:

1. His medical discharge documents from the Air Force, DD Form 
214, Certificate of Release or Discharge from Active Duty, 
and/or Permanent Disability Retired List (PDRL) be corrected to 
reflect his Post Traumatic Stress Disorder (PTSD).

2. His PTSD diagnosis be designated as a combat-related illness.

_________________________________________________________________

APPLICANT CONTENDS THAT:

He has documentation indicating his status as having PTSD and 
the Department of Veterans Affairs (DVA) has rated him as having 
PTSD.

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

_________________________________________________________________

STATEMENT OF FACTS:

The applicant’s military personnel records indicate he enlisted 
in the Regular Air Force on 28 Dec 00.

On 5 Sep 08, the applicant was relived from active duty with a 
narrative reason for separation of “Disability, Temporary” and 
was transferred to the Temporary Disability Retired List (TDRL).  

According to information provided by the applicant, on 30 Jun 
09, the DVA reevaluated the applicant’s claim and retroactively 
upgraded his diagnosis of PTSD and increased his disability 
rating from 30 percent to 70 percent.

On 12 Sep 12, as a result of his TDRL periodic re-evaluation, 
the applicant was removed from the TDRL and permanently retired 
with a combined compensable disability rating of 60 percent.
The remaining relevant facts pertaining to this application are 
contained in the letters prepared by the appropriate offices of 
the Air Force, which are at Exhibits C and E.

_________________________________________________________________

AIR FORCE EVALUATION:

AFPC/DPFD recommends denial indicating there was no evidence of 
an error or injustice that occurred during the disability 
process.  The applicant was diagnosed with a major depressive 
disorder associated with anxiety disorder, bilateral ankle and 
heel pain and chronic low back pain.  The Informal Physical 
Evaluation Board (IPEB) recommended placing the applicant on the 
Temporary Disability Retired List (TDRL) with a combined 
disability rating of 60 percent, with his major depressive 
disorder rated at 30 percent.  He concurred with the recommended 
findings and on 6 Sep 08 [sic], was discharged and transferred 
to the TDRL.  On 2 Aug 10, during the applicant’s TDRL 
reevaluation, the IPEB recommended he be retained on the TDRL 
for bipolar disorder with a 50 percent rating, while his ratings 
for bilateral ankle and heel pain and chronic low back pain 
remained unchanged.  On 25 Jun 12, during the applicant’s second 
TDRL reevaluation, the IPEB recommended he be removed from TDRL 
and permanently retired with a combined disability rating of 
60 percent.  The bipolar disorder and general medical condition 
was rated at 30 percent, bilateral ankle and heel pain at 
21 percent, and the chronic low back pain at 20 percent.  PTSD 
was not diagnosed from the original medical board and was not 
deemed combat related.  The applicant concurred with the 
recommended findings and was removed from the TDRL, effective 
12 Sep 12.

The DoD and DVA disability evaluation systems operate under 
separate laws.  Title 10 USC states that Physical Evaluation 
Boards (PEB) determine if a member’s condition renders them 
unfit for continued military service.  A diagnosed medical 
condition does not necessarily mean that the condition is 
unfitting for continued military service.  To be unfitting, the 
condition alone must preclude the member from fulfilling their 
military duties.  The USAF disability boards must rate 
disabilities based on the member’s condition at the time of 
evaluation.  The DVA picks up where the AF must, by law, leave 
off.  Under Title 38 USC, the DVA determines and reevaluates 
service-connected conditions.  Often times, the results are 
different ratings by the two agencies.

A complete copy of the AFPC/DPFD evaluation is at Exhibit C.

