IN THE CASE OF:	  

		BOARD DATE:  29 August 2013

		DOCKET NUMBER:  AR20130000530 


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, in effect, her narrative reason for separation be changed from personality disorder to a medical discharge due to post-traumatic stress disorder (PTSD). 

2.  The applicant states she did not request a discharge.  She was told she must leave the military due to a personality disorder.  She served in Iraq and she was exposed to disturbing things that caused her to have symptoms of depression and personality disorder.  After returning from the war, she had to be hospitalized due to a mental disorder.  When she returned to her unit, instead of receiving medical attention she was told she had to get out of the military due to a personality disorder.  

3.  The applicant provides:

* Orders 82-5, dated 23 March 2003 (reassignment)
* Office of the Assistant Secretary (Manpower and Reserve Affairs) letter
* Immediate commander's summary
* Separation notification memorandum
* Department of Veterans Affairs (VA) Form 21-4138 (Statement in Support of Claim)
* DD Form 214 (Certificate of Release or Discharge from Active Duty)




CONSIDERATION OF EVIDENCE:

1.  Title 10, U.S. Code, section 1552(b), provides that applications for correction of military records must be filed within 3 years after discovery of the alleged error or injustice.  This provision of law also allows the Army Board for Correction of Military Records (ABCMR) to excuse an applicant's failure to timely file within the 3-year statute of limitations if the ABCMR determines it would be in the interest of justice to do so.  While it appears the applicant did not file within the time frame provided in the statute of limitations, the ABCMR has elected to conduct a substantive review of this case and, only to the extent relief, if any, is granted, has determined it is in the interest of justice to excuse the applicant's failure to timely file.  In all other respects, there are insufficient bases to waive the statute of limitations for timely filing.

2.  The applicant's record shows she enlisted in the Regular Army on 6 July 2001 and she held military occupational specialty 92Y (Unit Supply Specialist).  She served in Southwest Asia from 24 March to 12 June 2003. 

3.  The complete facts and circumstances surrounding the applicant's discharge are not available for review with this case.  However, her record contains a 
DD Form 214 that shows she was discharged on 24 October 2003 under the provisions of paragraph 5-13 of Army Regulation 635-200 (Enlisted Active Separations) by reason of "Personality Disorder."  She completed 2 years, 
3 months, and 19 days of active service.  She was assigned a separation code of "JFX." 

4.  In connection with the processing of this case, on 10 July 2013, an advisory opinion was obtained from the Office of The Surgeon General (OTSG), Director of Health Care Delivery.  The OTSG official states the applicant requested her discharge for personality disorder be changed to PTSD.  Conclusions for this advisory opinion are drawn solely based on available documentation from her time in active service unless otherwise noted.  

	a.  (The applicant) presented for behavioral health assistance on 24 June 2002.  "She reported wanting help talking about and dealing with handling her family and work stress and anger," "looking to make myself back the same way I was before I changed for the worse."  She reported having problems the past two and a half months with sleeping and being awakened by nightmares.  No diagnosis was written in the record of this visit.  She was scheduled for an intake and she did not attend that appointment.  Later that month, her commander contacted the psychologist requesting a command-directed evaluation.  (The applicant) had not reported to work and had been found in her room unresponsive.  She stated she had taken five sleeping pills to help her sleep through the weekend, not as a suicide attempt.  A brief note stated (the applicant) met the criteria for a Personality Disorder Not Otherwise Specified (NOS) with mixed passive aggressive and immature features.  The noted features were not part of the professional diagnostic nomenclature in 2002 and no support for the diagnosis was recorded.  A week later, on 31 July 2002, she was seen for her mental health intake and received the additional diagnosis of an Occupational Problem.  On this same date, the completed Report of Mental Status Evaluation recommended administrative separation based on her diagnosed personality disorder.  There were no examples of long-standing difficulties to support the diagnosis aside from stating she had a history of not being able to handle new situations and/or stress.  Further, the report noted affectivity, interpersonal, functioning, and impulse control, though again, there was no documentation other than perhaps an inference of impulsivity from her history of disciplinary issues.  In addition, her workplace and family stressors appeared valid and significant.  A mental health specialist saw her twice for follow up sessions before she stopped attending appointments.  In the first session, she expressed indecision about whether or not to stay in the Army.  She stated her command and her mother were encouraging her to stay, and her command moved her to a new workplace.  During the second session, she stated she had decided to leave the Army and had sought the chaplain's help.  She was not separated at this time.

