Mr. Carl W. S. Chun | Director | |
Mr. Kenneth H. Aucock | Analyst |
Mr. Arthur A. Omartian | Chairperson | |
Mr. Ronald E. Blakely | Member | |
Ms. Eloise C. Prendergast | Member |
APPLICANT REQUESTS: In effect, that he not be required to reimburse the expenses the government has paid for his tuition under the Health Professions Scholarship Program (HPSP).
APPLICANT STATES: That he should be responsible for repayment of the stipend and educational expense money, but not for tuition repayment.
He began medical school on a HPSP, having passed all the physical and mental examinations. During his second year of medical school he began having difficulties with repetitious thoughts and behaviors that became debilitating to his daily work. He sought the help of a psychiatrist and was diagnosed with obsessive-compulsive disorder and started on a series of medications. He is currently taking a medicine called Zoloft, which helps him to a certain extent.
Nearing the end of his second year of school, he was rushed to the Tulane emergency room for what was ultimately diagnosed as a panic attack. All tests were run and were negative, and he was told to follow up with his psychiatrist. He has continued to suffer from these attacks in different degrees of severity. His life was changed significantly because of those attacks.
He was disenrolled from the HPSP on 5 November 2001 for the above reasons and was honorably discharged on 18 October 2002. He is no longer in the HPSP because of a medical condition he acquired two years into the program. His psychological impairments are equally as debilitating, if not more so. He will have to deal with and continue to grapple with his problems as he pursues his career and a normal life.
The bill he has been sent is unjust. The bill and its exorbitant penalty and administrative fees are punishment for his having a psychological condition that rendered him incapable of military duty.
He provides a copy of his emergency department record and his discharge summary from DePaul – Tulane Behavioral Health Center.
EVIDENCE OF RECORD: The applicant's military records show:
On 2 September 1999 orders were published reassigning the applicant to the Army Reserve Control Group (Officer Active Duty Obligor) effective 1 June 1999 because of his acceptance of an appointment in the Army Reserve.
An emergency room note from Tulane University Hospital and Clinics, shows that the applicant was examined on 14 May 2001, complaining of light-headedness, nausea, and sweating. The note revealed that his past medical history included attention deficit disorder, and obsessive-compulsive disorder, and that he was taking Adderall and Zoloft. Various tests were conducted, with no abnormalities indicated. His case was discussed with a psychiatrist, who recommended that the applicant call outpatient for referral for a probable panic attack. He was diagnosed as having an anxiety attack. His condition was good. A psychiatric admission history shows that he was a second year medical student on a military scholarship – currently withdrawing.
A 14 May 2001 psychiatric consultation shows that the applicant was diagnosed as having a panic attack, possible drug interaction. The examining physician recommended that the applicant discontinue using Zoloft, and to use only 1/2 of the usual dose of Adderall.
A discharge summary from DePaul – Tulane Behavioral Health Center, dated 15 May 2002, shows that the applicant was examined for an intake evaluation on 24 September 2001, having been referred by a physician who was treating him for almost a year prior to the intake evaluation. At the time of his evaluation, the applicant was treated for attention deficit disorder, without hyperactivity, panic disorder, and obsessive-compulsive disorder. He was instructed to take Zoloft, Zxanax, and Adderall. The summary indicated that the applicant was seen on three occasions over a seven-month period of time for his conditions, and prescribed certain medications. During the last session, the physician discussed future treatment options with the applicant. The applicant was diagnosed with attention deficit disorder without hyperactivity and panic disorder. The diagnosis indicated that the applicant had been having a hard time complying with treatment recommendations, and that as a result proper management had been a challenge. He was discharged to home, with a recommendation for follow up treatment at the student health center.
On 5 November 2001 The Surgeon General recommended to the Commander, Army Reserve Personnel Command in St. Louis that the applicant be discharged from the Army Reserve, and recoupment of the entitlements paid on his behalf. The applicant became ineligible for HPSP participation effective 31 October 2001 for a medically disqualifying psychiatric condition (attention deficit disorder, obsessive compulsive disorder, and panic attacks), and that due to the nature of his disqualifying condition, imposition of an alternative service other than recoupment was not in the best interest of the government. The Surgeon General stated that the applicant had received a four-year HPSP scholarship to obtain a medical degree with entitlements commencing on 16 August 1999. The applicant submitted a request for discharge based on his psychiatric condition and was placed on leave of absence from the HPSP on 1 April 2001. A medical summary from his treating psychiatrist was submitted for medical evaluation and he was found medically unfit for retention on 31 October 2001. The Surgeon General stated that the applicant remained in medical school with plans to complete his medical doctorate degree and his medical condition appeared not to preclude the use of his medical degree; and therefore, waiver of alternatives to active service, such as recoupment, was not recommended.
