BOARD DATE:	  12 September 2013

		DOCKET NUMBER:  AR20130010373 


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, correction of her DD Form 214 (Certificate of Release or Discharge from Active Duty) to remove the "personality disorder" narrative reason for her separation and associated separation and reentry codes.

2.  The applicant states the Department of Veterans Affairs (VA) determined she did not have personality disorder.  This disorder is a category of longstanding disorders that does not come and go with episodes like other mental disorders.  She was diagnosed as having a personality disorder (not otherwise specified (NOS)) in a combat zone where outside influences and stressors would have made an official diagnosis difficult if not impossible, which is why she was diagnosed as having a personality disorder-NOS because there was no follow up to determine if indeed she had a personality disorder or what manner of such she allegedly suffered from.  She was discharged without a complete evaluation which would have included any past mental health considerations (there are none) and interviews with people close to her – friends, family, etc. – to determine a severe impairment in her personal relationships and daily functioning and standardized testing, such as the Minnesota Multiphasic Personality Inventory.  As she was neither given an adequate evaluation nor sufficient time to correct her deficiencies after being made aware of them, her chapter action was based on an incorrect diagnosis and a failure to follow Army regulation.

3.  The applicant provides:

* DD Form 214 for the period ending 30 September 2008
* post-service psychiatric statement
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 records show she enlisted in the Regular Army on 7 December 2006 after having had prior U.S. Army Reserve (USAR) service and she held military occupational specialty 68W (Health Care Specialist).  She served in Iraq from 13 August 2007 to 29 April 2008.

3.  On 16 April 2008, she underwent a mental status evaluation.  Her Report of Behavioral Health Evaluation shows she did not have a severe mental disorder and she was not considered mentally disordered.  However, she manifested a long-standing disorder of character, behavior, and adaptability that was of such severity as to preclude further military service.

	a.  She had normal behavior, she was fully alert and fully oriented, her mood and affect were unremarkable, her thinking process was clear, and her thought content was normal.  She had the mental capacity to understand and participate in proceedings and she was mentally responsible.  Her evaluation consisted of a clinical interview and a psychological testing.  Her diagnoses were as follows:

* Axis I (Clinical Disorders) – adjustment disorder with anxiety
* Axis II (Personality Disorders) – personality disorder-NOS
* Axis III (General Medical Conditions) – non-contributory

	b.  She was well known to the evaluator and she had contact with other mental health professionals who also recommended separation on the grounds that her personality disorder, character traits and inadequacy of functioning created an atmosphere that was detrimental to her unit's mission and posed a risk to the health and well-being of other Soldiers.  She would not respond to further command efforts, which had been considerable, for rehabilitation or any treatment methods currently available.  She was cleared for any administrative actions deemed appropriate by her chain of command.
4.  On 24 April 2008, she was authorized early release from the theater of operations due to guidance from the Combat Stress Control Team.  She had been determined to be non-retainable and should be redeployed back to home station.

5.  On 30 May 2008, the applicant's immediate commander notified her of his intent to initiate separation action against her under the provisions of paragraph 5-13 of Army Regulation 635-200 (Active Duty Enlisted Administrative Separations) because of a personality disorder.  He stated the applicant had been diagnosed with a deeply-ingrained, maladaptive pattern of behavior of long duration that interfered with her ability to perform her duties.

6.  On 30 May 2008, the applicant acknowledged receipt of the notification of separation action.  She consulted with legal counsel and was advised of the basis for the contemplated separation and of the rights available to her in connection with the action.  Subsequent to receiving legal counsel, the applicant elected to submit a statement wherein she stated:

* she had been a good Soldier without any major disciplinary problems and her performance had been satisfactory
* she was aware that she displayed characteristics of borderline personality disorder, but she did not believe this had affected her performance
* there was no actual diagnosis in the records from a psychiatrist that indicated she had the non-combat stress/adjustment disorder-related personality disorder that was the basis for her separation
* the health care provider indicated her behavior was normal and she had clear thinking with normal thoughts and good memory
* she was also deemed mentally responsible which was not "conducive" with a person presenting with a borderline personality disorder

7.  On 2 June 2008, her defense counsel argued that her separation packet was legally insufficient.  He acknowledged she had been evaluated in Iraq and recommended for separation; however, her separation packet did not contain counseling which explained the diagnosis to her and allowed her the ability to rehabilitate herself.  She should also be reevaluated since she did not appreciate why a diagnosis of a personality disorder had been made in her case.

