RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:			DOCKET NUMBER:  BC-2014-01057

						COUNSEL:  DVA

						HEARING DESIRED:  NO


APPLICANT REQUESTS THAT:

Her narrative reason for separation of (Miscellaneous/General 
Reasons) be changed to a medical discharge reason.


APPLICANT CONTENDS THAT:

The reason for separation should be medical.  Court martial 
documents revealed that she was sexually assaulted and the defense 
indicated that she should be medically discharged.

It was not until her sexual assault was revealed during the court-
martial that she was able to get out.  She has Post-Traumatic 
Stress Disorder (PTSD) as a result of the trauma she received from 
the sexual assault and has been rated by the Department of 
Veterans Affairs (DVA) with a 100 percent disability.

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


STATEMENT OF FACTS:

On 27 Jan 09, the applicant initially entered active duty in the 
Regular Air Force.  

According to the applicant’s request for separation documents, on 
27 Aug 09, her commander recommended approval of her request for 
separation and submitted her request to the discharge authority 
for final approval.

On 30 Oct 09, the applicant was released from active duty with a 
reason for separation of miscellaneous/general reasons.  She was 
credited with 9 months and 4 days of active service.

On 6 Jun 13, the applicant was rated at 100 percent disability by 
the DVA for Depression/PTSD, effective 8 Nov 11.




AIR FORCE EVALUATION:

AFPC/DPSOR recommends denial indicating based on the documentation 
on file in the master personnel records, the discharge to include 
the SPD code, narrative reason for separation and character of 
service was appropriately administered and within the discretion 
of the discharge authority.  The applicant did not provide any 
evidence that an error or injustice occurred in the processing of 
her discharge.  

DPSOR notes the applicant indicated in her request that she did 
not like being in the Air Force and she regretted her decision to 
join.  Her commander concurred with her request after reviewing 
the manning for her career field and determining that it was in 
the best interests of the Air Force that she be separated.  
Therefore, the applicant's SPD code and narrative reason for 
separation are correct as reflected on her DD Form 214.  Since 
both the commander and the discharge authority recommended an 
honorable characterization, the character of service on her 
DD Form 214 is correct and in accordance with DoD and Air Force 
instructions.
 
The complete DPSOR evaluation is at Exhibit C.

The BCMR Medical Consultant recommends granting the applicant a 
permanent disability retirement with a compensable disability 
rating of 30 percent for Depression associated with PTSD with the 
Veterans Affairs Schedule for Rating Decisions (VASRD) codes 9434-
9411.  

The Medical Consultant notes based on the provided evidence, the 
applicant was the victim of a sexual assault in Jul 09 and she 
requested and was granted a voluntary discharge from the Air Force 
under the provisions of AFI 36-3208, for Miscellaneous Reasons.  
The preponderance of administrative documentation supplied for 
this review consists of the charges lodged against the applicant's 
assailant [allegations of conspiracy to commit rape, aggravated 
sexual contact, assault, burglary, and unlawful entry,  his pre-
trial confinement, appeals for release from confinement, the 
court-martial testimony, redacted witness statements, and the 
findings of guilt by the convening authority.]

On 23 Apr 09, the applicant presented with depression and grief 
related to her grandmother's death.  Record states, “She was very 
close to her grandmother and this is the first person she has lost 
in her life.”  Diagnostic Assessment: Bereavement without 
complications.  Disposition: Released without duty limitations.

The applicant has supplied post-service medical documentation from 
the DVA consisting of Compensation & Pension (C&P) examinations 
and disability rating decisions.  Evidence shows the applicant was 
initially assigned a 30 percent disability rating for 
Depression/PTSD, effective 31 Oct 09.

