IN THE CASE OF:	  

		BOARD DATE:	    23 July 2013

		DOCKET NUMBER:  AR20130011779 


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 his earlier request for correction of his DD Form 214 (Certificate of Release or Discharge from Active Duty) to show a different Separation Code and Reentry (RE) Code
* an evaluation to determine if he has a personality disorder, and if not, to have it removed from the official record
* a personal appearance before the Board 

2.  The applicant states he has discharged for Personality Disorder – Not Otherwise Specified (NOS).  However, he has since been reevaluated by the Department of Veterans Affairs and his records were also reviewed by the Office of the Surgeon General (OTSG).  He believes he was not given a proper medical screening and due to the findings of both the VA and the OTSG, he does not have a personality disorder.  He has applied several times but was denied.  The OTSG opines that he was symptomatic for post-traumatic tress disorder (PTSD) but not to the level that would have required a medical discharge.  Either he had PTSD but not to the level that required a medical discharge and therefore his discharge was in error or he did have PTSD to the level that required a discharge and he should have been given an appropriate medical discharge and a disability rating.  He also states that he wants the proper medical evaluation and the opportunity to appear before this Board to state his case.  

3.  The applicant provides his DD Form 214 (Certificate of Release or Discharge from Active Duty) and his 2011/2012 VA Psychological Evaluation.
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 AR20100021635 on 14 April 2011 and AR20110014895, dated 14 February 2012. 

2.  The applicant does not qualify for reconsideration of his request that pertains specifically to the Separation Code and the RE Code since his request has already been considered.  

3.  In view of the May 2012 letter from the Deputy Assistant Secretary of the Army (Military Personnel) to Soldiers who were discharged under the provisions of paragraph 5-13 of Army Regulation 635-200 by reason of personality disorder, the applicant's request warrants consideration by the Board.

4.  The applicant's record shows he enlisted in the Regular Army on 6 November 2003 and he held military occupational specialty 11B (Infantryman).  He served in Iraq from 15 September 2004 to 15 September 2005.  

5.  He reenlisted on 22 May 2006 and he was assigned to the 1st Battalion, 5th Infantry Regiment, Fort Lewis, WA.  

6.  On 19 June 2006, he underwent a mental status evaluation at the Behavioral Health Clinic, Madigan Army Medical Center, Fort Lewis, WA.  His Report of Mental Status Evaluation shows:

	a.  He was initially evaluated on 26 February 2006 and admitted to the psychiatric ward in early February 2006 for concerns about continued maladaptive thoughts and behaviors and suitability for continued military service. His evaluation revealed he was not suitable for continued service due to ongoing emotional disturbances with underlying maladaptive personality traits and associated maladaptive thoughts and behavior.  It is likely the current level of increased emotional distress is primarily arising from maladaptive coping and personality traits suggestive of personality disorder, with some residual effects of recent combat deployment as a secondary factor.  

	b.  The traits identified likely developed during childhood and usually indicate such individuals would continue to have difficulty managing stressful events unless they learn and implement new, more constructive coping skills.  In most cases, learning and implementing new coping skills is difficult for such individuals and will likely be difficult for the applicant.  The emotional instability and personality disturbances is at a level that is currently impairing his occupational functioning capacity and will not likely change significantly as long as he remains in the military, and is likely to worsen on a future deployment.  

	c.  His psychiatric condition does not rise to the level of a medical board and, therefore, it is recommended he be administratively separated under the provisions of paragraph 5-13.  He currently reports passive suicidal ideation (he denies intent or plans presently) and denies homicidal ideation which means he is low risk at the present time.  However, some precaution is still recommended.  His emotional and personality disturbances would not likely respond to command rehabilitative efforts such as a transfer, disciplinary action, or reclassification or to any treatment methods currently available in the military mental health system. His diagnosis was as follow:

* Axis I: Adjustment Disorder with Mixed Emotional Features
* Axis II: Personality Disorder – Not Otherwise Specified (NOS)

7.  On 8 August 2006, the applicant's immediate commander notified the applicant of his intent to initiate separation action against him under the provisions of paragraph 5-13, Army Regulation 635-200 (Personnel Separations) because of an adjustment disorder with mixed emotional features and a personality disorder.   

