BOARD DATE:	  13 June 2013

		DOCKET NUMBER:  AR20120015745 


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 reconsideration of her earlier request for correction of her DD Form 214 (Certificate of Release or Discharge from Active Duty) to change the narrative reason for her separation from personality disorder to medical discharge – post-traumatic stress disorder (PTSD).

2.  The applicant states after her unit came back from Iraq, 12 Soldiers were selected, including herself, and asked about their experience in Iraq.  She related to the captain that she was sexually molested by a guy in Iraq.  The captain was very upset and she (the applicant) does not know what the captain did or what was done about this issue.  In any case, her leaders recommended she talk to a health provider about her emotions and attitude problem.  She told the health provider about the problem and the next thing she knows, the health provider presented her with various chapters to get out of the military.  She did not know what each of these chapters stood for.  When she researched the meaning of these chapters, she was astonished.  Two weeks later, the health provider made her provide a white sealed envelope to send to her leaders.  Within 2 weeks, she was honorably discharged for schizophrenia, which she did not have. 

3.  The applicant provides a Department of Veterans Affairs (VA) Form 2507 (Compensation and Pension Exam Report), dated 16 November 2009.

CONSIDERATION OF EVIDENCE:

1.  Incorporated herein by reference are military records which were summarized in the previous consideration of the applicant's case by the Army Board for Correction of Military Records (ABCMR) in Docket Number AR20100000831, dated 10 August 2010.

2.  The applicant provides a new argument which coupled with the Compensation and Pension Exam Report and the recent advisory opinion from the Office of the Surgeon General (OTSG) constitute new evidence that warrants consideration by the Board.

3.  The applicant enlisted in the Regular Army on 19 March 2002.  She held military occupational specialty 92G (Food Service Specialist).  She served in Kuwait from 16 February 2003 to 1 June 2003.

4.  On 7 January 2004, she was diagnosed with sleepwalking and in order to rule out a mood disorder not otherwise specified, she was issued a temporary physical profile limiting her to assignments with access to regular outpatient care and duty hours from 0600 to 1630.  This profile also restricted her from access to weapons or performing 24-hour duty.

5.  On 26 January 2004, she was enrolled in an Anger Management program with the Center for Mental Health Services at Fort Riley, KS and scheduled to attend six group therapy sessions during the period 25 February through
31 March 2004. 

6.  On 5 February 2004, she underwent a mental status evaluation at her commander's request.  The military psychologist remarked that her behavior was normal, and she was fully alert and oriented with a clear thinking process and normal thought content.

	a.  The psychologist informed her that the evaluation suggested interpersonal difficulties associated with a personality disorder and sleepwalking behavior.  When questioned about her performance she indicated she had been late and had presented an unkempt uniform, but otherwise denied work performance difficulties.

	b.  The psychologist opined she met the criteria for Personality Disorder with Schizoid and Paranoid features; therefore, in accordance with the provisions of Army Regulation 625-200 (Personnel Separations - Enlisted Personnel) her unit should consider an administrative separation under chapter 5-13, as it was likely she would continue to present with emotional and behavioral difficulties that reflect a long-standing pattern of difficulties.

7.  She was placed on medical hold pending resolution of her temporary profile with a follow on deployment to Iraq with the 82nd Medical Company.  On 5 and 29 March 2004, she was counseled by the Rear Detachment Noncommissioned Officer in Charge (NCOIC) regarding her performance and frequent daydreaming and lack of situational awareness.  Her NCOIC also noted she was currently enrolled in Anger Management counseling and she had been evaluated by the Community Mental Health Clinic regarding her lack of focus, forgetfulness, and general lack of awareness.  During each counseling session, she was advised that if her deficiencies continued it could result in her administrative separation from the Army.

8.  On 11 March 2004, she underwent another mental status evaluation as part of pre-separation processing.  The military psychologist remarked that her behavior was normal, and that she was fully alert and oriented with a clear thinking process and normal thought content.

	a.  The psychologist noted she was currently attending Anger Management, but continued to report emotional difficulties in controlling outbursts and she had the potential to be self-destructive.

	b.  The psychologist opined she met the criteria for Personality Disorder with Schizoid and Paranoid features, therefore, in accordance with the provisions of Army Regulation 625-200 her unit should consider an administrative separation under chapter 5-13, as it was likely she would continue to present with emotional and behavioral difficulties that reflect a long-standing pattern of difficulties.

	c.  The psychologist opined she possessed the capacity to participate in the separation processing and recommended she be administratively eliminated from the military as expeditiously as possible.

9.  On 6 April 2004, the applicant's immediate commander notified her of his intent to initiate separation action against her under the provisions of Army Regulation 635-200, paragraph 5-13, by reason of personality disorder with an honorable discharge.

10.  On 6 April 2004, she acknowledged receipt of the notification of her pending separation action and she was subsequently advised by counsel of the basis for the contemplated action to separate her for a personality disorder under the provisions of Army Regulation 635-200, paragraph 5-13.  She elected not to submit a statement in her own behalf.

