MEMORANDUM OF CONSIDERATION


         IN THE CASE OF:



         BOARD DATE: 24 November 1998
         DOCKET NUMBER: AC97-10467

         I certify that hereinafter is recorded the record of consideration of the Army Board for Correction of Military Records in the case of the above-named individual.

         Mr. Loren G. Harrell              Director
         Mr. Edmund P. Mercanti                    Analyst


The following members, a quorum, were present:


         Mr. George D. P. Paxson                            Chairperson
         Ms. Celia L. Adolphi                      Member
         Mr. Robert W. Garrett                      Member


         The Board, established pursuant to authority contained in 10 U.S.C. 1552, convened at the call of the Chairperson on the above date. In accordance with Army Regulation 15-185, the application and the available military records pertinent to the corrective action requested were reviewed to determine whether to authorize a formal hearing, recommend that the records be corrected without a formal hearing, or to deny the application without a formal hearing if it is determined that insufficient relevant evidence has been presented to demonstrate the existence of probable material error or injustice.

         The applicant requests correction of military records as stated in the application to the Board and as restated herein.

The Board considered the following evidence:

         Exhibit A - Application for correction of
         military records
         Exhibit B - Military Personnel Records (including
         advisory opinion, if any)

APPLICANT REQUESTS : That his discharge be corrected to a medical retirement.

APPLICANT STATES : After serving in combat in Korea on his first enlistment, on his second enlistment he was hospitalized for combat related nervous conditions. While hospitalized, he was given 20 electroshock treatments for his nervous condition. Although the physician’s note shows that he was returned to duty, he was kept at the hospital. In addition, he suffered from ulcers while on active duty and the electroshock treatment he was subjected to resulted in thoracic fractures.

COUNSEL CONTENDS : That the applicant was a career soldier and was denied reenlistment based solely on clinical progress notes which indicated that he didn’t want to reenlist. Counsel contends that the applicant would naturally voice discontent with the Army while he was undergoing electroshock treatments. Counsel continues that it is inappropriate to base a denial of the applicant’s request on the fact that he was not found unfit by a medical board when he was never given that opportunity.

EVIDENCE OF RECORD : The applicant's military personnel and medical records show:

He was inducted on active duty on 1 October 1952, then being 23 years old and having a fourth grade education, served as a light weapons infantryman in an infantry company in the Korean War, was promoted to corporal, was awarded the Combat Infantryman Badge and two bronze Service Stars, and was honorably released from active duty at the expiration of his term of service on 30 September 1954.

He had a short break in active service and reenlisted in the Regular Army on 10 December 1954. He was promoted to sergeant and served as a truck master.

On 11 March 1958 the applicant was admitted to a military hospital for treatment of a duodenum ulcer. He was treated for that condition and released to duty on 20 March 1958.

On or about 23 May 1960 the applicant’s commander sent the applicant for a psychiatric evaluation. The applicant had been reported to be talking to God.

When evaluated the applicant reported experiencing things which were considered to be severe religious delusions, some of a grandiose nature, and auditory hallucinations, receiving instructions directly from Jesus. He was diagnosed as having a possible schizophrenic reaction.

He was admitted to the hospital for treatment on 2 June 1960. In a clinical progress report dated 1 July 1960 it is stated that the applicant had become quite hostile and resistive to electroshock treatment. He stated that he was homesick and would go AWOL if given the chance. He also stated that the ministry was calling him. The applicant’s physician stated that he was not motivated for further military duty. In a hospital discharge summary dated 5 October 1960 the applicant was diagnosed as having a schizophrenic reaction, paranoid type, chronic, severe. It was reported that he was given 20 electroshock treatments during his inpatient stay. His impairment for further military duty was stated to be minimal and he was released from hospitalization with no physical profile limitations.

On the same day, 5 October 1960, the applicant was honorably discharged. Item 11c of his DD Form 214, “Reason and Authority”, lists “Par 8 AR 635-205 SPN 412 Convenience of the Government – PETS”

The SPN 412 is for “Enlisted members of medical holding detachments who, upon completion of hospitalization, do not intend to immediately enlist or reenlist in the [Regular Army].”

Medical treatment records from the VA, provided by the applicant, show that he was initially treated by that agency in 1989 for depression and anxiety. At that time he stated that he had not been hospitalized since his hospitalization in the Army. He was next treated by the VA in late 1992 for depression. He was diagnosed as suffering from Post-Traumatic Stress Disorder (PTSD) in 1995 by the VA.

PTSD, an anxiety disorder, was not recognized as a psychiatric disorder until 1980 with the publishing of the Diagnostic and Statistical Manual of Mental Disorders (DSM) III. The condition is described in the current DSM-IV, pages 424 through 427. While PTSD has only been categorized by psychiatrists as a distinct diagnosis since 1980, it has, as early as the Civil War, been described in psychological literature, variously labeled as shell shock, soldier’s heart, effect syndrome, combat fatigue and traumatic neurosis. During the period of time in question, similar psychiatric symptomatology was categorized as hysterical neurosis.
Although the current label of PTSD is of rather recent acceptance, the idea that catastrophes and tragedies can result in persistent emotional and psychological symptoms is common even among the lay public. While PTSD was not recognized as a specific illness at the time of the applicant’s separation from the service, the fact that an individual might not be fit for further military service because of psychosis, psychoneurosis, or neurological disorders was outlined in Army Regulation 40-504 which was in effect at the time of his separation. The Army here established standards and procedures for determining fitness for retention and utilized those procedures and standards in evaluating individuals at that time. The specific diagnostic label given to an individual’s condition a decade or more after his discharge from the service may change, but any change does not call into question the application of then existing fitness standards.