8.  On 12 June 2008, an administrative law attorney reviewed the proposed separation action and found it legally sufficient.  The applicant had been properly counseled and informed of the reason for initiation of the separation action.

9.  On 31 July 2008, she was interviewed by a clinical psychologist in training at Soldier and Family Readiness Services, Fort Lewis, WA.  She expressed a verbal desire to have the provider generate a statement stating that she related her intentions to return to Soldier and Family Readiness Services to "correct her deficiencies" through individual therapy and was scheduled for a follow-up review.

10.  On 9 September 2008 subsequent to the applicant's acknowledgement and review by the lawyers, the immediate commander initiated separation action against her under the provisions of Army Regulation 635-200, paragraph 5-13, by reason of a personality disorder.  Her intermediate commander recommended approval.

11.  On 9 September 2008, the separation authority approved the applicant's separation under the provisions of paragraph 5-13, Army Regulation 635-200, by reason of a personality disorder and directed characterization of her service as honorable.  On 30 September 2008, the applicant was discharged accordingly.

12.  Her DD Form 214 shows she was honorably discharged under the provisions of chapter 5-13 of Army Regulation 635-200.  She completed 1 year, 9 months, and 24 days of active service.  She was assigned the separation program designator (SPD) code of "JFX" and reentry eligibility code of "3."

13.  In connection with the processing of this case, an advisory opinion was obtained from the Director of Health Care Delivery, Office of the Surgeon General (OTSG), dated 15 July 2013.  The OTSG official states conclusions for this advisory opinion are drawn solely based on available documentation from the applicant's time in active service unless otherwise noted.

	a.  After 8 months in the USAR, the applicant transitioned to the active duty Army.  Nine months later in August 2007, she deployed to Iraq.  In June prior to deployment, she sought assistance from her medical provider for insomnia.  She reported 2 weeks of not sleeping well and having been awake for 60+ hours at the time of the appointment and feeling tired all the time.  She also reported having nightmares about family members dying and increased stress with an upcoming deployment, recent engagement, and uncertainty about a wedding date.  There were some concerns about the increased speed of her speech and thoughts and her history of recent depression, as well as her family history of bipolar disorder.  She was diagnosed as having insomnia and a nightmare disorder.  Later that same day she was seen by a psychologist, reporting poor sleep for the past 3 or 4 weeks, and being up for 62 hours straight that past weekend.  This time, however, she described unusually enhanced energy despite her lack of sleep.  She reported her mood as happy and she noted no problems with racing thoughts or talking faster than her usual rate, which by her report tended to be fast.  She stated she had been volunteering for more tasks, for example, 24-hour charge-of-quarters duty, and spending more money than usual, though not to the point of significant consequence.  She reported her mood had been "really depressed since around December 2006" until about 10 days prior to this appointment.  She thought her depressed mood was related to a birth control pill she discontinued about the same time her mood changed for the better.  She stated she had missed a couple of pills and noticed she felt better.  She reported a history of periods of depression with no suicidal ideation, though she did report cutting her upper arm 1 to 2 months previously.  She stated she cut herself in adolescence to relieve intense emotional pain.  Inappropriate affect was noted at times during this session.  The psychologist diagnosed insomnia and episodic mood disorders with a rule-out for bipolar disorder, and placed a consult to psychiatry with a follow-up appointment for the following week.  A week later, she declined a referral to psychiatry and noted improved sleep on the medication prescribed by her primary care provider.  This same date, she was seen in the Soldier Wellness Assessment Pilot Program with the added information that she had felt anxious more than half the days of the past month.  She was cleared for deployment.