8.  On 9 August 2006, the applicant acknowledged receipt of the notification of separation action and he consulted with legal counsel and was advised of the basis for the contemplated separation and of the rights available to him in connection with the action.  Subsequent to receiving legal counsel, the applicant elected not to submit statements in his own behalf. 

9.  Subsequent to this acknowledgement, the immediate commander initiated separation action against the applicant under the provisions of Army Regulation 635-200, paragraph 5-13, by reason of personality disorder.  His intermediate commander recommended approval. 

10.  On 29 September 2006, the separation authority approved the applicant's separation under the provisions of paragraph 5-13, Army Regulation 635-200, by reason of personality disorder and directed the applicant be issued an honorable characterization of service.  On 19 October 2006, the applicant was discharged accordingly.  

11.  His DD Form 214 shows he was discharged under the provisions of paragraph 5-13 of Army Regulation 635-200 with an honorable character of service.  He completed 2 years, 11 months, and 14 days of active service.  He was assigned Separation Code "JFX" and an RE-3. 
12.  In connection with the processing of this case, an advisory opinion was obtained on 17 April 2013 from the Office of The Surgeon General (OTSG), Director of Health Care Delivery.  The OTSG official states conclusions for this advisory opinion are drawn solely based on available documentation from his time in active service unless otherwise noted.  The OTSG official stated:

	a.  The applicant has requested an evaluation to determine if he has a personality disorder, and if not, to have it removed from the official record of his discharge and his RE Code changed.  He presented for consideration a psychological evaluation performed by the VA in February and March 2011, approximately 4 years post discharge.  

	b.  He returned from deployment to Iraq in September 2005 after completing a tour of approximately one year.  During his deployment he reported experiencing traumatic events to include losing unit members and being involved in an improvised explosive device detonation.  On his post-deployment questionnaires, from September 2005 through January 2006, he endorsed increasing symptoms related to PTSD and depressive symptoms.  

	c.  In January 2006, he pursued civilian mental health care because he did not feel comfortable with military providers.  He presented with significant anxiety and depressive symptoms as well as significant irritability and anger.  Between January and October when he was discharged, he received treatment from military providers and a civilian provider (the civilian treatment notes were not available for review).  Treatment included a brief psychiatric inpatient hospitalization for anger and thoughts of harm to self and others with discharge 2 February 2006, psychotropic medication, a series of four post-deployment anger management groups, and individual sessions.  Various diagnoses included Adjustment Disorder with Disturbance of Emotions and Conduct, Adjustment Disorder with Mixed Emotional Features, Anxiety Disorder - NOS, and later, Personality Disorder (presumed to be NOS).  The diagnosis of Anxiety Disorder NOS was given during his hospitalization, and maintained by the treating psychologist through his 20 March visit, after which it was dropped without explanation.  The treating psychiatrist maintained adjustment disorder diagnoses. At his final mental health visit in October 2006, his diagnosis was Adjustment Disorder with Mixed Emotional Features and Personality Disorder (presumably NOS), and he was given refills for Quetiapine (Seroquel) and Fluoxetine (Prozac). 

	d.  The diagnosis of personality disorder first appears in June 2006. Psychological testing at the time supported a personality disorder diagnosis with a picture of mixed problematic personality traits.  The 19 June 2006 DA Form 3822-R (Report of Mental Status Examination) stated the diagnostic impression of Adjustment Disorder with Mixed Emotional Features and Personality Disorder NOS.  His mood and affect were noted as anxious and depressed, and it stated the personality traits likely developed in childhood, and that the psychiatric condition does not rise to the level of a Medical Board.  The challenge with the personality disorder diagnosis is it is not clear in the record that significant problems were pervasive and enduring.  While it is noted his anger, irritability, and challenges controlling his emotions were apparent in adolescence, it is not noted whether there were any negative impacts to his functioning and if his challenges were outside the norm of adolescent development.  It is clear his emotional difficulties increased after a difficult deployment.  It appears his passive suicidal ideations and thoughts of harm to others when angry or frustrated occurred after his deployment.  It is also during this period he cut, scratched and burned himself periodically.  One note indicates scratching himself was something he described as a compulsion he has experienced on a frequent basis in the past that had mostly been replaced by punching walls.  The time frame of "in the past" is unclear.  Further, other than one note describing [Applicant] as a loner, there is no assessment of his functioning across situations.  The record does not clearly support a diagnosis of personality disorder.  What is clear is that he was unhappy with the military and was not making significant progress with therapy and medication.