Army Regulation 635-40, now in effect, appendix B, paragraph B-107e, states that for a 30 percent rating a mental disorder: (a) does not require hospitalization, (b) displays some signs or symptoms of mental illness on examination, (c) Usually requires medication and or psychotherapy, (d) Usually there is job instability, and (e) Borderline social adjustment.

Title 10, United States Code, section 1201, provides for the physical disability retirement of a member who has at least 20 years of service or a disability rated at least 30 percent.

Title 38, United States Code, sections 310 and 331, permits the VA to award compensation for a medical condition which was incurred in or aggravated by active military service. The VA, however, is not required by law to determine medical unfitness for further military service. The VA, in accordance with its own policies and regulations, awards compensation solely on the basis that a medical condition exists and that said medical condition reduces or impairs the social or industrial adaptability of the individual concerned. Consequently, due to the two concepts involved, an individual's medical condition, although not considered medically unfitting for military service at the time of processing for separation, discharge or retirement, may be sufficient to qualify the individual for VA benefits based on an evaluation by that agency.

In the processing of this case an advisory opinion (COPY ATTACHED) was obtained from the Physical Disability Agency (PDA). The PDA stated that a review of the applicant’s medical records by a psychiatric expert at that Agency revealed that the applicant had received appropriate and competent treatment for his condition and that he had been properly determined medically qualified for retention. His psychiatric condition was in full remission at that time. As such, there was no basis for referring him to a Medical Evaluation Board (MEB). The PDA also stated that there is no evidence that the applicant was mentally unstable to such an extent that he was industrially impaired immediately following his discharge, that the record does not reveal any significant psychiatric deficiencies until the late 1980’s and early 1990’s. The PDA states that the applicant’s earnings immediately following his discharge are in keeping with a man with a 4 ^th grade education. The PDA recommends disapproval of the applicant’s request.

In response to that advisory opinion, the applicant submitted a rebuttal. In that rebuttal he stated that he was a career soldier but wasn’t given the opportunity to reenlist, as he should have been if he had, in fact, been medically qualified without any physical profile limitations. He opines that the Army was fully aware of his inability to function as a soldier and, therefore, proceeded to “smoothly put [him] out of the military service.” In support of his application he submits documentation from the Social Security Administration (SSA) which shows that he had very little Social Security wages reported in the years following his discharge. He also submits documentation from the VA showing that he is currently receiving a 50 percent disability rating for schizophrenia, a 10 percent rating for duodenal ulcer, and zero percent ratings for both impaired hearing and limited motion in his dorsal spine.

Also obtained was an advisory opinion from the Army Review Boards Agency (ARBA) Medical Advisor who stated that while the discharge of the applicant from medical hold for the Convenience of the Government may have been provided for in Army regulations, it does not seem to have been very equitable or compassionate. The Medical Advisor continues that the applicant should have been the subject of a medical board and, under the current VASRD, would have been rated at 30 percent disabled or greater.

DISCUSSION : Considering all the evidence, allegations, and information presented by the applicant, together with the evidence of record, applicable law and regulations, and advisory opinions, it is concluded:

1. The applicant was determined medically qualified for retention without any physical profile limitations, his schizophrenic reaction having gone into complete remission after treatment. Psychiatric experts at the PDA state that the applicant’s military treatment records support that finding. With a finding of medical qualification in conjunction with the applicant’s separation there was no basis for having a medical board consider his case.

2. Contrary to the applicant’s contention, he was separated because he was being released from hospitalization, his term of enlistment had almost expired, and he did not want to reenlist. This is supported by the statements he made while hospitalized, as recorded on the clinical progress notes the applicant provided to the Board. Those statements include strong indications that he wanted to go home, he wanted to go into the ministry, and that he did not want to remain on active duty. Regardless of the reason for the applicant’s decision not to continue his military career, the Army cannot normally retain an enlisted soldier past the expiration of his term of service. In this regard the Board has also considered the fact that there is no record of the applicant attempting to reenlist and of being denied that option.

3. Therefore, it appears that the applicant had a manic episode of schizophrenia, he was successfully treated for that condition, he was returned to duty, he chose to leave the Army, and he was discharged in accordance with his wishes since there was insufficient time left on his enlistment to warrant assigning him to another unit. There is no error or injustice in that scenario.

4. In addition, if the Board was to recommend granting the applicant’s request, should it recommend that he be rated for schizophrenia or PTSD? There is absolutely no evidence that the applicant has ever been treated for schizophrenia after his discharge, and there is no evidence that he was diagnosed with PTSD until 1995, 35 years after his discharge. Neither recommendation would be supportable with the existing documentation.

5. The Board has carefully considered the ARBA Medical Advisor’s comments in this case. However, in view of the fact that the applicant was not treated for any psychiatric or mental problem until 1989, 29 years after his discharge, it does not appear that he met the criteria for the award of a 30 percent rating as described by the VASRD when he was discharged. There is no indication that he displayed any signs or symptoms of mental illness or that he required continuous medication and or psychotherapy at the time of his discharge or immediately thereafter.

6. In view of the forgoing, there is no basis for granting the applicant’s request.

DETERMINATION : The applicant has failed to submit sufficient relevant evidence to demonstrate the existence of probable error or injustice.
BOARD VOTE :

GRANT

GRANT FORMAL HEARING

GDP CLA RWG DENY APPLICATION



                                    Edmund P. Mercanti
Loren G. Harrell
Director