	b.  Four months into her deployment, she was seen for a psychiatric consultation and medication evaluation.  The records do not specify whether she self-referred.  During this session, she disclosed periodic depressive episodes and several hypomanic episodes, describing periods of being awake for 5 nights, not needing sleep because she was not tired, happy mood, poor concentration with high distractibility, talking rapidly and moving quickly to the point others commented on her behavior, psychomotor agitation, and increased goal-directed activity, though that activity was not specified further.  She also reported cutting herself superficially every couple of months in response to stress "to calm me down and focus me."  She described mood swings since childhood.  She also stated her unit discouraged her from seeking mental health care prior to deployment.  She reported her only previous mental health counseling occurred subsequent to extended childhood trauma.  The provider diagnosed her with bipolar II disorder and a rule-out for borderline personality disorder.  Seen six times by this provider over the course of a month, she tried Seroquel (quetiapine fumarate) for mood stabilization, though it appeared she took it for only 5 or 6 days, stopping because of side effects.  During the 11 January 2008 visit, the provider diagnosed her as having borderline personality disorder, likely based on the history of cutting herself and mood lability (emotional instability) – two prominent, though insufficient, criteria for the diagnosis.  The provider discussed the case with a psychiatrist who did not think the applicant had bipolar disorder, and no Axis I diagnosis was given.  The provider did not record any further details explaining the drop of the bipolar disorder diagnosis.  The provider recommended an administrative separation in accordance with Army Regulation 635-200, paragraph 5-13, based on the personality disorder diagnosis.

	c.  The command requested a second opinion and the applicant was seen three times over the course of 3 days in February for this assessment, though the documented results were few.  The record reflected the commander confirmed the applicant was an excellent worker and he would prefer to retain her if it were in her best interests as well.  The provider reviewed the history of self-mutilation and further noted the applicant reported "obsessive-compulsive symptoms as far back as she can remember," though no details were recorded.  The provider rendered a diagnosis of adjustment disorder with anxiety, though the support for this diagnosis is not clear.  It could be the provider used the superficial cutting in response to stress during this deployment and obsessive compulsive traits as the basis for the anxiety, and the deployment and/or the incidents leading to a reported Equal Opportunity complaint by her.  If indeed it was an adjustment disorder, duration suggested it was acute in nature.  Also, the provider wanted to rule out personality disorder-NOS.  At this time, she agreed to a treatment plan and began individual and group therapy utilizing an evidence-based treatment.  The records showed eight individual and four group sessions from 13 February through 26 April 2008.

	d.  Also in April, she saw a different provider at a different clinic for case review and planning.  The record of that session reflected that she and her ex-boyfriend had a no-contact order and she was "under investigation for producing sexually-explicit videos leaked to the FOB [Forward Operating Base] in general," and apparently command was weighing discharging her versus significant action under the Uniform Code of Military Justice (UCMJ).  She was then seen by her primary therapist for a mental status evaluation on 16 April 2008 related to continuing difficulties adjusting to her role in the Army.  Though the problems were not specified in that note, the previous note and two sworn statements referred to the aforementioned inappropriate video of the applicant in circulation. She had also been counseled regarding an alleged refusal to accept transport to her appointments from one of her noncommissioned officers.  Though again the rationale is not documented, the social worker diagnosed the applicant as having an adjustment disorder with anxiety, appearing to be of acute duration, and a personality disorder-NOS, recommending her for an administrative separation for a personality disorder.  He stated the recommendation related to her "inadequate functioning and personality issues that have impeded her unit's mission and have negatively affected the well-being and safety of the other Soldiers in her Unit."  No specific information was documented to specify the concerns.

	e.  At her last individual session on 26 April 2008 prior to redeployment, she remained uncertain if she would be prosecuted for producing the video "as well as multiple other charges."  The alleged charges were not detailed.  The provider also noted she had made "some progress during her brief course of treatment.  The record of this visit reflected that she would redeploy "for further evaluation of the recommendation she be separated from the Army for her inability to adapt and function without disrupting the mission of her Unit because of her Personality Disorder."

