IN THE CASE OF:	  

		BOARD DATE:  21 August 2012

		DOCKET NUMBER:  AR20110025064 


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 a medical retirement.

2.  The applicant states:

	a.  He had a disability that was treated while on active duty that was incurred in the line of duty.  Therefore, it should have warranted a medical discharge/ retirement.

	b.  He spent nearly 5 years in active duty status to include a deployment to Afghanistan.  He was assigned to a remote fire base in a hostile area where Afghan and coalition government presence was virtually non-existent.  It was directly due to this deployment that he came home and developed the early symptoms of Post Traumatic Stress Disorder (PTSD).  Due to certain external factors in his unit he did not seek mental health treatment immediately out of fear of reprisal from his chain of command.

	c.  After the suicide of a battle buddy he sought mental health counseling from his battalion medical staff and he was placed on medication.  He then went to division mental health to seek formal counseling.  He was brushed off by the doctors/psychiatrists.  He was told everything he was experiencing was normal and to return to duty.  His chain of command was notified that he had shown up seeking counseling because he had a top secret security clearance, which could be affected.

	d.  Between on or about August 2009 until he was discharged in March 2010 he was seen at the Mental Health Clinic, Womack Army Medical Center, Fort Bragg, NC once a month and prescribed medication.  During this time he completed numerous tests wherein the results were positive for symptoms of PTSD.  However, their notes showed he was diagnosed with an adjustment disorder with disturbance of emotion, panic disorder, insomnia, anxiety, and depression.

	e.  On 3 November 2009, during a visit, the doctor entered "Chronic Post-Traumatic Stress Disorder" in his service medical records and from then on all his service medical records show PTSD.  He was escorted to mental health as a safety precaution and placed on suicide/homicide watch.  He began seeing a psychiatrist in November 2009 and later his commander contacted mental health to assess his fitness for duty.

	f.  He points out in November 2010 a licensed clinical psychologist stated a test score suggested marked distress due to PTSD but she immediately followed that by saying it's because he wants out of the military as soon as possible.  She acknowledged the PTSD, but made an excuse for it.  In December he was scheduled for a fit for duty evaluation but due to inadequate preparation of paperwork he was unable to be evaluated.  On that report, it was written "service member easily stressed and isolative.  Service member has PTSD-like symptoms of concern."

	g.  He was finally seen by the licensed clinical psychologist in January 2011 once more for a fitness for duty evaluation.  He was administered three written tests.  Each test showed he had noticeable symptoms of PTSD, but the doctor, using extreme bias, suggested that he was exaggerating his symptoms.  Her recommendations and the blatant ignorance of his months of medical treatment for mental health led to his security clearance being revoked and he was administratively discharged from the Army.    

	h.  The Department of Veterans Affairs (VA) diagnosed him with PTSD and awarded a combined rating of 70%.  However, he is being paid at the 100% rate due to unemployability.  The VA directly linked his current PTSD to his military service. 

	  i.  There were numerous discrepancies in the psychology report dated 11 January 2010. 

3.  The applicant provides a:

* DD Form 214 (Certificate of Release or Discharge from Active Duty)
* Report on Psychological Testing, dated 11 January 2010
* VA Service Medical Records 

CONSIDERATION OF EVIDENCE:

1.  The applicant enlisted in the Regular Army on 2 June 2005.  He completed his training and was awarded military occupational specialty 35P (Cryptologic Linguist).  He served in Afghanistan from 7 October 2007 to 26 April 2008. 

2.  The applicant provides medical documents dated beginning in May 2009.  He had multiple visits with behavioral health and the main diagnosis, provided by multiple provides, was adjustment disorder.  He had several family and work-related problems, including the fact his wife had cancer of the eye.  On              30 October 2009, he had a therapy session, and the diagnosis at that time as “Adjustment Disorder with Disturbance of Emotions.”

3.  On 3 November 2009, the applicant as seen for the first time by Doctor G.  It was a followup for medication management, not a therapy session.  Doctor G. addresses nothing but whether the medication does is adequately controlling the applicant’s symptoms; however, his assessment was (1) screening examination for depression (he performed no screening examination and depression was on the applicant’s problem list); (2) screening mental/developmental disorders (but there is no screening evident in his written discussion of the applicant’s medications); (3) chronic PTSD (he did not do any diagnostic exploration of PTSD but indicated initially that he thought the applicant was being treated for PTSD); (4) anxiety disorder not otherwise specified (this diagnosis occurs on previous problem lists); and (5) depression.  The problem list also included conditions of “functional diarrhea” and “nausea and vomiting.”