Addressing the applicant's expressed desire for a medical 
separation or retirement, the military Disability Evaluation 
System (DES), established to maintain a fit and vital fighting 
force, can by law, under Title 10, United States Code (U.S.C.), 
only offer compensation for those service incurred diseases or 
injuries which specifically rendered a member unfit for continued 
military 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 post-service progression.  Department of 
Defense Instruction 1332.32, Physical Disability Evaluation, 
Enclosure 3, Part 3, Standards For Determining Unfitness Due To 
Physical Disability Or Medical Disqualification, paragraph 
E3.P3.2.1, in effect at the time of the applicant's discharge, 
reads: “A Service member shall be considered unfit when the 
evidence establishes that the member, due to physical [or mental] 
disability, is unable to reasonably perform the duties of his or 
her office, grade, rank, or rating (hereafter called duties) to 
include duties during a remaining period of Reserve obligation.”  
Despite the unambiguous nature of the applicant's prosecuted 
sexual assault and the evidence of existence of unrelated mental 
health issues predating this tragic event, the Medical Consultant 
has not been supplied objective evidence to indicate that the 
applicant's mental status at the time of her release from service 
warranted a Medical Hold for processing through the DES.  
Specifically, no supporting documentations is supplied to indicate 
existence of a mental impairment affecting the applicant's 
worldwide qualification; as would be reflected on an AF Form 422, 
Physical Profile Serial Report, or the more contemporary AF Form 
469, Duty Limiting Condition Report. Indeed, except for the 
unquantified "duty limitations" imposed on 20 Jul 09 above, the 
applicant was near consistently released without duty restrictions 
during the course of her brief period of service, as relates to 
her Bereavement, Mild Depression, and Adjustment Disorder, each 
initially diagnosed prior to her sexual assault.  Nevertheless, 
one may ponder whether the applicant's voluntary separation should 
have been revoked, or that her mental health providers should have 
intervened in order to conduct a Medical Evaluation Board (MEB) 
and referral to a Physical Evaluation Board (PEB).  Moreover, 
under today's standards one would expect documented intervention 
by some type of support team.  However, we now know, per 
disclosure during a VA examination, the applicant may not have 
disclosed details of her sexual assault to her military mental 
health officials. Mental health records have not been supplied to 
refute this inference.  Consequently, she was medically cleared 
for separation.

The Medical Consultant is quite aware of the fact that many 
victims of assault do not report a sexual assault incident for 
fear of adverse occupational impact, adverse public opinion [blame 
the victim], or just embarrassment.  Unless the Board finds that a 
medical retirement should serve as reparation for the applicant's 
assault, the Medical Consultant did not find the objective 
evidence [as transcribed in the service record by her military 
providers] sufficient at the time of release from service 
sufficient to find her unfit for military service at the 
termination of her period of active military service.

On the other hand, should the Board find an injustice has occurred 
in the applicant's case, considering the likely cumulative reasons 
for the applicant's election to leave military service, then the 
Board should find the applicant was not voluntarily discharged 
from the Air Force, but that she was found unfit for military 
service for the diagnosis of Depression associated with PTSD, that 
her condition was initially rated at 50 percent under hyphenated 
VASRD code 9434-9411, IAW 38 C.F.R. Section 4.129, and that she 
was placed on the Temporary Disability Retired List (TDRL) for a 
period of six months, following which she was removed from the 
TDRL and retired permanently with a 30 percent disability rating, 
effective her established date of voluntary release from military 
service.  The final 30 percent rating is consistent with the 
30 percent disability rating assigned by the DVA; which the 
applicant carried from the effective date of her separation up 
until it was increased to 100 percent in Jun 13 and which up to 
that time depicted an intervening period of relative stability.

The complete BCMR Medical Consultant evaluation is at Exhibit D.


APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Copies of the Air Force evaluation were forwarded to the applicant 
on 12 Nov 14 for review and comment within 30 days (Exhibit E).  
As of this date, no response has been received by this office.


ADDITIONAL AIR FORCE EVALUATION:

The Clinical Psychology Consultant is in agreement with the BCMR 
Medical Consultant recommendation the applicant be placed on the 
TDRL with a compensable disability rating of 50 percent from the 
date of her discharge, with a permanent medical retirement at 
30 percent after six months (on the TDRL) to fall in line with her 
Jan 10 VA assessment.