	f.  In May 2008, she took steps to prevent her discharge from the Army.  She presented to the Behavioral Health Clinic requesting an evaluation for a second opinion, both on her way back from the theater and at her home station.  Both times she requested psychological testing and, while told testing would not be definitive, testing would have helped clarify her clinical picture.  The 15 May 2008 record from her home station stated she was told an evaluation without a command referral would not impact the separation decision, as her command had stated the evaluation at her deployed location sufficed.  She was referred to the Judge Advocate General (JAG).  The outcome of this referral is unknown.  She declined counseling services at that time, though she was seen again in the Soldier Wellness Assessment Pilot Program and she denied any post-deployment adjustment concerns, just her intent to go to JAG to find out how to fight her discharge.  In July she sought assistance from Soldier and Family Readiness Services for "correcting of mental health deficiencies for my unit."  She was diagnosed as having a phase-of-life or other life-circumstance problem. At her next visit, she requested a letter to support her attempt to stay in the Army. However, the provider stated she had too little information to be able to assist other than to document that she had been seen.

	g.  About 3 months following her discharge, she sought assistance through the VA, receiving the diagnosis of adjustment disorder with mixed anxiety and depressed mood, thought not to be related to her deployment, and borderline personality disorder traits, indicating she did not meet the full criteria for the diagnosis.  Seen in July 2009 and October 2010 related to her desire to reenlist in the USAR, the provider stated both times that she did not have any diagnoses at the time.  There is no indication of psychological testing and besides the self-mutilation behavior, her other challenges (such as emotional lability, disciplinary issues, long history of depressive episodes, hypomanic episodes, and obsessive compulsive behaviors) did not appear to be reported and considered.  Her last two VA visits to the Mental Health Clinic, during which she received no diagnoses, were related to her desire to reenlist in the USAR and it would not be unusual for a person to minimize a history of symptoms.

	h.  The records did not clearly support the diagnosis of personality disorder-NOS.  While she had two prominent features of borderline personality disorder, namely her self-mutilating behavior and emotional lability, other features from that or any other personality disorder – as often personality disorder-NOS is a mix of symptoms – were not documented.  Her records did appear to support the diagnosis of bipolar II disorder with her reported history of recurrent depressive episodes and several hypomanic episodes.  In addition, the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, states about 15 percent of individuals with this disorder continue to display mood lability and interpersonal or occupational difficulties.  While further bipolar symptoms were not reported, it is possible that she did not have an active depressive or hypomanic episode during the rest of her time in the Army.  It is also possible that her symptoms fit cyclothymic disorder (chronic mood disorder); however, details provided in the records regarding the history of her symptoms were insufficient to make a definitive judgment.  A medical evaluation board may have been indicated prior to her discharge.

14.  On 25 August 2013, the applicant submitted a rebuttal wherein she stated:

	a.  She feels that several conditions of her chapter action were not met as she did not demonstrate deeply-ingrained, maladaptive behaviors of long durations.  Her therapist stated she had made improvements on her condition, proving it neither maladaptive nor ingrained.  Also, per Army Regulation 635-200, paragraph 5-13, the maladaptive behavior did not interfere with her ability to perform her duties and the disorder was not so severe as to impair her ability to function effectively in the military environment.  Lastly, under this same chapter, she was not given ample time to overcome these deficiencies as her official counseling concerning correction of her deficiencies were only 2 weeks apart.

	b.  Four months into her deployment, she referred herself to the Behavioral Health Clinic in response to harassment from her immediate supervisor (SGT C____).  As later stated in her records review, when she refused to go to an appointment with her SGT, it was the same SGT who was the reason for her mental health visits and the object of her equal opportunity complaint whom they had assigned to take her to the appointment.

	c.  Her reported "hypomanic episodes" were not her optionally staying up for days on end.  She was first performing 12-hour night shifts and then 24-hour shifts with 24 hours afterward as secondary shift responding to any calls that arose when the primary shift was already on call.  Her staying up for days was a response to her schedule and a complaint of being awake, not of deliberately staying awake out of psychological distress.  Besides charge-of-quarters duties and her shifts in Iraq, she had no hypomanic or depressive episodes or indeed any mental health concerns since her redeployment in 2008.

	d.  Her self-mutilating behaviors that are mentioned in the recommendation refer to only one incident of cutting and several piercing behaviors as she had several body piercings and tattoos at the time.  The psychologist whom she was seeing for her therapy at the time stated that tattoos and piercings are a form of self-mutilation.

