RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER: BC-2013-03241
	XXXXXXX	COUNSEL:  XXXXXXX	
		HEARING DESIRED: YES

________________________________________________________________

APPLICANT REQUESTS THAT:

1.  Her administrative discharge be changed to a medical 
retirement with a 30 percent disability rating.

2.  Her narrative reason for separation be changed to reflect a 
less inflammatory reason for discharge than “Personality 
Disorder.”

3.  On 5 Feb 2014, the applicant amended her request to change 
her administrative discharge to a medical retirement with a 
60 disability rating rather than 30 percent.

________________________________________________________________

APPLICANT CONTENDS THAT:

In a 9-page statement the applicant’s counsel presents the 
following major contentions:

1.  The applicant was incorrectly diagnosed with a Personality 
Disorder.  Her diagnosis of Personality Disorder is in error.  
By definition a Personality Disorder is a pattern of inner 
experience and behavior that deviates from the expectations of 
an individual's culture.  Personality Disorders are not fleeting 
in nature and are not associated with temporary stressors but 
instead are a long-lasting impairment in social, occupational, 
or other areas of functioning.  If she in fact suffers from a 
Personality Disorder then she would have had some symptoms prior 
to Apr 2010.  In Apr 2010, she was forty-three years old and had 
completed two Bachelor's degrees and a Master's degree with a 
3.9+ grade point average.  Prior to her military career, she led 
a perfectly normal life with an impeccable work history and 
maintained healthy and lasting relationships.  Beginning in 
2010, she started seeing a clinical psychologist, in light of 
the command's insistence that she suffers from a Personality 
Disorder.  According to her treating physician, she does not 
meet any of the criteria for a Personality Disorder according to 
the Diagnostic and Statistical Manual of Mental Disorders, Fifth 
Edition (DSM-V).  As set forth by her clinical psychologist, an 
individual with a Personality Disorder must meet at least two of 
the following conditions to be diagnosed with a Personality 
Disorder:

      a.  A problematic pattern of behavior which has its 
beginnings in at least adolescence or early adulthood;
      b.  In appropriate affectivity, such as intense or labile 
affect, abnormal emotional response, etc.;
      c.  Difficulties in interpersonal relations, social 
situations; and,
      d.  Lack of impulse control.
      
When one considers the stark contrast between her work ethic, 
commitment, and drive to succeed prior to her terminal diagnosis 
of idiopathic pulmonary fibrosis, it is quite clear that her 
change in behavior is solely attributable to that diagnosis and 
not an enduring maladaptive pattern of behavior and cognition 
consistent with a Personality Disorder.

2.  She should have been processed through the Disability 
Evaluation System (DES).  She should have been permanently 
retired from the Air Force due to her diagnosis of idiopathic 
pulmonary fibrosis.  Her health has repeatedly declined and will 
continue to decline in years to come.  In Jun 2010 she was 
informed by her physician that she would likely require a lung 
transplant within three to five years.  The Physical Evaluation 
Board (PEB) correctly determined that her conditions were 
service connected and that she should have been retired with a 
permanent rating of 30 percent.  The only reason she was not 
permanently retired was due to the incorrect separation based on 
Personality Disorder.  When one considers the fact that 
immediately after she was released from the military she 
received a combined rating of 100 percent from the Department of 
Veterans Affairs (DVA), it becomes abundantly clear that she 
should have been processed through the DES system.  Notably the 
DVA assigned a 60  percent disability rating for her diagnosis 
of idiopathic pulmonary fibrosis effective 3 Dec 2011.  
Regardless of the percentage difference between the DVA and the 
Medical Evaluation Board (MEB), it cannot be ignored that both 
departments viewed her pulmonary fibrosis as service connected.  
Clearly, she should have been separated through the DES system 
and not separated under the auspices of "Personality Disorder."

3.  Characterizing her as having a Personality Disorder is 
inequitable.  Since her separation on 2 Dec 2011, she has been 
unable to find employment.  The characterization of Personality 
Disorder carries with it a negative stigma that unfairly 
jeopardizes her future employment prospects, particularly in her 
career as a social worker.  The Mental Health Evaluation is an 
inaccurate, cursory review of her mental health history; counsel 
respectfully requests that the narrative reason of discharge be 
changed to reflect a less inflammatory reason for discharge than 
Personality Disorder.

In support of her request, the applicant provides copies of her 
AF Form 356, Findings and Recommended Disposition of USAF 
Physical Evaluation Board; DVA Rating Decision; medical 
documents, memorandums, and various other documents associated 
with her request.

Her complete submission, with attachments, is at Exhibit A.

________________________________________________________________

STATEMENT OF FACTS:

On 28 Jun 2009, the applicant entered active duty.

On 28 Jul 2009, the applicant was notified by her commander that 
she was considering she be disenrolled from Commissioned Officer 
Training (COT) for lack of adaptability.

On 31 Jul 2009, the Staff Judge Advocate found the COT 
disenrollment legally sufficient.

In a 19 Aug 2009 electronic communiqué, COT leadership and the 
career filed manager provided the applicant a second opportunity 
at COT beginning on 24 Aug 2009.