4.  The available record ends in January 2010.  There are records of multiple mental health encounters after 3 November 2009.  Not a single assessment by any of the multiple providers (including a later appointment with Doctor G.) includes the diagnosis of PTSD.  The most common diagnosis is adjustment disorder or anxiety disorder.  Every cline visit after 3 November 2009; however includes PTSD on the problem list (along with diarrhea, vomiting, and a host of others).

5.  On 11 January 2010, the applicant underwent a behavioral health evaluation and the licensed clinical psychologist diagnosed him with an adjustment disorder with disturbance of emotions.  She discussed his PTSD symptoms and also noted the PTSD stressors.  She did not conclude that he had PTSD.  She noted that his adjustment disorder was treatable but he may be poorly compliant with treatment because he does not seem motivated to get better.  She stated that were he motivated for treatment, the recommendation could be made to allow him a period of time to receive care and then re-assess his fitness for duty.  However, given his strong desire to get out of the military, it was unlikely that any investment in his care would result in improvements in his functioning.  She was strongly recommended that he be separated from the service under paragraph   5-17, Army Regulation 635-200.

6.  On 19 February 2010, the applicant's unit commander initiated action to separate him under the provisions of Army Regulation 635-200 (Active Duty Enlisted Administrative Separations), paragraph 5-17, for other designated physical or mental conditions.  The commander cited the applicant had been diagnosed with an adjustment disorder with disturbance of emotions.

7.  On 22 February 2010, the separation authority approved the recommendation for separation and directed that the applicant be furnished an honorable discharge.  

8.  On 12 March 2010, he was honorably discharged under the provisions of Army Regulation 635-200, paragraph 5-17, by reason of a physical condition, not a disability.   

9.  He provided service medical records, dated between November 2009 and January 2010, which notes PTSD symptoms.

10.  He provides VA documentation which states:

   a.  his evaluation for PTSD was increased from 30% to 70% effective 
13 March 2010; and

   b.  his overall or combined rating is 70% but he was being paid at the 100% rate because he was unable to work due to his service connected disability.

11.  Army Regulation 635-200 sets forth the basic authority for separation of enlisted personnel.  Chapter 5 provides for separation for the convenience of the government.  Paragraph 5-17 provides for discharge for other designated physical or mental conditions.  Commanders may approve separation under this paragraph on the basis of other physical or mental conditions not amounting to disability under the provisions of Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) and excluding conditions appropriate for separation processing under paragraph 5-11 (separation of personnel who did not meet procurement medical fitness standards) or 5-13 (separation because of personality disorder) that potentially interfere with assignment to or performance of duty.  
12.  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.  The unfitness is of such a degree that a Soldier is unable to perform the duties of his office, grade, rank, or rating in such a way as to reasonably fulfill the purposes of his employment on active duty.

13.  Paragraph 3-36 (Adjustment Disorders) of Army Regulation 40-501 (Standards of Medical Fitness) states situational maladjustments due to acute or chronic situational stress do not render an individual unfit because of physical disability, but may be the basis for administrative separation if recurrent and causing interference with military duty.

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 office, rank, grade or rating because of disability incurred while entitled to basic pay.

15.  Title 38, U.S. 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.  

DISCUSSION AND CONCLUSIONS:

1.  The applicant contends he should have been medically retired from the Army.  However, he did not have an unfitting condition when he was separated for a condition, not a disability.  

2.  The evidence of record shows he was diagnosed as having an adjustment disorder with mixed disturbance emotions in 2010 and he was discharged under the provisions of Army Regulation 635-200, paragraph 5-17, for a condition, not a disability.  This diagnosis was presumably made by competent military medical authorities.

3.  The governing regulation states adjustment disorders do not render an individual unfit because of physical disability.  

4.  Although his service medical records note PTSD there is no evidence to show PTSD or any medical condition rendered him unable to perform his duties.  PTSD would appear on each appointment form.  The appointment form contains a problem list that is generated with each appointment and is a historical record.  When a clinician makes a diagnosis in his assessment, that diagnosis will then appear on the problem list in future clinic visits.  It does not mean, such as the “functional diarrhea” and “nausea and vomiting” entries, that the patient currently has diarrhea and vomiting.  Therefore, there is no basis for a medical retirement.

5.  The documentation provided by the applicant was carefully considered.  It is acknowledged the VA has granted him a 70% disability rating for PTSD.  However, the rating action by the VA does not necessarily demonstrate an error or injustice on the part of the Army.  The VA, operating under its own policies and regulations, assigns disability ratings as it sees fit.  

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)                                         AR20110025064



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ABCMR Record of Proceedings (cont)                                         AR20110025064



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