MEMORANDUM OF CONSIDERATION


         IN THE CASE OF:


         BOARD DATE: 23 SEPTEMBER 2003
         DOCKET NUMBER: AR2003085559


         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. Carl W. S. Chun		Director
Mr. Kenneth H. Aucock		Analyst

The following members, a quorum, were present:

Ms. Jennifer L. Prater		Chairperson
Mr. Arthur A. Omartian		Member
Mr. Patrick H. McGann, Jr.		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: Reconsideration of his earlier appeal to correct the reason for his separation from active duty and to permit him to receive separation pay.

APPLICANT STATES: In effect, that contrary to the Board’s original Memorandum of Consideration, he was not given any mental status evaluations in the year 2000, “let alone March 6^th 2000” as the Board noted. He states that the Board’s conclusion that he showed no evidence of mental illness is incorrect and that the diagnosis of “Major Depressive Disorder (single episode)” in also incorrect. He states that he was given a personality assessment on 9 August 1999 and that the results showed “no sign or diagnosis of any personality disorder (non-specific) and only the diagnosis of Major Depressive Disorder.” He maintains that he only signed the separation papers “out of fear because of recent retaliation by [his] platoon sergeant and 1^st sergeant.” He states that the Department of Veterans Affairs (VA) also found no diagnosis or treatment for a personality disorder. In support of his request he submits a June 2002 “Intake Evaluation” which he states clearly shows “no evidence of any personality disorder.” He also submits an April 2003 statement in which he was diagnosed with moderate recurrent major depression and PTSD (Posttraumatic Stress Disorder). The applicant maintains, in effect, that he was suffering from major depression, and not a personality disorder and as such, was erroneously discharged from the Army.

NEW EVIDENCE OR INFORMATION: Incorporated herein by reference are military records, which were summarized in a memorandum, prepared to reflect the Board's previous consideration of the case (AR2002076019) on
21 November 2002.

Army Regulation 15-185 sets forth the policy and procedures for the ABCMR. It provides that, if a request for a reconsideration is received within one year of the prior consideration and the case has not been previously reconsidered, it will be resubmitted to the Board if there is evidence (including but not limited to any facts or arguments as to why relief should be granted) that was not in the record at the time of the Board’s prior consideration. The staff of the Board is authorized to determine whether or not such evidence has been submitted.

It is unclear if the June 2002 “Intake Evaluation” was previously available to the Board, as it was not discussed in the Board’s November 2002 case summary, although it was in the applicant’s file. As such, the June 2002 intake evaluation and the April 2003 diagnosis constitute new evidence that requires Board consideration.




The applicant’s Official Military Personnel File (OMPF) indicates that the applicant reported being treated by a “mental health professional” between August 1993 and September 1995 at the Family Services Center in Clearwater, Florida. This information was provided by the applicant on a Standard Form 86 (Questionnaire for National Security Positions) as part of his initial enlistment processing.

As noted in the Board’s original proceedings, the applicant entered active duty on 18 September 1997 and successfully completed basic and advanced individual training. On 30 January 1998, after arriving at Fort Knox, Kentucky, the applicant had his initial counseling session with his section sergeant. The section sergeant explained the duties, expectations, and responsibilities of the applicant as a member of “Alpha Troop” and offered his assistance when ever necessary.

The applicant continued to receive monthly performance counseling while assigned to that organization.

In August 1998 the applicant was counseled for missing a formation. The counseling statement noted that the applicant had “a lot on [his] mind” but that he had been making it to formations on time for several months and that he (the counseling official) did “not need [him] to start missing formations.” In February 1999 the applicant failed to report for a clean-up detail and was counseled concerning his responsibility to check the duty roster on a daily basis.

Although the applicant’s service medical records were not available to the Board, his OMPF contains a 26 March 1999 referral statement for civilian medical care. The referral document noted that the applicant was a 20 year old, active duty male, with a 1-year history of depression. The statement noted that he did not have suicidal or homicidal ideations, but did state that the applicant indicated that he “does not feel like living anymore.” The applicant was prescribed Zoloft (a brand name drug used to treat depression, panic or anxiety, obsessive or compulsive symptoms, or other psychiatric symptoms) and referred for evaluation and recommendations for counseling and treatment. His record contains no follow up information concerning the referral.

A June 1999 counseling statement notes that the applicant was “faced with some problems right now” but was reminded that he was in the military and must “act accordingly at all times, on and off duty.” The statement commended the applicant for recently reorganizing his finances and for recognizing a potential problem and solving it.




On 7 October 1999 the applicant was identified as a “high risk soldier” by his supervisor and counseled concerning the “upcoming extended weekend.” The counseling official reminded the applicant that he was under age and as such should not consume any alcohol, that if he was stranded, had any car trouble, or needed any assistance, he could call any of the numbers provided to him. The applicant was told that his duty performance was good but that he “must control [his] attitude and anger” and that he should relax, and enjoy activities during his time off, while being and thinking safe.

