IN THE CASE OF:	  

		BOARD DATE:	  16 February 2012

		DOCKET NUMBER:  AR20110014069 


THE BOARD CONSIDERED THE FOLLOWING EVIDENCE:

1.  Application for correction of military records (with supporting documents provided, if any).

2.  Military Personnel Records and advisory opinions (if any).


THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE:

1.  The applicant requests change of her medical discharge to a medical retirement.  

2.  She states she was going through the Medical Evaluation Board (MEB) proceedings, but it was illegally stopped by her commander without an evaluation.  Afterward, her commander submitted the discharge packet.  She states she was not properly evaluated for a medical discharge.

3.  She provides her DD Form 214 (Certificate of Release or Discharge from Active Duty), and states her medical records are located at the Winston-Salem Regional Office of the Department of Veterans Affairs (DVA).  

CONSIDERATION OF EVIDENCE:

1.  The applicant enlisted in the Regular Army on 22 April 2004.  She was deployed to Iraq from 25 January 2005 through 29 January 2006.

2.  On an unknown date, a clinical psychologist at the Department of Behavioral Health, Womack Army Medical Center, Fort Bragg, NC forwarded a memorandum to the applicant’s company commander in regard to a Mental Health Evaluation.  The clinical psychologist stated the applicant was seen on 5 March 2009 after a command referral for a non-emergency evaluation because of questions about diagnosis and appropriate military disposition.  The applicant was evaluated by clinical interview, review of Army medical records, review of 


medical records from her TRICARE network psychologist, review of information obtained by her Warrior Transition Battalion (WTB) Case Manager from her former unit regarding her experiences while deployed, and review of previous neuro-psychological testing conducted in the Traumatic Brain Injury (TBI) Clinic, Department of Neurology, Womack Army Medical Center.  The applicant was diagnosed with Adjustment Disorder with Mixed Disturbance of Emotions and Conduct.  The clinical psychologist listed proposed treatments, precautions, and opined on her fitness and suitability for continued service.  He recommended the applicant be returned to duty with no change in duty status.

3.  On 6 April 2009, she underwent a mental health evaluation and she was diagnosed with an Adjustment Disorder with Mixed Disturbances of Emotions and Conduct.  The clinical psychologist noted the following findings:

	a.  The diagnosis represented Adjustment Disorder with Depressed Mood within the meaning of Army Regulation 40-501 (Standards of Medical Fitness) and DSM IV [Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition].  In the opinion of this examiner, this condition and the problems presented by this individual were not amendable to transfer, disciplinary action, or training or reclassification to another type of duty within the military.  Given the applicant's history, it was clear she lacked the emotional resources to cope with the usual demands of military service.

	b.  There was no evidence of mental defect, emotional illness, or psychiatric disorder of sufficient severity to warrant disposition through military medical channels.

	c.  The applicant was mentally responsible, could distinguish right from wrong, and possessed sufficient mental capacity to understand and participate intelligently as a respondent in any administrative proceedings.

	d.  She was psychiatrically cleared for any administrative action deemed appropriate by the command.

4.  The clinical psychologist made three recommendations:

   a.  the applicant should be expeditiously separated under the provisions of Army Regulation 635-200 (Personnel Separations - Active Duty Enlisted Administrative Separations), paragraph 5-17 based on her diagnoses.

   b.  the applicant should continue her present treatment.

   c.  if her mental condition should deteriorate or if there was new suicidal ideation, the applicant should be immediately returned to the Department of Behavioral Health or to the Emergency Department, Womack Army Medical Center, for further evaluation.

5.  On 6 May 2009, the applicant completed a:

	a.  DD Form 2697 (Report of Medical Assessment) that shows in:

		(1)  block 10, she marked “Worse” indicating the condition of her overall health compared to her last medical assessment/physical examination.  She commented “I am in a lot of pain; it is difficult for me to turn my head and exercise.”

		(2)  block 11, she marked “No” indicating she did not have any illnesses or injuries that caused her to miss duty for longer than 3 days since her last medical assessment/physical examination.