On 1 Feb 2010, she received a Letter of Admonishment for 
dereliction of duties, attempting to deceive superior officers 
and providing false information.

In a “Mental Health Evaluation date 1 Apr 2010, the applicant 
was seen for a non-emergent Commander Directed Evaluation (CDE) 
on 23 Mar 2010, 25 Mar 2010, 29 Mar 2010 and 31 Mar 2010.   The 
applicant was referred by her commander for an evaluation due to 
a pattern of lying, undue anxiety in dealing with patients and 
not benefiting from supervision.

On 29 Jul 2010, the applicant’s commander initiated separation 
action under the provisions of AFI 36-3206, Administrative 
Discharge for Commissioned Officers.  The specific reason for 
his action was the applicant was diagnosed with an Adjustment 
Disorder with anxiety and with a Personality Disorder with 
borderline paranoid and compulsive features by a clinical 
psychologist.

On 19 Jul 2011, the applicant was referred to the Informal 
Physical Disability Evaluation Board (IPEB) for “Interstitial 
Lung Disease NOS, likely Idiopathic Pulmonary Fibrosis.”  The 
IPEB recommended permanent retirement with a disability rating 
of 30 percent. 

On 1 Aug 2011, the applicant concurred with the medical 
recommendation for permanent retirement.

On 4 Aug 2011, the applicant's case was forwarded to the 
Secretary of the Air Force Personnel Counsel (SAFPC) for review 
of her dual action case.

On 14 Nov 2011, SAFPC directed the applicant be discharged by 
execution of the approved AFI 36-3206, Administrative Discharge 
Procedures for Commissioned Officers, action and terminated the 
action under the provisions of AFI 36-3212, Physical Evaluation 
for Retention, Retirement, and Separation. 

On 2 Dec 2011, the applicant was honorably discharged from the 
Air Force after serving 2 years, 5 months and 5 days of active 
service.  Her narrative reason for separation is “Personality 
Disorder.”

On 29 Nov 2012, the DVA granted the applicant a 60 percent 
service connected rating effective 3 Dec 2011, for “Sarcoidosis, 
Unusual Interstitial Pneumonia (UIP), Idiopathic Pulmonary 
Fibrosis, and Sleep Apnea.”  Her overall combined rating is 
100 percent.

________________________________________________________________

AIR FORCE EVALUATION:

AFPC/DPFD recommends denial.  DPFD states that the preponderance 
of evidence reflects that no error or injustice occurred during 
the disability process or the rating applied at the time of the 
board.  In accordance with AFI 36-3212, when a case is being 
processed with a final recommendation of unfit and 
administrative action is pending, the case is processed as a 
dual action and forwarded to SAFPC for finalization.  Once SAFPC 
reviewed the case as a dual action they had the option to retain 
the applicant on active duty, direct the medical retirement or 
uphold the administrative discharge.  On 14 Nov 2011, SAFPC 
directed the applicant be discharged by execution of the 
approved AFI 36-3206 action and terminated the action under the 
provisions of AFI 36-3212.  After reviewing all the facts and 
evidence SAFPC noted "...the Board determined there was no 
causal relationship between the member's medical condition and 
her misconduct, and that there were insufficient mitigating 
factors to disregard the disciplinary action.  Therefore, the 
Board determined that execution of the previously approved AFI 
36-3206 action is appropriate.”

The complete DPFD evaluation is at Exhibit C.

The BCMR Medical Consultant recommends granting the applicant 
alternative relief by changing the reason for discharge to 
“Secretarial Authority.”  The Medical Consultant states that he 
found sufficient evidence of an alternative choice available to 
the applicant's commander in selecting the narrative reason for 
administrative discharge, which would remedy the injustice 
caused by the stigma of the diagnosis of Personality Disorder.  
It should be noted that the applicant's CDE predated the 1 Apr 
2010 medical narrative explaining her diagnosis and prognosis.  
Thus, while the applicant may have experienced some symptoms of 
her disease, the Medical Consultant does not link her 
performance difficulties to her knowledge of the diagnosis or 
prognosis for recovery.  Instead, the applicant's demonstrated 
performance difficulties and the multiple documented 
observations of co-workers collectively resulted in the CDE.  
Noting the recurrent reference to the applicant's poor or 
difficult adaptability to the Air Force, her Axis I Adjustment 
Disorder with anxiety could have and should have taken 
precedence when selecting the administrative reason for 
discharge.  Choosing this route would have been both legal and 
appropriate, with the added benefit of a much less adverse 
occupational stigma when compared to her co-morbid diagnosis of 
Personality Disorder; notwithstanding the plausible diagnostic 
challenge by the applicant's legal counsel.