On 15 October 1999 the applicant’s records were “flagged” (favorable personnel actions suspended) when he was placed in the Army’s weight control program. His records remained flagged until 29 November 1999.

The applicant’s OMPF contains an undated statement, signed by the applicant, which may have been in response to one of his counseling sessions. In the statement he indicated that he was “completely overwhelmed with distress, depression, fear, loneliness, uncontrollable anger, very emotional, and [his] perception of things are completely out of control.” He stated that he had “very little care for anything or anyone” and that “nothing means anything to me and I don’t care what happens to me.” He indicated that he thought “very negatively and feel I nothing to lose.” He concluded by stating that “he never felt this low everyday and for so long.”

According to a 6 December 1999 memorandum, addressed to the applicant’s commander from the Chief, Behavioral Medicine Clinic at Fort Knox, the applicant underwent a mental status evaluation on 6 December 1999. In the Board’s original consideration of the applicant’s case it was incorrectly reported that the evaluation took place on 6 March 2000. The memorandum notes that the mental status evaluation was conducted at the request of the applicant’s command. The evaluation indicated:

AXIS I: 296.23 Major Depressive D/O [disorder] Single Episode

AXIS II: 301.9 Personality D/O NOS [nonspecific]

AXIS III: Reported Knee, Back and GI problems.

The term “Axis” refers to the use of the multiaxial system of evaluation outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Axis I refers to clinical syndromes and V codes (conditions not attributable to a mental disorder that are a focus of attention or treatment). Axis II refers to developmental disorders and personality disorders. Axis III refers to physical disorders and conditions. Axis IV refers to the severity of psychosocial stressors. Axis V refers to the global (overall) assessment of functioning.

The mental status findings went on to note that “there was no evidence of mental defect, emotional illness, or psychiatric disorder of sufficient severity [emphasis added] to warrant disposition through military medical channels” and cleared the applicant “psychiatrically” for any administrative actions deemed appropriate by the applicant’s command.

The applicant’s records contain additional counseling statements following the December 1999 mental status evaluation. A 23 January 2000 statement indicates that the applicant had been attending bi-monthly behavioral medicine classes and that he had been prescribed medication for anxiety and insomnia and an antidepressant. Other counseling statements noted that the applicant had been found sleeping on duty, late for formations, but also offered the applicant assistance if needed.

The applicant indicated in a 17 March 2000 statement that he was having some financial difficulties and that no one in his chain of command offered to help solve his problems except by counseling him.

As noted in the Board’s previous action, the applicant’s commander initiated actions to administratively separate the applicant from active duty under the provisions of Army Regulation 635-200, paragraph 5-13 (personality disorder) on 28 March 2000. The applicant acknowledged receipt of the proposed recommendation and waived his attendant rights. On 20 June 2000 the applicant was discharged.

The 29 June 2002 “intake evaluation” was conducted at the Family Psychology Associates in Safety Harbor, Florida. It noted the applicant was seeking an evaluation “regarding his being pressured to prematurely leave the military for what he felt to be unfair and inaccurate reasons.” The “Background Information” contained in the evaluation appears to be information provided by the applicant to the evaluating psychologist. That information indicated that the applicant’s parents were divorced and both remarried, and that when he was 17 years old his mother informed him that she had divorced his father because of verbal and physical abuse. It notes that the applicant joined the Army after graduating from high school and that while in the military he became depressed and felt other soldiers were harassing him. It notes that the applicant reported that he was “told” to sign the discharge papers and that if he did not “there would be hell to pay.” The summary stated that the applicant reported that “immediately following his discharge his depression increased.”

The intake evaluation indicated that the applicant had been administered the Minnesota Multiphasic Personality Inventory and that it did not suggest that the applicant was “suffering from any major psychopathology” and that there was “no evidence of any personality disorder” which the evaluating psychologist noted the applicant’s “background information” supported. The test indicated that the applicant was “not significantly depressed” and there “was no sign of any type of psychotic thinking nor any significant depressive and anxiety disorder.” The evaluating psychologist concluded:

         Axis I; Adjustment disorder with depression (mild)

         Axis II: None

         Axis III: Deferred

         Axis IV: Occupational

         Axis V: 70

The 23 April 2003 evaluation, by a psychiatrist, noted, “I believe his diagnosis is:”

         Axis I: Major Depression, recurrent, moderate 296.32
                  PTSD 309.81

         Axis II: No Diagnosis

         Axis III: Deferred

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, indicates that the first three digits of the Major Depressive Disorder diagnostic code is 296, the fourth digit is either a 2 (if there is only a single episode) or 3 (if there are recurrent episodes), and the fifth digit indicates the following: 1 for mild severity, 2 for moderate severity, 3 for severe without psychotic features, 4 for severe with psychotic features, 5 for in partial remission, 6 for in full remission, and 0 if unspecified.