		(3)  block 12, she marked “Yes” indicating she had been seen by or been treated by a health care provider, admitted to a hospital, or had surgery since her last medical assessment/physical examination.  She commented “seen by my PCM [primary care manager] for neck and back pain.”

		(4)  block 15, she marked “Yes” indicating she had conditions which 
currently limited her ability to work in her primary military specialty or required geographic or assignment limitations.  She indicated “neck, back injuries, asthma, PTSD” [Post Traumatic Stress Disorder].

		(5)  block 20, the care provider indicated the applicant had multiple complaints, primarily back and neck – film and MRIS [Magnetic Resonance Imaging and Spectroscopy] were done.  The care provider indicated an MEB was previously started and terminated (question mark at the end of statement).  The Care provider also indicated the applicant had a prior permanent profile, but it was revoked by (medical) history and the applicant was currently being processed for chapter 5-17.

	b.  DD Form 2807-1 (Report of Medical History) in which she included a listing of 21 medical conditions [listing included PTSD].  The examining physician reiterated the statements made on the applicant’s DD Form 2697.  In block 29 (Explanation of “Yes” Answer(s)), the applicant indicated she:

		(1)  had a partial hysterectomy on 25 January 2008;


		(2)  was treated in the Emergency Room for an internal hemorrhoid that ruptured;

		(3)  had a ganglion cyst removed from her left hand;

		(4)  had a strange mole removed twice from her back;

		(5)  had a lipoma removed from her right shoulder; and

		(6)  was diagnosed with active cytomegalovirus.

	c.  DD Form 2808 (Report of Medical Examination), for separation physical and she was found qualified for separation.  She was given a physical profile of 111111.  In item 77 (Summary of Defects and Diagnoses) of this medical report the examining physician commented that the applicant was in the WTB and she was seen for a multitude of complaints.  The examining physician indicated that the medical evaluation processing was started and suspended.  The examining physician commented that the applicant had prior permanent profile for low back pain and had no current permanent profile in the system; however, she had temporary profiles in effect.  The temporary profiles are not available.

6.  On 18 June 2009, the company commander initiated discharge proceedings under the provisions of Army Regulation 635-200, paragraph 5-17, for other designated physical or mental condition.  The applicant consulted with counsel and she elected to submit a statement in her own behalf.  Her statement is not available for review.

7.  On 30 June 2009, the MEB Outreach Counsel, Womack Army Medical Center, Fort Bragg, submitted a memorandum to the company commander objecting to the counseling process under the authority of the "Enlisted Separations on the Basis of Personality Disorder Policy Memorandum," dated
10 February 2009.  The Policy required acts that had not been followed in this case:

	a.  Corroboration of the alleged personality disorder by the Medical Treatment Facility Chief of Behavioral Health (or equivalent official);

	b.  Forwarding of the corroborated diagnosis for final review and confirmation by the Director, Proponency of Behavioral Health, Office of the Surgeon General; 


	c.  Consideration of the applicant's current diagnosis of PTSD was a significant contributing factor; and

	d.  Evaluation by the PDES because PTSD was a significant contributing factor.

8.  The 30 June 2009 memorandum also stated:

	a.  the applicant is entitled to evaluation through the physical disability process under Army Regulation 40-400 (Patient Administration), chapter 7 for her physical and mental medical issues.  She entered the PDES process in the Spring of 2007, but her status was abruptly stopped when her profile changed on 29 January 2009 from a permanent to a temporary profile.  The new temporary profile states the process will begin again "[W]hen Soldier has completed her evaluation and treatment….";

	b.  at the time the PDES process was dismissed on 29 January 2009, the applicant had been in treatment for PTSD and Depressive Disorder by a TRICARE provided psychologist, Dr. S----- A. M------, Ph.D. since September 2008.  The applicant also had several physical injuries and diseases in treatment by the Army system;

	c.  on 20 February 2009, the separation action began with no allegations of misconduct, interference with assignment to or performance of duty;

	d.  the psychiatrist who evaluated the applicant in one session found adjustment disorder.  The report failed to define reasons the psychiatrist was able to find adjustment disorder in a single visit when her psychologist had been treating her for PTSD and Depression for more than 6 months; and 

	e.  due to the lack of factual substantiation for this action and the clear policy in this specific case, the applicant requested that no further action be taken until the PDES process was restarted.