	e.  As shown on her Enlisted Record Brief, she has never been punished under the UCMJ and she was never facing UCMJ action to her knowledge.  She was counseled and made to teach a class on the Army value of "Integrity" for misleading a superior by the way she worded a statement.  However, the reported "video" (as reported by SGT C____, the SGT whom she had filed an equal opportunity complaint against) was nothing more than a rumor and was never found which is why she was never punished under the UCMJ.

	f.  As part of her attempt to prevent her discharge from the Army, she went to JAG.  Her discharge was stayed as her packet was legally insufficient.  She was not properly counseled on her deficiencies nor was she given adequate time to rehabilitate herself.  She was then counseled on 23 June and 8 July.  She was informed of her inability to access government computers and her inability to carry a weapon.  She was given no plan of action nor was she given more than 2 weeks to correct her deficiencies.  As the members of her chain of command were the only ones who could restore these privileges to her, she had no way to correct these issues except by seeking mental health treatment which could have given no recommendation one way or the other as to her ability to perform her duties in such a short time.

	g.  As stated on several occasions in the recommendation from OTSG, much about her mental health appointments and the reasoning behind her diagnoses is undocumented.  She has no documented periods of emotional lability except as a result of medications, nor is there a report of long periods of depression or hypomanic episodes other than two incidents that were a result of her duty schedule.  There are no reported obsessive-compulsive behaviors except possibly those of self-harm.  During her visits to the VA mental health clinic they had full access to her military records and, as such, had access to her mental health history as well as her current mental status.  The VA found her fit for duty as reflected in the letters previously submitted with her request for the clearance of her DD Form 214.  It is also reflected in her separation physical that she was psychologically normal with no personality deviations.

	h.  She has had no mental health concerns prior to or since her deployment in which a significant number of psychosocial stressors were present.  Bipolar II diagnostic criteria consist of one or more hypomanic as well as depressive episodes with no manic episodes or mixed episodes.  These symptoms would have to cause significant distress or impairment in social or occupational areas.  She was awarded an Army Achievement Medal for her outstanding contribution to her unit's mission while in Iraq.  At no point in time was she removed from duty until she was sent home for evaluation for the recommendation for her separation from the Army.  She was also a student at Pierce College pursuing an associate's degree with above satisfactory grades in addition to numerous military educational courses to better her military education.

	i.  She feels she was wrongfully separated as she was denied any reevaluation, sufficient time to rehabilitate any deficiencies with a clear understanding of how she would do so, or a review of her proceedings from a medical board.  She was deemed to be fit for duty both by her separation physical and by a mental health professional from the VA.  She faced a significant number of psychosocial stressors in addition to her deployment and still maintained satisfactory performance in all of her duties.  As she has been found to not have personality disorder, she feels it is in the interest of justice that personality disorder and any resulting separation code or reentry code should be removed from her DD Form 214.

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

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

DISCUSSION AND CONCLUSIONS:

1.  The applicant underwent a mental status evaluation that led to a diagnosis of a personality disorder.  Accordingly, her chain of command initiated separation action against her and she was discharged.  

2.  The evidence of record contains at least one mental status evaluation completed on the applicant that confirmed a diagnosis of personality disorder not amounting to a disability was made by proper medical authority.  

3.  Nevertheless, a thorough review of the applicant's case was conducted by OTSG.  The OTSG official opined that the available records did not clearly support the diagnosis of a personality disorder.  In view of the foregoing, and in response to her specific request and as a matter of equity, the applicant's narrative reason for her separation should be changed to "Secretarial Authority" with the corresponding separation code.

BOARD VOTE:

___X_____  __X______  __X__  GRANT FULL RELIEF 

________  ________  ________  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

________  ________  ________  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

The Board determined the evidence presented is sufficient to warrant a recommendation for 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 30 September 2008 and issuing her a new DD Form 214 to show she was discharged with an honorable character of service by reason of Secretarial Authority with an SPD code of "JFF" and an RE code of "1."



      __________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)                                         AR20130010373



3


ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

 RECORD OF PROCEEDINGS


1

ABCMR Record of Proceedings (cont)                                         AR20130010373



2


ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

 RECORD OF PROCEEDINGS


1