The Board is advised that despite the advent of electronic medical 
records Air Force mental health policy has required providers to 
“double document” in such a way that the electronic medical record 
contains fewer details than a separate hardcopy chart.  This is 
presumably intended to protect sensitive details of a patient’s 
life from unnecessary exposure to others who may have access to 
electronic medical records.  However, a collateral consequence of 
this approach to recordkeeping is detailed records of a patient’s 
mental health care may often be unobtainable after just a few 
years of terminating care because records were sent for permanent 
disposition.  This leaves an applicant with access to copies of 
electronic records that are significantly less detailed, rendering 
the task of showing service impairment more daunting.  The level 
of detail in the electronic medical record has been known to vary 
considerably over time and is often based on provider preference 
or clinic policy.  This Consultant is aware of recent efforts 
within the Air Force Medical Service to standardize documentation 
across mental health clinics and to enhance the quality of 
information placed into the electronic medical record.  However, 
this applicant’s case predates these changes and a considerably 
different opinion may be rendered in this case based solely on a 
review of electronic medical records versus inclusion of detailed 
notes from the applicant’s hardcopy mental health chart.  This is 
evidenced by a review of the detailed notes embedded within court-
martial documentation as described in the FACTS section.  Indeed, 
this Consultant observes information contained within the notes 
printed from the electronic medical record contain so little 
information that it is difficult to determine the status of the 
applicant’s mental disorder at that time.  The two detailed notes 
uncovered from court-martial proceedings clearly indicate the 
applicant was profiled for her disorder.  Unfortunately, the 
mental health provider writing those notes did not explain why the 
applicant was not worldwide qualified (e.g., new diagnosis, recent 
medication adjustment, poor fit for military service, etc.). 

The Clinical Psychology Consultant argues the totality of the 
materials supplied for this case suggest although the applicant 
was experiencing significant depressive symptoms prior to her 
sexual assault the additive effect from symptoms of posttraumatic 
stress stemming from the assault led to the granting of an early 
release after less than a year of service.  This Consultant 
advises that the results of her VA compensation and pension exam 
generally support this conclusion given its relative proximity to 
her separation.  This Consultant is aware of the numerous stresses 
experienced by victims of sexual assault that, when combined with 
previous depressive symptoms as in this case, could lead a victim 
to select a quick exit from military service in hopes of obtaining 
immediate relief.  The Clinical Psychology Consultant observes 
such relief did not occur for this applicant despite the release 
from her military service obligation.  The BCMR Medical Consultant 
has already noted the lack of clear objective evidence in this 
case to support the conclusion that this applicant was errantly 
overlooked for disability evaluation system processing.  The 
Clinical Psychology Consultant argues that the few detailed mental 
health records available for this case combined with subsequent 
VA documentation and court-martial evidence paints a picture of an 
emotionally distressed airman who was suffering from a mental 
health condition that more likely than not rendered her unfit for 
military service.  

The Clinical Psychology Consultant reminds the applicant that the 
Military Department operates under Title 10, United States Code 
(U.S.C.), and must base its actions upon evidence available at the 
“snap shot” in time of final military disposition.  Therefore, the 
progression of her condition that resulted in her current 
100 percent disability rating from the VA does not equate to the 
same rating at discharge from military service.  Alternatively, 
the VA operates under a different set of laws (Title 38, U.S.C.), 
with a different purpose, and is authorized to offer service 
connection and compensation for any medical condition for which it 
has established a nexus with military service regardless of the 
narrative reason for separation or the length of time transpired 
since discharge.  The VA is also permitted to reassess a veterans 
condition periodically and adjust ratings accordingly. 

The complete Clinical Psychology Consultant evaluation is at 
Exhibit F.


APPLICANT'S REVIEW OF THE ADDITIONAL AIR FORCE EVALUATION:

The applicant notes that she was proud of the time spent in the 
Air Force and had the circumstances been different she would have 
made a career in the Air Force.

The applicant reiterated the circumstances leading up to her early 
separation and noted that she was very depressed subsequent to the 
sexual assault and did not have much of an appetite and barely 
slept.