9.  On 27 July 2009, the separation authority waived a rehabilitative transfer, approved the separation recommendation under the provisions of Army Regulation 635-200, paragraph 5-17, and directed the applicant receive an honorable discharge.  These decisions were based upon a review of the separation action including any endorsements and statements submitted by and on behalf of the applicant.  


10.  On 13 August 2009, the applicant was discharged accordingly by reason of a condition, not a disability.

11.  Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) governs the evaluation of physical fitness of Soldiers who may be unfit to perform their military duties because of physical disability.  The unfitness must be of such a degree that a Soldier is unable to perform the duties of his or her office, grade, rank, or rating in such a way as to reasonably fulfill the purposes of his or her employment on active duty.

12.  Army Regulation 635-200 provides the basic authority for the separation of enlisted personnel.  Paragraph 5-17 provides that a Soldier may be separated for other designated physical or mental conditions not amounting to disability and excluding conditions appropriate for separation processing under paragraph 5-11 or 5-13 that potentially interfere with assignment to or performance of duty.  Such conditions may include, but are not limited to chronic airsickness, chronic seasickness, enuresis, sleepwalking, dyslexia, severe nightmares, claustrophobia, or other disorders manifesting disturbances of perception, thinking, emotional control, or behavior sufficiently severe that the Soldier's ability to effectively perform military duties is significantly impaired.

13.  Army Regulation 40-501 states that adjustment disorders render an individual administratively unfit rather than unfit because of physical illness or medical disability.  These conditions will be dealt with through administrative channels.

14.  Title 10, U.S. Code, chapter 61, provides disability retirement or separation for a member who is physically unfit to perform the duties of his or her office, rank, grade or rating because of disability incurred while entitled to basic pay.

DISCUSSION AND CONCLUSIONS:

1.  The evidence of record shows the applicant's administrative separation under the provisions of Army Regulation 635-200, paragraph 5-17 was accomplished in 
compliance with applicable regulations with no indication of procedural errors which would have jeopardized her rights.  

2.  The applicant contends she was being processed through an MEB, but it was illegally stopped by the commander without an evaluation.  However, the evidence of record does not indicate the discontinuance of her MEB proceedings were in error or unjust.

3.  The applicant has not provided any medical treatment record to support her request for a medical retirement.  On her application she indicated her medical records were located at a DVA regional office, but none are provided for review.

4.  Her service record contains a separation physical (as opposed to a clinical treatment record) in which she claimed to have a variety of medical conditions, including PTSD.  The examining physician indicated she had a prior permanent profile for low back pain, but her service record does not include clinical treatment records to support any unfitting condition to include PTSD.

5.  She was seen by a qualified mental health professional for a command-directed mental health evaluation.  The evaluation was noted to specifically include a clinical interview, a review of Army medical records and medical records from her civilian psychologist, information supplied by her unit regarding her experiences while deployed, and also a neurological testing conducted by the TBI clinic.  She was diagnosed with Adjustment Disorder with Mixed Disturbance of Emotions and Conduct and she was psychiatrically cleared for any administrative action deemed appropriate by her command.

6.  The evidence of record shows that prior to the applicant's separation in August 2008 competent medical authority determined she was medically qualified for separation with a physical profile of 111111.  There is no evidence to show the applicant had any medically unfitting disability which required physical disability processing.

7.  The 30 June 2009 memorandum from the MEB Outreach Counsel was considered.  This memorandum contends the process for a personality disorder was not followed.  However, the applicant was diagnosed with an Adjustment Disorder with Mixed Disturbance of Emotions and Conduct and not a personality disorder.  

8.  In view of the foregoing, there is an insufficient evidentiary basis for granting the applicant's requested relief.

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF 

________  ________  ________  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

____X____  ____X____  ____X____  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.



      ___________X____________
               CHAIRPERSON
      
I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case.

ABCMR Record of Proceedings (cont)                                         AR20110014069



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ABCMR Record of Proceedings (cont)                                         AR20110014069



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