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ARMY | BCMR | CY2005 | 20050006823C070206
Original file (20050006823C070206.doc) Auto-classification: Denied



                            RECORD OF PROCEEDINGS


      IN THE CASE OF:


      BOARD DATE:        12 January 2006
      DOCKET NUMBER:  AR20050006823


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

|     |Mr. Carl W. S. Chun               |     |Director             |
|     |Mrs. Nancy L. Amos                |     |Analyst              |


      The following members, a quorum, were present:

|     |Ms. Linda D. Simmons              |     |Chairperson          |
|     |Mr. Rodney E. Barber              |     |Member               |
|     |Ms. Rea M. Nuppenau               |     |Member               |

      The Board considered the following evidence:

      Exhibit A - Application for correction of military records.

      Exhibit B - Military Personnel Records (including advisory opinion,
if any).

THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE:

1.  The applicant requests, in effect, that she be granted a medical waiver
that will allow her to enlist.

2.  The applicant states she was fraudulently discharged twice.  She
states, in a letter to the Secretary of the Army, that she broke both her
ankles after stepping in a pothole in her seventh week of training.  She
asked to speak to a chaplain of her own faith because she was having
trouble with her husband.  Her husband was jealous and was giving her a lot
of grief.  The chaplain asked her what she thought about suicide.  She told
the chaplain she did not believe in suicide.  The chaplain then told her
captain that she had threatened suicide, which was a false statement.

3.  The applicant states she ended up on a psychiatric ward for about 10
days.  During those 10 days she only spoke to Doctor O___ for about 10
minutes.  Doctor O___ never did any of the testing that is required to
diagnose someone with a Personality Disorder.  She was released to her
unit.  Soon after, she came down with a severe chest infection and was
hospitalized.  She was not even in the hospital 10 minutes when she was
checked out without receiving any treatment because she was being
discharged.  When she arrived at her stepmother's house, she was coughing
so hard she pulled every muscle in her body.  She went to the Department of
Veterans Affairs hospital, where they ran every test they could to find out
what was going on and found out absolutely nothing.

4.  The applicant states she requested her service medical records, and
there were no documents validating her Personality Disorder in her records.
 She then paid two psychologists to give her the testing required to
diagnose someone with a Personality Disorder.  The tests proved the
Personality Disorder discharge was wrong and fraudulent.  She was never
treated for her severe chest infection or her two broken ankles.  In 1997,
the Military Entrance Processing Station (MEPS) did not find any evidence
of a Personality Disorder in 1997 because she was and still is of sound
mind and body.

5.  The applicant states she contacted her Senator and she was allowed to
reenlist.  She took a physical again and again nothing wrong with her was
found. She was limited to a 4-year enlistment and also refused the GI Bill.
 During basic training, she wrenched her left knee.  Her drill sergeant
told her that if she did not go on sick call he would give her an Article
15, so she went.  The doctor looked at her knee and then sent her to
physical therapy.  First Lieutenant H___ looked at her knees, never took x-
rays, and then stated the applicant's career was over. She was discharged
again.  She feels she should have been able to get a second opinion from an
actual doctor, not a physical therapist.

6.  The applicant states that, after her discharge, she went to an
orthopedist.  Doctor K___ took x-rays and looked at her knees and found
nothing wrong.  She went back to the recruiter to enlist, but when she went
to the MEPS to take her physical, they refused to give it to her.  The
recruiting battalion sent a request to the U. S. Army Recruiting Command
(USAREC) to ask them to allow her to take her physical.  However, USAREC
said they would not allow her to take the physical due to the fact she had
been discharged with a Personality Disorder.  She went to her two Senators,
and USAREC told her Senators the reason was because of her bilateral
anterior knee pain.

7.  The applicant provides Reports of Medical History dated 18 October 1996
and 3 December 1999; a Report of Medical Examination dated 3 December 1999;
her DD Forms 214 (Certificate of Release or Discharge from Active Duty) for
the periods ending 1 April 1997 and 21 September 2001; a Brief
Psychological Evaluation (dates of evaluation 2 March 2000 and 7 March
2000); a memorandum for record dated 2 March 2000; an extract from Army
Regulation 601-210; a Standard Form 600 (Chronological Record of Medical
Care), date of examination 27 July 2001; a DA Form 4707 (Entrance Physical
Standards Board (EPSBD) Proceedings); and a 29 April 2003 letter from
Jewett Orthopaedic Clinic, P.A.