	e.  The record does not show an assessment specific to PTSD beyond the health assessment screenings.   He was seen in the Soldier Wellness Assessment Pilot Project (SWAPP), and it is reasonable to assume an evaluation for PTSD at that time given the note refers to PTSD symptoms of minor concern. Given that result, it appears he did not meet the full criteria for PTSD at that time.  An evaluation later in his treatment would have been helpful.  Taking all available information, it appears he met all the criteria for PTSD except for the persistent re-experiencing of an event given his report of nightmares, frequency and content is inconsistent over time.  While he had significant PTSD symptoms, they were likely sub-threshold for the diagnosis and Anxiety Disorder NOS would have been the better diagnosis at that time.  Given his anxiety and depressive symptoms were intractable and exacerbated by military service, with Anxiety Disorder NOS he would have been referred for a Medical Evaluation Board in accordance with Army Regulation 40-501 (Standards of Medical Fitness) for determination of fitness status at the time of his separation.

13.  After a copy of this advisory opinion was provided to the applicant in order to have the opportunity to respond to or rebut its contents.  On 24 June 2013, the applicant resubmitted his application together with the letter from the Deputy Assistant Secretary of the Army (Military Personnel) and his VA psychological report to the Board.

14.  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. 

15.  Army Regulation 601-210 (Regular Army and Army Reserve Enlistment Program) covers eligibility criteria, policies, and procedures for enlistment and processing into the Regular Army and the U.S. Army Reserve.  Chapter 3 of that regulation prescribes basic eligibility for prior-service applicants for enlistment.  That chapter includes a list of Armed Forces RE codes including Regular Army RE codes.  

* An RE-1 applied to persons who completed an initial term of active service who were fully qualified for enlistment when separated
* An RE-3 applied to persons who were not qualified for reentry or continuous service at the time of separation, but the disqualification was waivable

16.  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 SPD code of "JFX" is the correct code for Soldiers separating under paragraph 5-13 of Army Regulation 635-200 by reason of a personality disorder.

17.  The SPD/RE Code Cross Reference Table provides instructions for determining the RE code for Active Army Soldiers and Reserve Component Soldiers.  The SPD/RE Cross Reference Table in effect at the time of the applicant's separation established an RE code of 3 as the proper RE code to assign Soldiers separated with an SPD code of "JFX."  

18.  Army Regulation 15-185 (ABCMR) states ABCMR members will review all applications that are properly before them to determine the existence of an error or injustice; direct or recommend changes in military records to correct the error or injustice, if persuaded that material error or injustice exists and that sufficient evidence exists on the record; recommend a hearing when appropriate in the interest of justice; or deny applications when the alleged error or injustice is not adequately supported by the evidence and when a hearing is not deemed proper. The ABCMR will decide cases on the evidence of record.  It is not an investigative body. The ABCMR may, in its discretion, hold a hearing.  Applicants do not have a right to a hearing before the ABCMR.  The Director or the ABCMR may grant a formal hearing whenever justice requires. 

DISCUSSION AND CONCLUSIONS:

1.  The applicant's raises three issues:  reconsider his earlier request to change his Separation Code and RE Code, an evaluation to determine if he has a personality disorder, and if not, to have it removed from the official record of his discharge and his RE Code changed, and a personal hearing.  As a related issue, the intent of the May 2012 letter from the Deputy Assistant secretary of the Army (Military Personnel) was to determine if PTSD was an underlying issue.

