RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBERS:  02-02624
		INDEX 108.02  108.04
	 	COUNSEL:  None

	 	HEARING DESIRED:  No

_________________________________________________________________

APPLICANT REQUESTS THAT:

His existed-prior-to-service (EPTS) condition be changed to a compensable discharge that was service aggravated/connected.

_________________________________________________________________

APPLICANT CONTENDS THAT:

His disability did not exist prior to service. He provides a statement from a civilian doctor who asserts that at no time prior to Aug 01 did the applicant exhibit signs or symptoms of schizophrenia, depression, psychosis or other mental illness. 

The applicant’s complete submission, with attachments, is at Exhibit A.

_________________________________________________________________

STATEMENT OF FACTS:

The applicant, an AFROTC cadet, underwent a commissioning physical on 11 Aug 99 and was found fit. He entered active duty on 14 Jun 01 and was assigned to Vandenberg AFB, CA as a student in the missile program.

A Vandenberg AFB mental health clinic entry, dated 31 Aug 01, indicates the applicant was referred by his supervisor for administrative concerns. The applicant had failed several exams and reported difficulty handling the “physical stress” and keeping up in class. Follow-up visits occurred on 4 and 6 Sep 01 and indicate he was experiencing depression, anxiety, agitation, confusion, isolation, obsessive rumination and fatigue. Diagnosis on 6 Sep 01 was schizotypal personality disorder.

On 25 Sep 01, he was eliminated from training for failure to meet course standards.

A 30 Nov 01 medical entry reflects the applicant’s section commander accompanied him as an emergency walk-in because of perceptual problems, including visual and auditory hallucinations. He was admitted to the hospital on 1 Dec 01. Diagnosis on 6 Sep 01 was schizotypal personality disorder.

A Medical Evaluation Board (MEB) summary dated 19 Dec 01 provides additional details and diagnosed the applicant as having a psychotic disorder, not otherwise specified (NOS). Prognosis was guarded. The applicant was released on 21 Dec 01 and placed on convalescent leave. 

An MEB convened on 3 Jan 02 and subsequently referred the case to a Physical Evaluation Board (PEB) for psychotic disorder. A history of substance abuse was noted. On 22 Jan 02, the applicant’s commander recommended separation. 

An Informal Physical Evaluation Board (IPEB) convened on 27 Mar 02. The IPEB determined his psychotic disorder, NOS, to be unfitting, EPTS and not service aggravated. The board recommended discharge.  The applicant disagreed and requested that a Formal PEB (FPEB) adjudicate his case. 

On 2 May 02, the FPEB agreed with the IPEB’s findings (psychotic disorder, NOS, EPTS, history of substance abuse) and recommendation. The applicant did not concur and elected to submit a written rebuttal to the Secretary of the Air Force Personnel Council (SAF/MRBP). 

On 11 Jun 02, SAF/MRBP advised HQ AFPC/DPPDS that the applicant should be discharged under other than Chapter 61, title 10, USC, as his condition was found not in the line of duty and EPTS without service aggravation.

The applicant was honorably discharged in the grade of 2nd lieutenant for disability, EPTS, on 9 Jul 02 with 1 year and 26 days of active service.

_________________________________________________________________

AIR FORCE EVALUATION:

The AFBCMR Medical Consultant provides a lengthy discussion of the case. He notes that when the onset of manifestations of a chronic disease is so soon after entering active duty that the disease could not have originated in so short a period of time (within 180 days of entering service), it is presumed to have EPTS. It is apparent that the applicant’s condition became considerably worse while on active duty. The stress of entering military service no doubt played a significant role. Other stresses would have produced the same result and it could be argued that this was the natural progression of his condition that was coincident with service. Whether any aggravation that occurred was permanent or not cannot be determined from the available information. The preponderance of the evidence leads the Consultant to conclude that the applicant had preexisting conditions that largely contributed to his psychosis. The stress of military service was the “straw that broke the camel’s back” in what appears to be a more chronic condition consistent with the natural course of evolving schizophrenia. To the extent that this is a chronic illness and that it did manifest while on active duty, aggravation, possibly permanent, can be proposed and the benefit of the doubt can go to the applicant in this regard. The Consultant recommends the records be changed to EPTS with service aggravation with severance pay at 10% after subtracting for EPTS factors and natural progression.

A complete copy of the evaluation is at Exhibit C.

HQ AFPC/DPPD also discusses the case at length. The IPEB again reviewed the file and noted that the pre-existence of the applicant’s mental health condition was not in question but rather whether or not the condition was aggravated by his military service and, if so, whether that aggravation was permanent. The IPEB opined that the applicant’s manifestation was a natural progression of his pre-existing condition and would have occurred regardless of his military status. Further, permanent aggravation was doubtful. The IPEB’s position was that the manifestation of the applicant’s psychotic disorder was an unavoidable consequence of being placed in a somewhat stressful position, regardless of whether it was a military or civilian setting. The board believed his condition could be treated for a fully functional life in the civilian environment. DPPD’s consensus is that the applicant’s psychotic disorder was a condition which existed prior to his entrance into service and that it was not aggravated due to his military service. Denial is recommended.