8.  The applicant also provides a USAREC memorandum dated 1 December 2003;
a Task Manager printout dated 3 December 2003; a USAREC "HQ Medical Waiver
Workflow Notification"; a 14 April 2004 letter from USAREC to Congressman
Gene T___; a 17 June 2004 letter from USAREC to Senator L___; a 28 June
2004 from the White House to the applicant; a 4 August 2004 letter from
USAREC to the applicant; a 24 May 2001 memorandum from the U. S. Total Army
Personnel Command (PERSCOM) to USAREC; separation orders dated 18 September
2001; an Associate in Science degree certificate; a Processee/Enlistee
Record; a DD Form 2808-1 (Report of Medical History)  dated 29 October
2004; a DD Form 2808 (Report of Medical Examination)   dated 29 October
2004; a USMEPCOM Form 601-23-2-E (Records Flag) dated 29 October 2004; a
Body Fat Content Worksheet dated 29 October 2004; and a Statement of
Understanding (Army Policy) dated 18 June 2004.

CONSIDERATION OF EVIDENCE:

1.  The applicant was born on 4 November 1969.  She completed an entrance
physical examination on 18 October 1996.  Her Report of Medical Examination
noted, in part, that she had mild hallux valga (angulation of the great toe
away from the midline of the body) and pes cavus (high arches).  She
enlisted in the Regular Army, in pay grade E-3, on 6 January 1997.

2.  On 22 January 1997, the applicant was treated for severe pelvic pain.
Also on 22 January 1997, she was treated for right knee pain which occurred
at the knee cap while she was doing jumping jacks.  She denied any trauma.
On          27 January 1997, she was treated for right knee pain again.  On
5 February 1997, she was treated for headaches (experienced for the
previous 6 – 7 years). On 7 March 1997, she was treated for left and right
ankle pain, left greater than right.  She stated she had tripped and fallen
two weeks previously.

3.  On 28 February 1997, the applicant was counseled by her drill sergeant
for stating to another private that she was going to kill herself and she
needed to be watched and if she did kill herself she wanted the private to
tell the applicant's family she loved them.

4.  On 12 March 1997, the applicant was referred to the emergency room by
the chaplain and drill sergeant for a complaint of "lots of problems."  On
17 March 1997, she was treated for ankle, knee, and leg pain and toes that
were cracked and bleeding.

5.  On 19 March 1997, a mental status evaluation diagnosed the applicant
with Personality Disorder, Not Otherwise Specified.  She was found to have
the mental capacity to understand and participate in proceedings.  She was
cleared for any administrative or judicial action as deemed appropriate by
the command. The examining physician (Lieutenant Colonel O___, Chief,
Inpatient Psychiatry) noted the applicant stated she had feelings of
"feeling like a failure," and that those feelings came from an unstable and
troubling past and having fear of abandonment.  The applicant had a past
history of marijuana use with alcohol to stop the pain and loneliness.  She
had a past history of being abused.  She had six family members die in six
months.  She had a past history of suicide gestures by cutting her wrist,
and suicide ideation.

6.  The applicant was afforded the opportunity to consult with appointed
counsel. She declined the opportunity and she did not submit a statement in
her own behalf.  She indicated she did not desire a separation medical
examination.

7.  On 27 March 1997, the applicant’s commander initiated separation action
under the provisions of Army Regulation 635-200, paragraph 5-13,
Personality Disorder.

8.  On 28 March 1997, the appropriate authority approved the recommendation
and directed the applicant be discharged with a character of service of
uncharacterized.

9.  On 1 April 1997, the applicant was discharged, in pay grade E-3, under
the provisions of Army Regulation 635-200, paragraph 5-13, Personality
Disorder.  She had completed 2 months and 26 days of creditable active
service with no lost time.

10.  The applicant completed an entrance physical examination on 3 December
1999.  Her Report of Medical Examination noted she had mild pes cavus,
asymptomatic.  It noted she had previously been discharged from the Army
for personality disorder.  It noted she was 24 pounds overweight (but
apparently met the body fat standards).  It was noted she had a permanent 3
profile under the psychiatric portion of the PULHES (111113); however, a
waiver was recommended.

11.  In item 11 of the applicant's Report of Medical History dated 3
December 1999, she checked that she did not have and never had broken
bones.