	b.  (The applicant) deployed from March to June 2003, returning as scheduled.  In August 2003, she was admitted for psychiatric hospitalization.  During the intake, she described a difficult deployment as she had deployed alone to join another unit and felt terrified by active hostilities experienced there.  En route home from her deployment, she reportedly drank heavily and did not stop until she was on leave the next month.  When she quit drinking, she experienced severe symptoms leading to a psychiatric hospitalization, followed by a month of medical leave.  It was at that point she returned to her home station.  She described post-traumatic stress symptoms and depressive symptoms and was admitted with a diagnosis of PTSD and Major Depressive Disorder.  While the documentation does not clearly support the diagnoses, the post-traumatic stress symptoms described were sufficient for a sub-threshold PTSD diagnosis of Anxiety Disorder NOS.  The record stated her symptoms had manifested since April 2003, though it is unclear to which symptoms that time frame applied.  Multiple disciplinary issues were noted, "counseling statements galore at present assignment," which suggested her occupational functioning was impaired.  Not stated, however, were the nature of the counseling statements and whether her behavioral health issues impacted her behavior.  (The applicant) was discharged from the hospital 12 days later with the diagnoses of Social Anxiety Disorder, Alcohol Dependence, Poly-substance Abuse, and Personality Disorder NOS with dependent and passive aggressive features.  Again, support for the diagnoses was not documented.  The note read, "[Patient] admitted for [symptoms] initially thought to be "PTSD"; however, review of pre-morbid history revealed that they were chronic and secondary to the conditions noted above."  This statement appeared to contradict the admission note documenting onset of significant symptoms during deployment and was inconsistent with her symptoms related to deployment, such as flashbacks.

	c.  A memorandum for the commander, dated 13 August 2003, listed the above diagnoses and recommended administrative separation in accordance with Army Regulation 635-200, paragraph 5-13.  Social Anxiety Disorder, or more accurately, Social Phobia, is a potentially boardable condition, though it was not addressed in the memorandum.  The applicant's hospital discharge summary contained some information in addition to the admission note; however, it did not document the support for the diagnoses given.  Prior to separation, her record contained documentation of her attendance in one session of a Transition Group. Two years following her discharge, she saw a VA psychiatrist who diagnosed her with PTSD, chronic based on the symptoms she reported.

	d.  Considering the available record in its entirety, it appeared the applicant experienced difficulty coping with stress related to challenges at home, at work, and during deployment.  During her time in the Army she expressed ambivalence about serving, and she apparently received numerous disciplinary consequences for her behavior.  The memorandum for the commander recommending administrative separation included a potentially boardable diagnosis, and though it appeared the more appropriate diagnosis would have been Anxiety Disorder NOS, regardless the issue of a medical evaluation board (MEB) was not addressed.  Given the two psychiatric hospitalizations in a relatively short period of time, the applicant's functioning appeared significantly impaired.  An MEB would have been appropriate at the time of discharge.  The available information in the record did not validate the diagnosis of personality disorder.

5.  On 14 August 2013, she responded with a rebuttal.  She stated that based on the conclusions of paragraph 6 of the advisory opinion, she expects the Board to correct her DD Form 214 to show an accurate narrative reason for separation as Anxiety Disorder NOS.  

6.  Army Regulation 635-200 (Active Duty Enlisted Administrative Separations) prescribes the policy for the administrative separation of enlisted personnel.  Paragraph 5-13 provides for separating members by reason of personality disorder (not amounting to disability) that interferes with assignment or with performance of duty.  

7.  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 a physical disability.  It states the mere presence of an impairment does not, of itself, justify a finding of unfitness because of physical disability.  In pertinent part, it states that although the ability of a Soldier to reasonably perform his or her duties in all geographic locations under all conceivable circumstances is a key to maintaining an effective and fit force, this criterion will not serve as the sole basis for a finding of unfitness.  In each case, it is necessary to compare the nature and degree of physical disability present with the requirements of the duties the member may reasonably be expected to perform because of his or her office, rank, grade, or rating.