11.  On 15 April 2004, her immediate commander initiated separation action against her under the provisions of Army Regulation 635-200, paragraph 5-13, by reason of mental disorder.  The commander remarked she was diagnosed with a personality disorder with schizoid and paranoid features which significantly impaired her capacity to adapt to and function in a military environment.

12.  The separation authority approved the proposed separation action against the applicant in accordance with Army Regulation 635-200, paragraph 5-13, and directed the issuance of an Honorable Discharge Certificate.

13.  On 23 April 2004, she was discharged accordingly.  She completed 2 years, 1 month, and 5 days of creditable active service.  The DD Form 214 she was issued at the time shows in:

* item 26 (Separation Code) the entry "JFX"
* item 28 (Narrative Reason for Separation) the entry "Personality Disorder"

14.  In the processing of this case, on 3 May 2013, an advisory opinion was obtained from the OTSG.  The advisory official stated:

	a.  The applicant requested her DD Form 214 be amended to reflect PTSD. Conclusions for this advisory opinion are drawn solely based on available documentation from her time in service unless otherwise indicated.  A hardcopy of her in-garrison Behavioral Health record was available for review.

	b.  She deployed to Iraq approximately 17 February to 1 June 2003.  She completed a Post-deployment Health Assessment toward the end of deployment. She did not endorse any post-traumatic stress or depressive symptoms at that time.  In the letter she attached to her DD Form 149 (Application for Correction of Military Record), she stated she experienced and reported a military sexual trauma (MST) after returning from deployment.  She did not know of any further action taken with that report.  In her Behavioral Health record, there are intake notes referring to her MST.  She endorsed "victim" under sexual stressors, flashbacks and a provider's interview notes, though not precise, at a minimum stated "sexual abuse…in Iraq," in addition to childhood sexual abuse.  Further, the notes reflect, "Bring back memories."

	c.  Her file presented a confusing picture of her symptoms and care.  She presented to Behavioral Health on 15 December 2003 with anxiety, mild depressive symptoms, and anger and hostility toward members of her unit in the context of a pending deployment back to Iraq.  The intake notes seem to indicate she was seen by a counselor and then by a psychiatrist.  The note by the 

counselor has the provisional diagnosis of Psychotic Disorder Not Otherwise Specified (NOS), and the diagnoses Anxiety Disorder NOS and Personality Disorder with Schizoid and Paranoid Traits, though it is unclear whether the diagnoses were made at that session.  The psychiatrist wrote the applicant's thoughts and behavior were noted to be overtly disorganized and she presented with limited range and reactivity of affect.  Her thought processes were described as concrete and moderately disorganized.  She received a provisional diagnosis of Psychotic Disorder NOS.  She was returned to duty with no medication and with an appointment for psychological testing at the end of the month.

	d.  During her testing appointment, only one instrument was given instead of the two planned because of significant difficulty completing the first inventory. The psychologist stated the applicant's significant difficulty comprehending items suggested borderline intellectual functioning and difficulty with information processing.  "Her speech was slightly blocked, delayed, disorganized and tangential at times.  Overall, her cognitive process was suggestive of odd, disorganized, and eccentric."  A rule out diagnosis of Cognitive Disorder NOS was given, in addition to a diagnosis of Personality Disorder with Schizoid Structure and Borderline and Paranoid Traits.  The note does not state anything beyond the test administration, such as a clinical interview.  When she returned approximately a week later to complete several brief assessments for the same psychologist, including an estimate of intellectual functioning, she completed items without difficulties, presented as more calm, and her cognitive functioning was judged to be grossly intact.  At this time, the diagnosis was rule out Psychotic Disorder NOS and Axis II, where the personality disorder was given in the previous note, was deferred despite the earlier diagnosis.  Unfortunately, there are no notes addressing the results of the testing.  On this same date, the psychologist completed her physical profile and noted under Medical Condition, "Sleepwalking, R/O (rule out) Mood Disorder NOS."

	e.  Seen for a follow up to review the testing results and assess current functioning, she presented as anxious and at times smiled at inappropriate times, the psychologist thought possibly because of her nervousness.  Her thought content was described as tangential at times and her affect full-ranged.  At this time, she received the diagnosis of Cognitive Disorder NOS, rule out Anxiety Disorder NOS, and Personality Disorder with Schizoid and Paranoid Features. The plan at that time was to schedule her for a medication evaluation to assist with the diagnostic impression, though there is no record of that occurring.  The next note by a nurse practitioner is toward the end of January 2004, and the applicant stated she was doing well with a small circle of friends and working with rear detachment, away from individuals in her unit whom she reported had harassed her.  Her behavior was described as normal, her thought process clear, 

and thought content normal.  She was scheduled for anger management, presumably because of homicidal ideation she experienced toward an individual who had repeatedly harassed her in Iraq, according to her report.