12.  A memorandum for record dated 2 March 2000 noted the applicant's
medical waiver had been disapproved on 7 February 2000 by the USAREC
Command Surgeon.

13.  The applicant provided a Brief Psychological Evaluation, dates of
evaluation 2 March 2000 and 7 March 2000.  A licensed psychologist provided
a summary of information gathered during two psychological interviews.  The
applicant had stated her problems were created by her former husband's
behavior.  Previously she had received counseling once a month for six
months because of problems at school – primarily being teased and ridiculed
by her peers.  She related numerous traumatic experiences beginning when
she was raped at 15 years of age.  She was again raped at 17 by her uncle.
Her first husband was very abusive.  He threatened her with a gun and raped
her.  Her first husband was shot and killed in front of her by her uncle.
She stated she put most of her symptoms – specifically, being edgy at
sudden moves – behind her.  She reported no suicide attempts and no alcohol
or drug abuse.  She reported numerous disruptions to her childhood.

14.  The licensed psychologist stated the applicant's difficulty in her
relationships likely stemmed from the disruptions she experienced and
preliminary indications did not add support to her being diagnosed with a
Personality Disorder.

15.  Apparently the applicant's recruiter requested another waiver.  By
memorandum dated 26 May 2001, PERSCOM approved the applicant's enlistment
in the Regular Army, not to exceed 4 years, in pay grade E-3 as an
exception to Retention Control Point policy.

16.  The applicant enlisted in the Regular Army on 12 July 2001.

17.  On 27 July 2001, the applicant was treated for pain in both knees and
in the right femur.  It was noted at this time that her pes cavus was
extreme.

18.  A DA Form 4707 dated 14 August 2001 shows the applicant had complaints
of bilateral knee pain without a history of trauma and that she had been
administratively separated in 1997 secondary to following slow recovery of
stress fractures of both ankles.  Her knee was found to have lax patellar
ligament/tendons with a positive "RP" grind, positive genu recurvatum
(hyperextension of the knee), and moderate/severe pes cavus.  It was
recommended she be separated for failure to meet medical procurement
standards, not permanently service aggravated.  She did meet medical
retention standards.

19.  On 24 August 2001, the applicant disagreed with the proceedings
because her condition did not exist prior to service.  She requested her
case be returned to the medical approving authority for reconsideration.
The unit commander recommended her case be returned to the medical
approving authority.  On       17 September 2001, the discharge authority
determined she would be separated from the Army.

20.  On 21 September 2001, the applicant was discharged, with a character
of service of uncharacterized, under the provisions of Army Regulation 635-
200, paragraph 5-11 for failing to meet procurement medical fitness
standards.

21.  The applicant provided a 29 April 2003 letter from Jewett Orthopaedic
Clinic, P.A.  The letter indicated the applicant was being treated at the
clinic for bilateral anterior knee pain.  An examination on 28 April 2003
found her to have normal exams in both knees.  She had no evidence of intra-
articular abnormalities.  Her cartilage appeared intact and her ligaments
were stable.

22.  By memorandum dated 1 December 2003, U. S. Army Recruiting Battalion,
Tampa, FL requested a medical waiver from USAREC.  On 8 December 2003, the
USAREC Command Surgeon disapproved the request for waiver.

23.  By letter dated 14 April 2004, USAREC informed Congressman T___ that
the applicant was not eligible for reentry into the Army since she did not
meet the medical standards set by the Army.  The memorandum stated the
Chief Medical Officer at the MEPS found her not medically eligible for
enlistment.  The USAREC Command Surgeon was the sole approval authority for
medical waivers on all Army applicants.  Officials of the Tampa U. S. Army
Recruiting Battalion forwarded the applicant's medical records to the
USAREC Command Surgeon for his review and requested the applicant be
allowed to take the Armed Forces Entrance Physical.  After careful
consideration of all the medical documents provided, the USAREC Command
Surgeon determined the applicant was not a viable candidate for waiver
consideration due to her history of, and discharge for, bilateral anterior
knee pain.

24.  USAREC informed the applicant's Congressman T___ that, as a result of
his inquiry and in an effort to ensure the applicant received due process,
documents provided by the Representative were presented to the Command
Surgeon for review; however, the Command Surgeon upheld his original
decision.  The Command Surgeon stated that, although the applicant might
not be experiencing any difficulty in her current environment, the
particular rigors of military training could aggravate her medical
condition.