Subsequent to her separation, she tried to act as though nothing 
had happened and to go back to her life prior to military service; 
however, she had to go back for the court- martial and says the 
whole experience traumatized her even more.  Between her anger, 
drug use, depression, etc., she has not been the person she once 
was making it very hard to make friends.  She is being treated by 
the VA and has been seeing a therapist every week for a year and a 
half.  She is bothered by her DD Form 214 because it invokes 
questions every time she has to show it to someone.

The applicant's complete response, with attachments, is at Exhibit 
H.


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 an injustice.  After a thorough review of the 
evidence of record and the applicant’s complete submission, we 
believe the applicant is the victim of an error or injustice.  We 
note the comments of AFPC/DPSOR indicating that relief should be 
denied because the applicant’s records contain no documentation 
substantiating an error or injustice in the discharge process.  
Notwithstanding the recommendation of DPSOR, we note the analyses 
of the BCMR Medical Consultant and the BCMR Psychology Consultant 
who also found no error in the discharge; however, in our view, 
when looking at the few detailed mental health records available, 
combined with subsequent VA documentation and court-martial 
evidence, paints a picture of an emotionally distressed airman who 
was suffering from a mental health condition that more likely than 
not rendered her unfit for military service.  Therefore, we direct 
the relief proposed by the BCMR Medical Consultant that the 
applicant be placed on the TDRL with a compensable disability 
rating of 50 percent and then permanently retired and rated at 
30 percent.  We believe this approach presents the applicant a 
fair and equitable determination in her case.  Accordingly, we 
recommend the applicant’s records be corrected as indicated below.  


THE BOARD RECOMMENDS THAT:

The pertinent military records of the Department of the Air Force 
relating to the APPLICANT be corrected to show that:

      a.  On 29 Oct 09, she was found unfit to perform the duties 
of her office, rank, grade, or rating by reason of physical 
disability, incurred while she was entitled to receive basic pay; 
the diagnosis in her case was Depression associated with Post-
Traumatic Stress Disorder (PTSD), that her condition was under 
hyphenated VASRD code 9434-9411; with a disability rating of 
50 percent; the degree of impairment was temporary; the disability 
was not due to intentional misconduct or willful neglect; the 
disability was not incurred during a period of unauthorized 
absence; and the disability was not received in the line of duty 
as a direct result of armed conflict or caused by an 
instrumentality of war and was not combat-related.

	b.  On 29 Oct 09, she was honorably discharged from active 
duty and on 30 Oct 09, her name was placed on the Temporary 
Disability Retired List (TDRL) with a compensable disability 
rating of 50 percent.  

	c.  On 30 April 10, the applicant was removed from the TDRL 
and transferred to the Permanent Disability Retired List (PDRL) 
with a compensable disability rating of 30 percent.   

	d.  Her election of the Survivor Benefit Plan option will be 
corrected in accordance with her expressed preferences and/or as 
otherwise provided for by law or the Code of Federal Regulations.


The following members of the Board considered AFBCMR Docket Number 
BC-2014-01057 in Executive Session on 27 Aug 15 under the 
provisions of AFI 36-2603:

		, Panel Chair
		, Member
		, Member

All members voted to correct the records as recommended.  The 
following documentary evidence was considered:

	Exhibit A.  DD Form 149, dated 14 Feb 14, w/atchs.
	Exhibit B.  Pertinent Excerpts from Personnel Records.
	Exhibit C.  Letter, AFPC/DPSOR, dated 7 Apr 14.
	Exhibit D.  Letter, BCMR Medical Consultant, 
                 dated 21 Oct 14.
	Exhibit E.  Letter, SAF/MRBR, dated 12 Nov 14.
	Exhibit F.  Letter, BCMR Psychology Consultant, 
                 Dated 12 Jun 15.
	Exhibit G.  Letter, SAF/MRBR, dated 18 Jun 15.
	Exhibit H.  Letter, Applicant, dated 5 Jul 15, w/atchs.