The AFBCMR Medical Consultant recommends denial indicating the 
applicant has not met the burden of proof of error or injustice 
that warrants the desired change of his record.  The fact that 
the applicant was given a different diagnosis by the DVA 
provider is insufficient to invalidate the conclusions reached 
by competent military mental health authorities at the time of 
his military service.  The diagnostic nomenclature assigned to a 
given set of psychiatric symptoms and stressors, as reported by 
a patient at a given point in time, may change over time, or may 
be reported differently at a subsequent point in time. 
Therefore, with disclosure of a different clinical history or 
set of symptoms, a new mental health provider is more inclined 
to reach a different diagnostic conclusion, as is likely in the 
applicant’s case.  Professional diagnostic opinions may even 
vary between two different providers when given the same set of 
clinical symptoms from the same patient, given the fact that 
symptoms are often shared by one or more different clinical 
diagnoses (e.g., the depressed mood seen in Adjustment Disorder, 
Major Depressive Disorder, Dysthymic Disorder, Anxiety Disorder, 
PTSD, or secondary to Alcohol Dependence, and mood swings seen 
in Bipolar Disorder and Borderline Personality Disorder).  Yet 
two or more mental disorders [Axis I and/or Axis II diagnoses] 
may even co-exist concurrently, often making it difficult to 
separate the two as individual functional entities due to their 
close association and shared clinical features (e.g., the 
applicant's initial diagnoses of Major Depressive Disorder 
associated with Anxiety Disorder).  Thus, given the clinical 
symptoms recorded and conclusions reached at the applicant's 
military mental health evaluations, the fact that he has been 
given a different diagnosis by the DVA is insufficient to 
invalidate the accuracy or appropriateness of the conclusions 
reached by equally competent military mental health authorities, 
who were equally aware of the applicant's pattern of behavior 
reported at the time of his military service and TDRL 
assessment.  

According to DoDI 1332.38, Enclosure 3, Part 6, paragraph 
E3.P6.2.4.1, Compensability of New Diagnoses, conditions newly 
diagnosed during TDRL periodic physical examinations shall be 
compensable when: "The condition is unfitting" and, "the 
condition was caused by the condition for which the member was 
placed on the TDRL, or directly related to its treatment; or, 
"the evidence of record establishes that the condition was 
either incurred while the member was entitled to basic pay or as 
the proximate result of performing duty, whichever is 
applicable, and was an unfitting disability at the time the 
member was placed on the TDRL.  Otherwise, such conditions shall 
be deemed unfitting due to the natural progression of the 
condition and noncompensable under Chapter 61 of 10 U.S.C., 
although the member may be eligible for benefits for these 
conditions under the Office of Veterans Affairs (OVA)."  The 
applicant’s diagnosis of PTSD was not an unfitting condition at 
the time he was released from service and placed on the TDRL, 
nor was it caused by the condition for which he was placed on 
the TDRL.


A complete copy of the AFBCMR Medical Consultant’s evaluation is 
at Exhibit D.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Copies of the Air Force and AFBCMR Medical Consultant 
evaluations were forwarded to the applicant on 8 Aug 13 for 
review and comment within 30 days.  As of this date, no response 
has been received by this office (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 an error or injustice.  We took 
notice of the applicant’s complete submission in judging the 
merits of the case; however, we agree with the opinions and 
recommendations of the Air Force office of primary 
responsibility (OPR) and BCMR Medical Consultant adopt their 
rationale as the basis for our conclusion the applicant has not 
been the victim of an error or injustice.  The applicant’s 
contentions are duly noted; however, we do not find these 
assertions, in and by themselves, sufficiently persuasive to 
override the evidence of record or the rationale provided by the 
noted advisory opinions.  As for the applicant’s request that 
his PTSD be deemed a combat related disability, in view of the 
fact that we are not convinced that his PTSD was unfitting at 
the time of his discharge, there is no basis for us to conclude 
that his PTSD should have been found to be combat related.  
Therefore, in the absence of evidence to the contrary, we find 
no basis to recommend granting the relief sought in this 
application.

_________________________________________________________________

THE BOARD DETERMINES THAT:

The applicant be notified the evidence presented did not 
demonstrate the existence of material error or injustice; the 
application was denied without a personal appearance; and 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-2013-01627 in Executive Session on 23 Jan 14, under 
the provisions of AFI 36-2603:

	                    , Panel Chair
	                    , Member
	                    , Member

The following documentary evidence was considered:

	 Exhibit A.  DD Form 149, dated 19 Mar 13, w/atchs.
	 Exhibit B.  Applicant's Master Personnel Records.
	 Exhibit C.  Letter, AFPC/DPFD, dated 30 May 13.
	 Exhibit D.  Letter, AFBMCR Medical Consultant, 
	             dated 7 Aug 13.
	 Exhibit E.  Letter, SAF/MRBRC, dated 8 Aug 13.




                                   
                                   Acting Panel Chair




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