	f.  At her next appointment with the psychologist in early February 2004, they discussed the need to share information regarding problems with her continued military service.  Her diagnoses during this visit included Anxiety Disorder NOS, Occupational Problem, and rule out Sleepwalking by history, in addition to Personality Disorder NOS with Schizoid and Paranoid Traits.  The first DA Form 3822-R (Report of Mental Status Evaluation (MSE)) was completed recommending separation under chapter 5-13 with the diagnosis Personality Disorder with Schizoid and Paranoid features.  Schizoid personality traits are a pervasive pattern of detachment from social relationships and a restricted range of expression of emotion, which appears incongruent with her small circle of friends, expressed anger toward certain individuals, and anxious mood in later notes.  The basis for schizoid and paranoid traits are not documented in the record.  The MSE did not mention the Axis I concerns and stated she was "informed that the evaluation suggests interpersonal difficulties associated with a personality disorder and sleep walking behavior.  When questioned about her performance she indicated that she had been late and had presented with an unkempt uniform, but otherwise denies work performance difficulties."  The record does not indicate what, if any, pattern of difficulties she experienced in her occupational performance related to her diagnoses.  On 11 March 2004, the applicant attended her last individual session with the psychologist.  The notes stated to complete the MSE for her administrative separation.  At this time, the diagnosis is only the personality disorder, with Axis I as No Diagnosis.  Another MSE form was completed on this date.

	g.  An unclear clinical- picture is documented in the medical record.  There was insufficient support for the diagnosis of personality disorder in her documented symptoms or behaviors.  Particularly missing was any history suggesting a long-term, enduring pattern of maladaptive personality traits.  Psychotic Disorder NOS, Cognitive DisorderNOS, and Anxiety Disorder NOS were diagnosed at different times; however, the notes did not clearly support any of these diagnoses.  By the end of treatment, including attendance in Anger Management Group, there were no concerning clinical symptoms noted.  From what is written, it did not appear any of her symptoms rose to the level of a boardable condition impairing occupational functioning which would have required a medical evaluation board.  Specifically, she did not appear to have met criteria for PTSD during treatment nor at the time of her discharge.

15.  On 20 May 2013, the applicant was provided a copy of the OTSG advisory opinion for information and to allow her the opportunity to submit comments or a rebuttal.  She did not respond.

16.  Army Regulation 635-200 provides the basic authority for the separation of enlisted personnel.  Paragraph 5-13 provides that a Soldier may be separated for personality disorder, not amounting to disability under Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation), that interferes with assignment to or performance of duty.  The regulation requires that the condition is a deeply ingrained maladaptive pattern of behavior of long duration that interferes with the Soldier's ability to perform duty.

17.  Army Regulation 635-5-1 (Separation Program Designator (SPD) Codes) states that the SPD codes are three-character alphabetic combinations, which identify reasons for, and types of separation from active duty.  The "JFX" SPD code is the correct code for members separating under the provisions of Army Regulation 635-200, paragraph 5-13, by reason of personality disorder.

DISCUSSION AND CONCLUSIONS:

1.  The applicant contends her narrative reason for separation should be corrected.

2.  The evidence of record shows despite participating in Anger Management sessions, the applicant continued to report emotional difficulties in controlling outbursts and had the potential to be self-destructive.  She underwent mental status evaluations and the psychologist opined she met the criteria for Personality Disorder with Schizoid and Paranoid features and it was likely she would continue to present with emotional and behavioral difficulties that reflect a long-standing pattern of difficulties.  Accordingly, she was separated under the provisions of Army Regulation 635-200, paragraph 5-13 for personality disorder (not schizophrenia).

3.  The evidence of record shows her separation action was accomplished in compliance with applicable regulations and there is no indication of procedural errors that would have jeopardized her rights.  The discharge proceedings were conducted in accordance with law and regulations applicable at the time and the character of the discharge is commensurate with the applicant's overall record of military service.

4.  It appears her discharge was made based on a mental status evaluation that confirmed a diagnosis of personality disorder not amounting to disability was made by proper medical authority.  The record is void of any indication that the 

applicant was suffering from PTSD at the time of his discharge.  As confirmed by the advisory opinion, there is insufficient medical evidence to support an unfitting PTSD finding at the time of discharge.

5.  Her DD Form 214 appropriately reflects that based on the authority and reason for separation, she was assigned the correct corresponding SPD code and narrative reason for separation.  The record is void of any indication that the applicant was suffering from PTSD at the time of her discharge.  As confirmed by the OTSG advisory opinion, there is insufficient medical evidence to support an unfitting PTSD finding at the time of her discharge.

6.  In view of the foregoing and absent any evidence of error or injustice in the separation process or medical evidence confirming the applicant was suffering from an unfitting PTSD condition at the time of her discharge, there is an insufficient evidentiary basis to support 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 to amend the decision of the ABCMR set forth in Docket Number AR20100000831, dated 10 August 2010.



      _________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)                                         AR20120015745



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ABCMR Record of Proceedings (cont)                                         AR20120015745



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