25.  By letter dated 17 June 2004, USAREC provided Senator L___ the same
information as provided to Congressman T___.

26.  An unsigned USMEPCOM Form 601-23-2-E dated 29 October 2004 indicated
the applicant had an incomplete medical ("date created 2003-11-05") and
contained the annotation, "Waiver recommended."

27.  The applicant completed an entrance physical examination on 29 October
2004.  In item 12i (Have you ever had or do you now have knee trouble
(e.g., locking, giving out, pain or ligament injury, etc.) of her Report of
Medical History, she checked, "No."  Item 74a of her DD Form 2808 dated 29
October 2004 indicated she was not qualified for service.

28.  Army Regulation 635-200 sets forth the basic authority for the
separation of enlisted personnel.  Paragraph 5-13 sets the policy and
prescribes procedures for separating members with a Personality Disorder
(not amounting to a disability) that interferes with assignment to or
performance of duty when so diagnosed by a physician trained in psychiatry
and psychiatric diagnosis or a licensed clinical psychologist.

29.  The Diagnostic and Statistical Manual of Mental Disorders, 4th edition
(DSM-IV) lists ten specific Personality Disorders.  In addition,
Personality Disorder Not Otherwise Specified is a category provided for two
situations:  (1) the individual's personality pattern meets the general
criteria for a Personality Disorder and traits of several different
Personality Disorders are present, but the criteria for any specific
Personality Disorder are not met; or (1) the individual's personality
pattern meets the general criteria for a Personality Disorder, but the
individual is considered to have a Personality Disorder that is not
included in the Classification.

30.  The DSM-IV states personality traits are enduring patterns of
perceiving, relating to, and thinking about the environment and oneself
that are exhibited in a wide range of social and personal contexts.  Only
when personality traits are inflexible and maladaptive and cause
significant functional impairment or distress do they constitute
Personality Disorders.  The essential feature of a Personality Disorder is
an enduring pattern of inner experience and behavior that deviates markedly
from the expectations of the individual's culture and is manifested in at
least two of the following areas:  cognition (ways of perceiving and
interpreting self, other people, and events); affectivity (the range,
intensity, lability, and appropriateness of emotional response);
interpersonal functioning; or impulse control.  This enduring pattern is
inflexible and pervasive across a broad range of personal and social
situations and leads to clinically significant distress or impairment in
social, occupational, or other important areas of functioning.  The pattern
is stable and of long duration, and its onset can be traced back at least
to adolescence or early adulthood.

31. Army Regulation 635-200, paragraph 5-11 sets the policy and prescribes
procedures for separating members who were not medically qualified under
procurement medical fitness standards when accepted for enlistment or who
became medically disqualified under these standards prior to entry on
active duty.  Medical proceedings, regardless of the date completed, must
establish that a medical condition was identified by appropriate military
medical authority within 6 months of the Soldier’s entrance of active duty
that would have permanently or temporarily disqualified him or her for
entry into the military service or entry on active duty had it been
detected at that time and does not disqualify him or her for retention.

32.  Army Regulation 40-501 governs medical fitness standards for
enlistment, retention, and separation.  Chapter 2 governs medical fitness
standards for enlistment.  Paragraph 2-11 states chronic retropatellar knee
pain syndrome with or without confirmatory arthroscopic evaluation is a
cause for rejection for enlistment.  This condition is not listed in
chapter 3 as a reason for referral to a medical evaluation board.
33.  Army Regulation 40-501, paragraph 1-6 states medical fitness standards
cannot be waived by medical examiners or by the examinee.  Examinees
initially reported as medically unacceptable, when the medical fitness
standards in chapters 2, 3, 4, or 5 apply, may request a waiver of the
medical fitness standards in accordance with the basic administrative
directive governing the personnel action.  Upon such request, the
designated administrative authority or his or her designees for the purpose
may grant such a waiver in accordance with current directives.  The waiver
authorities include the commander of USAREC.

34.  Army Regulation 635-40 governs the evaluation of physical fitness of
Soldiers who may be unfit to perform their military duties because of
physical disability.  In pertinent part, it states that according to
accepted medical principles, certain abnormalities and residual conditions
exist that, when discovered, lead to the conclusion they must have existed
or have started before the individual entered the military service.
Manifestation of lesions or symptoms of chronic disease from date of entry
on active military service (or so close to that date of entry that the
disease could not have started in so short a period) will be accepted as
proof that the disease existed prior to entrance into active military
service.