The manual states that a “single episode” is used only for the first episode and that it is sometimes difficult to distinguish between a single episode with waxing and waning symptoms, and two separate episodes which may warrant a coding of “recurrent.”

Diagnostic code 301.9 was used to in the December 1999 mental status evaluation to denote the applicant’s Axis II diagnosis of Personality Disorder Not Otherwise Specified. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, individuals diagnosed as having Personality Disorder Not Otherwise Specified, in part, show behaviors which include a persistent and pervasive feeling of dejection, gloominess, cheerlessness, joylessness, and unhappiness. These individuals tend to brood and worry, dwelling persistently on the negative and unhappy thoughts and while they may pride themselves on being realistic, are considered by others to be pessimistic.
The manual groups disorders into 16 major diagnostic classes. Mood disorders, which includes depressive disorders such a major depressive disorder, is a separate diagnostic class from anxiety disorders and personality disorders.

Army Regulation 635-40 establishes the policies and provision for the separation of soldiers because of disability. It notes that the mere presence of an impairment does not, of itself, justify a finding of unfitness because of physical disability. In each case, it is necessary to compare the nature and degree of physical disability present with the requirements of the duties the soldier reasonably may be expected to perform because of his or her office, grade, rank of rating. It states that to ensure all soldiers are physically qualified to perform their duties in a reasonable manner, medical retention standards have been established in Army Regulation 40-501.

Army Regulation 40-501 states an individual with a mood disorder may be referred for disability processing with persistence or recurrence of symptoms sufficient to require extended or recurrent hospitalization, or persistence or recurrence of symptoms necessitating limitations of duty or duty in protected environments; or persistence or recurrence of symptoms resulting in interference with effective military performance.

Army Regulation 40-501 states that personality disorders may render an individual administratively unfit rather than unfit because of physical disability. Interference with performance of effective duty in association with these conditions will be dealt with through appropriate administrative channels. It also states that transient, situational maladjustment due to acute or special stress do not render an individual unfit because of physical disability, but rather may be the basis for administrative separation if recurrent and causing interference with military duty.

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

1. Although the applicant does not specifically indicate that he believes he should have been retired or separated by reason of physical disability, the information contained in his original application to the Board and in the subsequent mental status evaluations provided by him in his request for reconsideration, tends to support of conclusion that the applicant is in fact seeking correction of his records to show that he was retired or separated by reason of physical disability and as such would have been entitled to disability separation pay or disability retired pay.



2. The Board notes that the December 1999 mental status evaluation did include a diagnosis of Major Depressive Disorder. However, the evaluating physician concluded that it was not ”of sufficient severity” to warrant referral for disability processing. The fact that the evaluation, rendered in June 2002, concluded that the applicant suffered from an Anxiety Disorder, and not from the previously diagnosed Major Depressive Disorder, further supports this conclusion.

3. Although the applicant may again have been diagnosed with Major Depressive Disorder in April 2003, the Board notes that the evaluating physician at the time found the applicant’s condition to be of moderate severity, while the original diagnosis in 1999 was “severe without psychotic features.” The variations in the severity of the applicant’s mood disorder further supports the Board’s conclusion that referral for disability processing was not warranted.

4. The Board notes that the applicant’s argument that his depression was not a “single episode” but rather was recurrent, is without foundation. As noted in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, “single episode” refers to the first episode and should not be confused to mean only “one” episode.

5. While the applicant’s subsequent evaluations may have concluded that he was not suffering from a personality disorder, such conclusions are not evidence that the 1999 diagnosis was in error. Like the variations in the severity of the applicant’s mood disorder, a physician renders a diagnosis based on the information available to him at the time of the evaluation. The Board, concludes, based on the evidence which was available at the time, that his separation as a result of a personality disorder was appropriate and the fact that subsequent physicians may conclude differently is not a basis for the Board to conclude that the applicant’s administrative separation was inappropriate.

6. The applicant also contends that he signed his separation document out of “fear because of recent retaliation by [his] platoon sergeant and 1^st sergeant” is not supported by any evidence in records available to the Board or in documents provided by the applicant.

7. The overall merits of the case, including the latest submissions and arguments are insufficient as a basis for the Board to reverse its previous decision.






8. In view of the foregoing, 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

__JLP___ __AAO__ __PHM__ DENY APPLICATION



         Carl W. S. Chun

Director, Army Board for Correction
         of Military Records

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INDEX

CASE ID	AR2003085559
SUFFIX
RECON
DATE BOARDED	20030923
TYPE OF DISCHARGE
DATE OF DISCHARGE
DISCHARGE AUTHORITY
DISCHARGE REASON
BOARD DECISION	DENY
REVIEW AUTHORITY
ISSUES 1.	108.00
2.
3.
4.
5.
6.