Re-addressing the applicant's desire for a medical 
separation/retirement, the military DES, established to maintain 
a fit and vital fighting force, can by law, under Title 10, 
United States Code (USC), only offer compensation for those 
service incurred diseases or injuries which specifically 
rendered a member unfit for continued active service and were 
the cause for career termination; and then only for the degree 
of impairment present at the time of separation and not based on 
future occurrences.  Although the applicant was found unfit due 
her pulmonary condition, because she was concurrently the 
subject of an approved and unrelated administrative discharge, 
the SAFPC acted within its authority to execute the 
administrative discharge and to set aside the medical discharge.  
SAFPC found no causal or mitigating relationship between the 
reason for the applicant's administrative discharge and the 
medical condition for which she was found unfit for further 
military service and, thus, recommended execution of the 
previously approved administrative discharge.

On the other hand, operating under a different set of laws 
(Title 38, USC.), with a different purpose, the DVA is 
authorized to offer compensation for any medical condition 
determined service incurred, without regard to [and independent 
of] its demonstrated or proven impact upon a service member's 
fitness to serve or the narrative reason for separation.  So, 
the fact that the DVA assigned the applicant's disability rating 
effective so close to her date of release from service is not 
relevant to the administrative action executed by the Air Force; 
unless there was a convincing and proven cause and effect 
relationship between the two.

?
The complete Medical Consultant’s evaluation is at Exhibit D.

________________________________________________________________

APPLICANT'S REVIEW OF THE AIR FORCE EVALUATION:

The advisory opinion incorrectly characterizes the applicant’s 
arguments on appeal and further fails to address her arguments 
as to why her request for relief should be granted.  
Furthermore, it should be noted that the Medical evaluation was 
prepared by a general medical practitioner as opposed to a 
psychologist who would recognize the inadequacies in her 
diagnosis.  As set forth in the Medical evaluation, and 
reflected in the Mental Health Evaluation, the only factual 
basis for supporting her diagnosis is her "lack of adaptability" 
to military service.  There is absolutely no information 
establishing a "problematic pattern of behavior" which began in 
adolescence or early adulthood. Furthermore there is no 
information establishing any of the other three conditions set 
forth by the DSM-IV.  The only basis appears to be "several 
minor disciplinary infractions" and her failure to adapt during 
COT.  Instead, she has offered significant documentation which 
proves she does not have a Personality Disorder, but instead was 
responding to a major life stressor that occurred after joining 
the military.  As corroborated by an outside physician, the 
applicant was diagnosed with Adjustment Disorder with Mixed 
Anxiety as a result of being diagnosed with a terminal condition 
in early 2010.  Counsel further expounded on her previous 
contentions that the applicant should have been processed 
through the DES and characterizing her as having a Personality 
Disorder is inequitable.  Moreover, should the Board grant the 
relief requested, she should be medically retired from the Air 
Force with a rating of at least 60 percent based on the DVA's 
rating shortly after her discharge.

Counsel’s complete 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 an error or injustice to warrant 
changing her administrative discharge to a medical retirement 
with a 60 percent disability rating.  We took notice of the 
applicant's complete submission in judging the merits of the case 
and do not find that it supports a determination that she should 
be medically retired.  While the applicant’s response to the BCMR 
Medical Consultant is noted, she has provided no evidence which, 
in our opinion, successfully refutes the assessment of her case 
by the BCMR Medical Consultant.  Therefore, we agree with the 
opinion and recommendation of the BCMR Medical Consultant and 
adopt his rationale as the basic for our conclusion that the 
applicant has not been the victim of an error or injustice.  In 
view of the above and in the absence of evidence to the contrary, 
we find no basis to favorably consider this portion of the 
applicant’s request.

4.  Notwithstanding the above sufficient relevant evidence has 
been presented to demonstrate the existence of error or 
injustice warranting a degree of relief.  In coming to our 
determination we reviewed the complete evidence of record, in 
particular, the advisory prepared by the BCMR Medical Consultant 
who recommends changing the applicant’s records to reflect that 
her narrative reason for separation be changed to “Secretarial 
Authority.”  Accordingly, we agree with the opinion and 
recommendation of the BCMR Medical Consultant and adopt the 
rationale expressed as the basis for our decision that the 
applicant has been the victim of either an error or an 
injustice.  Therefore, in the interest of justice, we recommend 
her records be corrected to the extent indicated below.

5.  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 issue(s) 
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 at the 
time of her 2 Dec 2011 discharge, the narrative reason for her 
separation was Secretarial Authority with a separation code of 
JFF.
________________________________________________________________

The following members of the Board considered this application 
in Executive Session on 6 May 2014, under the provisions of AFI 
36-2603:

 , Panel Chair
 , Member
 , Member
?
All members voted to correct the record as recommended.  The 
following documentary evidence was considered in AFBCMR BC-2013-
03241:

   Exhibit A.  DD Form 149, dated 28 Jun 2013, w/atchs.
   Exhibit B.  Applicant's Master Personnel Records.
   Exhibit C.  Letter, AFPC/DPFD, dated 25 Jul 2013.
   Exhibit D.  Letter, BCMR Medical Consultant, dated 2 Jan 2014. 
   Exhibit E.  Letter, SAF/MRBC, dated 6 Jan 2014.
   Exhibit F.  Letter, Counsel, dated 5 Feb 2014.




								
								Panel Chair