DISCUSSION AND CONCLUSIONS:

1.  The Board will not change comments made in a mental status evaluation
report.  Unlike a doctor who treats the physical aspects of a patient’s
body, a psychiatrist must consider a noncorporeal entity – the mind.
Almost by definition he must note personal impressions rather than physical
conditions in making a diagnosis.

2.  The applicant was evaluated by the Chief, Inpatient Psychiatry who
noted the applicant had feelings of "feeling like a failure" that came from
an unstable and troubling past, noted she had a past history of marijuana
use with alcohol, and noted she had a history of suicide gestures by
cutting her wrist.  The Board presumes regularity and that the Chief
entered what he heard the applicant say and, based upon that information,
determined she had a Personality Disorder that resulted from severe
abnormalities in her childhood environment.

3.  The Army has an interest in promoting the reliability of its medical
records.  Alteration of a diagnosis in those records after the fact may
lead to fundamental questions about the veracity of the records in this
case and in general.  For these reasons, the Board declines to alter a
diagnosis in the applicant’s medical records.  The Secretary’s interest is
in ensuring an orderly system in which a physician makes certain
observations and recording them faithfully in the medical records at the
time.  It would take an extraordinary showing for the Board to alter such a
diagnosis.  In this case, the applicant’s physician made a diagnosis in
good faith and based upon accepted medical principles at the time.  That
observation was duly recorded in the applicant’s medical records and she
has not presented sufficient reason to alter that observation.

4.  The applicant contended she was discharged without receiving treatment
for two broken ankles and a severe chest infection.

5.  There is no evidence the applicant had two broken ankles.  In item 11
of her Report of Medical History dated 3 December 1999, she checked that
she did not have and never had broken bones.  She had been treated for left
and right ankle pain on 7 March 1997; however, as she stated she had
tripped and fallen two weeks previously, it appears this pain may have been
the result of stress fractures.

6.  Regarding the severe chest infection, the applicant herself stated she
went to the Department of Veterans Affairs hospital, where they ran every
test they could to find out what was going on and found out absolutely
nothing.  It is difficult to understand what the Army could have treated
her for if every test given her found nothing wrong.

7.  Despite having been separated due to a diagnosed Personality Disorder,
it appears the applicant was given a waiver to reenlist.  She reenlisted on
12 July 2001 and within two weeks she was treated for pain in both knees
and in the right femur.  She had also experienced knee pain within about
two weeks of her initial enlistment, in January 1997.  There is no evidence
to show that knee pain was the result of some trauma that occurred while
she was in the Army.

8.  Although the 29 April 2003 letter from Jewett Orthopaedic Clinic, P.A
indicated the applicant had no evidence of intra-articular abnormalities
and her cartilage appeared intact and her ligaments were stable, the letter
also stated she was being treated at the clinic for bilateral anterior knee
pain.

9.  Army Regulation 40-501, chapter 2 states chronic retropatellar knee
pain syndrome with or without confirmatory arthroscopic evaluation is a
cause for rejection for enlistment.  The applicant therefore did not meet
enlistment medical standards for her knee pain.  Based on all the known
facts, it appears the USAREC Command Surgeon made a sound medical decision
not to grant her a waiver to enlist.

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF

________  ________  ________  GRANT PARTIAL RELIEF

________  ________  ________  GRANT FORMAL HEARING

__lds___  __reb___  __rmn___  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

The evidence presented does not demonstrate the existence of a probable
error or injustice.  Therefore, the Board determined that the overall
merits of this case are insufficient as a basis for correction of the
records of the individual concerned.




                                  __Linda D. Simmons____
                                            CHAIRPERSON



                                    INDEX

|CASE ID                 |AR20050006823                           |
|SUFFIX                  |                                        |
|RECON                   |                                        |
|DATE BOARDED            |20060112                                |
|TYPE OF DISCHARGE       |                                        |
|DATE OF DISCHARGE       |                                        |
|DISCHARGE AUTHORITY     |                                        |
|DISCHARGE REASON        |                                        |
|BOARD DECISION          |DENY                                    |
|REVIEW AUTHORITY        |Mr. Chun                                |
|ISSUES         1.       |108.01                                  |
|2.                      |                                        |
|3.                      |                                        |
|4.                      |                                        |
|5.                      |                                        |
|6.                      |                                        |


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