The Surgeon General recounted the amount of money that was recoupable under the terms of his service agreement, and stated that since he continued to successfully complete his school requirements, and remained on track to graduate as anticipated, he appeared to have the ability to use his degree in the civilian sector, and therefore, recoupment of funds expended was deemed appropriate. The Surgeon General stated that the applicant had incurred a two-year minimum active duty service obligation; however, the nature of his condition made imposition of alternative service in a military treatment facility unlikely to be fruitful for the government or the applicant. The Surgeon General recommended that the applicant be discharged from the Army Reserve, waiver of the active duty service obligation, and recoupment of all educational expenses, plus interest, under the terms of his service agreement.
In a 7 December 2001 memorandum for the Health Services Personnel Management Directorate, the Army Reserve Personnel Command Judge Advocate stated that it had no legal objection to the applicant's proposed separation, in that he had submitted an unqualified resignation and could be discharged; however the processing of the separation should be delayed. That official concurred in the recommendation to recoup the educational funds paid on behalf of the officer, but stated that a final determination as to recoupment could only be made by the Secretary of the Army or his designee prior to separation; accordingly, the file should be forwarded to the Secretary for a determination prior to the separation of the applicant.
In an undated memorandum to the Deputy Chief of staff, G-1, the Deputy Assistant Secretary (Human Resources), Office of the Assistant Secretary Manpower and Reserve Affairs approved the request to discharge the applicant from the Army Reserve, to waive his active duty service obligation and military service obligation, subject to recoupment.
On 18 October 2002 the applicant was discharged from the Army Reserve.
The applicant's official military personnel records, to include his HPSP contract agreement, other than depicted above, are not available to the Board.
A sample Department of the Army Service Agreement – F. Edward Hebert Armed Forces Health Professions Scholarship Program (AFHPSP) (USAREC Fm 1131-R-E), which the applicant necessarily would have completed to enter the scholarship program, indicates in pertinent part:
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That a participant will not be permitted to voluntarily withdraw from the program;
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That any subsequent changes in physical condition will not be grounds for subsequent release from the terms of the contract unless specifically provided for by statute or applicable Army Regulations or instructions in effect at the time;
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That a program participant incurs an eight-year service obligation, a portion of which is an active duty obligation, that the active duty obligation is a minimum of two years, and that the remaining portion of the service obligation is a Reserve service obligation served in the Individual Ready Reserve;
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That a participant is eligible to receive payment for all actually incurred and approved educational expenses, to include tuition, fees, books, etc., and that except when serving on active duty for training, a participant will receive a stipend at the rate established by law; and
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That if a participant's status as a student is suspended or discontinued for deficiency in conduct or studies, or for other reasons, the participant will be required to perform active duty in an appropriate military capacity in accordance with the active duty obligation incurred, when such service is determined to be in the best interest of the government. That a participant agrees to reimburse the government for all costs which it incurred, plus interest, as determined by the Secretary of the Army, if relieved of active duty or Reserve service obligation.
Army Regulation 601-141 establishes the Army portion of the Armed Forces Health Professions Scholarship Program, and states in effect, that if a scholarship participant does not complete the program, the Secretary of the Army may require the member to reimburse the government for all or any portion of tuition and other educational costs. The Secretary of the Army may relieve a member who is dropped from the program from any military obligation or reimbursement of the government if the action would be in the best interest of the Army.
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. Absent information to the contrary, the evidence indicates that the applicant contracted with the Army to participate in the HPSP, to receive financial support in return for an active duty obligation, and to agree with the provisions of that contract. The applicant himself does not dispute his participation in the HPSP, nor the amount of money the government has paid on his behalf, only indicating that a portion of the amount (the tuition) is unfair because he was disenrolled from the program because of medical reasons.
2. The evidence also indicates that the applicant remained in medical school, and that he planned to complete his degree. The Surgeon General indicated that in spite of his disqualifying medical condition, it did not appear to preclude the use of his medical degree, and therefore, recommended recoupment of the money paid on his behalf. The Secretary of the Army did so direct.
3. Consequently, it appears to this Board that the government paid the bill for approximately 20 months of the applicant's medical education, an education that will lead or has led to a doctorate of medicine with the ensuring responsibilities and benefits.
4. Therefore, the determination that the applicant repay the government for that portion of the applicant's medical education that it subsidized, with no corresponding return, is considered reasonable, and not unjust as the applicant contends.
5. The applicant has submitted neither probative evidence nor a convincing argument in support of his request.
6. In order to justify correction of a military record the applicant must show to the satisfaction of the Board, or it must otherwise satisfactorily appear, that the record is in error or unjust. The applicant has failed to submit evidence that would satisfy that requirement.
7. 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
__AAO__ __REB __ __ECP __ DENY APPLICATION
CASE ID | AR2003090703 |
SUFFIX | |
RECON | YYYYMMDD |
DATE BOARDED | 20031113 |
TYPE OF DISCHARGE | (HD, GD, UOTHC, UD, BCD, DD, UNCHAR) |
DATE OF DISCHARGE | YYYYMMDD |
DISCHARGE AUTHORITY | AR . . . . . |
DISCHARGE REASON | |
BOARD DECISION | DENY |
REVIEW AUTHORITY | |
ISSUES 1. | 103.00 |
2. | |
3. | |
4. | |
5. | |
6. |
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