2.  The applicant underwent a mental status evaluation that resulted in a diagnosis of an adjustment disorder with mixed emotional features and a personality disorder.  Since his condition did not rise to the level of a medical board and was not amenable to hospitalization, his chain of command initiated administrative separation actions against him.  His separation processing was accomplished in accordance with the applicable regulation.  All requirements of law and regulation were met and the rights of the applicant were fully protected throughout the separation process. 

3.  With respect to the Separation and RE Codes:

	a.  His narrative reason was assigned based on the fact that he was discharged under the provisions of paragraph 5-13 of Army Regulation 635-200.  Absent the personality disorder, it appears there was no fundamental reason to process him for discharge.  The underlying reason for his discharge appears to be his personality disorder.  The only valid narrative reason for separation permitted under that paragraph is "Personality Disorder" and the appropriate SPD and RE codes associated with this discharge are JFX and RE-3, both of which are correctly listed on his DD Form 214. 

	b.  The ABCMR does not correct records solely for the purpose of establishing eligibility for other programs or benefits.  The applicant is advised that if he desires to reenter military service, he should contact a local recruiter who can best advise him on his eligibility for returning to military service.  Those individuals can best advise a former service member as to the needs of the service at the time and may process enlistment waivers for the applicant’s RE code.

4.  With respect to the personal hearing, the applicant's request for a personal appearance hearing was carefully considered.  However, by regulation, an applicant is not entitled to a hearing before the ABCMR.  Hearings may be authorized by a panel of the ABCMR or by the Director of the ABCMR.  In this case, the evidence of record and independent evidence provided by the applicant is sufficient to render a fair and equitable decision at this time.  As a result, a personal appearance hearing is not necessary to serve the interest of equity and justice in this case.

5.  With respect to the PTSD issue, implied in the May 2012 letter from the Deputy Assistant Secretary of the Army (Military Personnel) but not raised by the applicant as an issue, 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 disability was made by proper medical authority.  The record is void of any clear indication that the applicant was suffering from an unfitting PTSD condition at the time of his discharge.  As confirmed by the OTSG advisory opinion, it is possible he may have developed PTSD at a later date, there is no evidence he met full criteria for PTSD at the time of his separation and that diagnosis is not recorded in his available record during his time of active service.  There is insufficient medical evidence to support an unfitting PTSD finding at the time of discharge.  

6.  As for his request for an evaluation to determine if his narrative reason for separation was appropriate, as the OTSG official opines, given the applicant's anxiety and depressive symptoms were intractable and exacerbated by military service, with Anxiety Disorder NOS he would have been referred for a Medical Evaluation Board in accordance with Army Regulation 40-501 for determination of fitness status at the time of his separation.  As a result, the applicant should be afforded the opportunity to be considered by a medical evaluation board for the purpose of determining his fitness, as recommended below. 

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF 

___X____  __X____  ___X____  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

________  ________  ________  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

1.  The Board determined that partial relief is warranted.

2.  With respect to the issue of an evaluation to determine if he has a personality disorder, and if not, to have it removed from the official record, the Board determined that the evidence presented was sufficient to warrant a recommendation for relief.  As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by:

* having OTSG contact the applicant and arrange a physical evaluation via appropriate medical facilities and, if appropriate, referral to a medical evaluation board (MEB)
* directing OTSG to issue appropriate invitational travel orders to the applicant to accomplish the physical evaluation and, if appropriate, the MEB
* directing OTSG to issue appropriate invitational travel orders to the applicant to prepare for and participate in consideration of his case by a formal PEB in the event that a physical evaluation board (PEB) becomes necessary

3.  With respect to the issue of reconsideration of his Separation and RE Codes, 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 decisions of the ABCMR set forth in Docket Number AR20100021635 on 14 April 2011 and AR20110014895, dated 14 February 2012.

4.  With respect to the issue of a personal appearance before the Board and the PTSD issue, the evidence presented does not demonstrate the existence of a probable error or injustice.  Therefore, the Board determined 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)                                         AR20130011779





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ABCMR Record of Proceedings (cont)                                         AR20130011779



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