8.  Army Regulation 635-40 states there are many conditions, including neuropsychiatric disorders, which may be improved sufficiently by treatment to prevent disability, or to significantly decrease it.  If a Soldier unreasonably fails or refuses to submit to medical or surgical treatment or therapy, that portion of the disability that results from such failure or refusal will not be rated.

9.  Army Regulation 635-40 provides for MEBs which are convened to document a Soldier's medical status and duty limitations insofar as duty is affected by the Soldier's status.  A decision is made as to the Soldier's medical qualifications for retention based on the criteria in chapter 3 of Army Regulation 40-501 (standards of Medical Fitness).  If the MEB determines the Soldier does not meet retention standards, the board will recommend referral of the Soldier to a PEB.

10.  Army Regulation 40-501 governs medical fitness standards for enlistment, induction, appointment (including officer procurement programs), retention, and separation (including retirement).  It outlines medical conditions which may render and individual unfit or which may preclude enlistment and notes that both personality and adjustment disorders will be dealt with through administrative and not medical channels.  Paragraph 3-35 of this regulation states that a history of or current manifestations of personality disorders render an individual administratively unfit.  These conditions render an individual administratively unfit rather than unfit because of physical illness or medical disability.  These conditions will be dealt with through administrative channels, including Army Regulation 635-200.

DISCUSSION AND CONCLUSIONS:

1.  The applicant's request to change narrative reason for separation from personality disorder to a medical discharge due to PTSD has been carefully considered.  However, there is insufficient evidence to support this claim.  

2.  With respect to the issue of her personality disorder versus PTSD, the applicant's service medical records are not available for review and she provides none in support of her application.  However, the available records show she underwent a mental status evaluation that led to a diagnosis of a personality disorder.  Accordingly, her chain of command initiated separation action against her.  Her separation processing was presumably accomplished in accordance with the applicable regulation.  All requirements of law and regulation were presumably met and the rights of the applicant were fully protected throughout the separation process. 

3.  The record is void of any clear indication that the applicant was suffering from an unfitting PTSD condition at the time of her discharge.  It is possible she may have developed PTSD at a later date; however, there is insufficient evidence she met full criteria for PTSD at the time of her separation and that diagnosis is not recorded in her available record during her time of active service.  There is insufficient medical evidence to support an unfitting PTSD finding at the time of discharge.  

4.  Nevertheless, a review of her available records by OTSG concluded that the available information in the record did not validate the diagnosis of personality disorder.  Although this opinion is not conclusive and is only based on what was available to OTSG for review, it is accepted as sufficient to change the narrative reason for her separation from personality disorder to Secretarial Authority with the appropriare Separation and Reentry Codes.  

5.  As for her new request that the narrative reason for separation be changed to reflect her anxiety disorder, this diagnosis was neither determined to have failed retention standards nor found unfitting.  Therefore, notwithstanding the OTSG's opinion regarding this condition, there is insufficient medical evidence in the available record to support such a finding. 

6.  In view of the foregoing, absent any evidence of error or injustice in the separation process or medical evidence confirming the applicant was suffering from an unfitting PTSD or anxiety disorder conditions at the time of her discharge, there is an insufficient evidentiary basis to support granting the requested relief. 







BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF 

____X___  ____X___  ___X__ _  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

________  ________  ________  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

1.  The Board determined that the evidence presented was sufficient to warrant a recommendation for partial relief.  As a result, the Board recommends that the Department of the Army records of the individual concerned be corrected by
voiding her DD Form 214 for the period ending 24 October 2003 and issuing her a new DD Form 214 to show she was discharged with an honorable characterization of service by reason of Secretarial Authority, with an SPD code of "JFF." 

2.  The Board further determined that the evidence presented was insufficient to warrant a portion of the requested relief.  As a result, the Board recommends denial of so much of the application that pertains to changing her narrative reason for separation to a medical discharge because of PTSD or anxiety disorder. 



      _______ _  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)                                         AR20130000530





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ABCMR Record of Proceedings (cont)                                         AR20130000530



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