A complete copy of the evaluation is at Exhibit D.

_________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Complete copies of the Air Force evaluations were forwarded to the applicant on 22 Nov 02 for review and comment within 30 days.  As of this date, this office has received no response. 

_________________________________________________________________

THE BOARD CONCLUDES THAT:

1.	The applicant has exhausted all remedies provided by existing law or regulations.

2.	The application was timely filed.

3.	Sufficient relevant evidence has been presented to demonstrate the existence of error or injustice to warrant partial relief. After carefully reviewing the available evidence and the conflicting Air Force recommendations, we are persuaded that the AFBCMR Medical Consultant makes the more compelling argument.  In this regard, the applicant appears to have had preexisting conditions that largely contributed to his psychosis. The onset of initial symptoms within two months of entry into active duty, the reported history of hallucinogen use prior to service and the nature of the psychosis appear to indicate that drug use and personality disorder were the overwhelming causation of his problems. His condition became considerably worse while on active duty. Other stresses would have produced the same result and it could be argued that this was the natural progression of his condition that was coincident with military service. However, we agree with the AFBCMR Medical Consultant’s opinion that the stress of military service may have been the “straw that broke the camel’s back” in what appears to be a more chronic condition consistent with the natural course of evolving schizophrenia. As a chronic illness that manifested itself while on active duty, possibly permanent aggravation can be proposed and the benefit of the doubt should go to the applicant in this respect. We therefore recommend the applicant’s records be changed to reflect that the EPTS condition was service aggravated and he be separated with severance pay at 10% with the appropriate Separation Program Designator (SPD) and reenlistment eligibility (RE) codes.  

_________________________________________________________________

THE BOARD RECOMMENDS THAT:

The pertinent military records of the Department of the Air Force relating to APPLICANT, be corrected to show that:

	a.  On 8 July 2002, he was found unfit to perform the duties of his office, rank, grade or rating by reason of psychotic disorder, disability rating 10%, VASRD Code 9210; that the degree of impairment may be permanent; that the EPTS condition was service aggravated; that the disability was not due to intentional misconduct or willful neglect; that the disability was not incurred during a period of unauthorized absence; and the disability was not received in the line of duty as a direct result of armed conflict or caused by an instrumentality of war. 

	b.  On 9 July 2002, he was honorably discharged under the provisions of AFI 36-3212 and Title 10, USC, Section 1203, Disability, Entitled to Disability Severance Pay with a 10% disability rating, and was issued a Separation Program Designator code of “JFL” rather than “JFM,” and a reenlistment eligibility code of “2Q.” 

_________________________________________________________________

The following members of the Board considered this application in Executive Session on 20 February 2003, under the provisions of AFI 36-2603:

	         

All members voted to correct the records, as recommended. The following documentary evidence relating to AFBCMR Docket Number 02-02624 was considered:

   Exhibit A.  DD Form 149, dated 12 Aug 01, w/atchs.
   Exhibit B.  Applicant's Master Personnel Records.
   Exhibit C.  Letter, AFBCMR Medical Consultant, dated 7 Oct 02.
   Exhibit D.  Letter, HQ AFPC/DPPD, dated 18 Nov 02.
   Exhibit E.  Letter, SAF/MRBR, dated 22 Nov 02.

                                   

AFBCMR 02-02624

MEMORANDUM FOR THE CHIEF OF STAFF

	Having received and considered the recommendation of the Air Force Board for Correction of Military Records and under the authority of Section 1552, Title 10, United States Code (70A Stat 116), it is directed that:

	The pertinent military records of the Department of the Air Force relating to    , be corrected to show that:

	a.  On 8 July 2002, he was found unfit to perform the duties of his office, rank, grade or rating by reason of psychotic disorder, disability rating 10%, VASRD Code 9210; that the degree of impairment may be permanent; that the EPTS condition was service aggravated; that the disability was not due to intentional misconduct or willful neglect; that the disability was not incurred during a period of unauthorized absence; and the disability was not received in the line of duty as a direct result of armed conflict or caused by an instrumentality of war. 

	b.  On 9 July 2002, he was honorably discharged under the provisions of AFI 36-3212 and Title 10, USC, Section 1203, Disability, Entitled to Disability Severance Pay with a 10% disability rating, and was issued a Separation Program Designator code of “JFL” rather than “JFM,” and a reenlistment eligibility code of “2Q.”