RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2002-03817
		INDEX CODE:  110.00

		COUNSEL:  NONE

		HEARING DESIRED:  NO

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APPLICANT REQUESTS THAT:

His Reenlistment Eligibility (RE) code be changed.

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APPLICANT CONTENDS THAT:

His discharge was based on having bipolar disorder.  A physician with the Department of Veterans Affairs (DVA) in Tennessee overturned this diagnosis.

In support of his appeal, the applicant provided a letter of recommendation, dated 1 August 2001, VA Rating Decision, dated 16 August 2002, and a copy his Certificate of Release or Discharge from Active Duty (DD Form 214).

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

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STATEMENT OF FACTS:

Applicant enlisted in the Regular Air Force on 3 February 1999 in the grade of airman basic for a period of six years.

Medical records reveal the following:

On 25 April 2001, the applicant was hospitalized following a suicide attempt.  He was diagnosed with bipolar disorder, depressed, unspecified degree, prolonged post-traumatic stress disorder, poisoning by other specified analgesics and antipyretics.

On 10 July 2001 the applicant was seen by a Medical Evaluation Board (MEB) and was diagnosed with bipolar disorder as manifested by unstable mood, periods of highs and lows, predominantly depressed mood, suicidal attempt, insomnia, loss of interest, or pleasure, withdrawal, easily annoyed, irritable, hopeless and helpless, no energy, lacks confidence or motivation, difficulty thinking, and poor concentration.  They recommended his case be referred to the Informal Physical Evaluation Board (IPEB).

The Findings and Recommended Disposition of the IPEB dated 13 August 2001 found the applicant unfit for duty and recommended he be discharged with severance pay with a 10% disability rating based on the following:

	Category I - Unfitting Conditions that are compensable and ratable:  bipolar disorder associated with post-traumatic stress disorder.  Definite social and industrial adaptability impairment.  His disability was rated at 10% (current rating 30%, less contributing/aggravating factors 20%, compensable disability rating 10%).

	Category II - Conditions that can be unfitting but are not currently compensable or ratable:  Migraine Headaches.

	Category III - Conditions that are not separately unfitting and not compensable or ratable:  Personality Traits not otherwise specified.

The IPEB further indicated that the applicant’s interrelated mental health conditions prevented him from performing duties commensurate with his office, grade, rank, or rating.  The IPEB noted the applicant’s definite social and industrial adaptability impairment rating; however, it also noted his personality traits and pre-disposition evident from early childhood.  The IPEB opined these two factors, which were non-ratable/non-compensable under disability law/policy, significantly affected the severity of the applicant’s mental health condition.  Were it not for those factors, the applicant’s social and industrial adaptability impairment rating would best be described as mild in accordance with (IAW) Department of Defense (DOD) and VASRD guidelines.

On 27 August 2001, the applicant signed an AF Form 1180 (Action on Physical Evaluation Board Findings and Recommended Disposition) indicating that he agreed with the findings and recommended disposition of the IPEB and understood he was waiving the right to a formal PEB hearing.

On 30 August 2001 the Secretary of the Air Force determined that the applicant was physically unfit for continued military service and directed a disability discharge under the provisions of 10 USC 1203.

The applicant’s performance rating for the period 3 February 1999 through 2 October 2000 reflected a rating of 5.

On 22 October 2001 the applicant was honorably discharged in the grade of senior airman, under the provisions of AFI 36-3208 (Disability, Severance Pay).  He served a total of 2 years, 8 months, and 20 days of total active service.  The applicant received an RE code of 2Q - Personnel medically retired or discharged.

The applicant provided a DVA Rating Decision, dated 16 August 2002, awarding 50% for Post-Traumatic Stress Disorder effective 23 October 2001 and reducing the rating to 10 percent effective 8 April 2002 after completion of a formal mental health evaluation.

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AIR FORCE EVALUATION:

The AFBCMR Chief Medical Consultant recommended denial.  He indicated that the applicant was disability discharged due to mental illness diagnosed as Bipolar Disorder and Post Traumatic Stress Disorder PTSD (caused by significant childhood trauma).  His significant history of childhood abuse and the presence of maladaptive personality traits (thought to be of sufficient severity to have warranted a diagnosis of personality disorder by the inpatient psychiatrists) were significant contributing factors to the severity of his condition.  Following discharge, his diagnosis of PTSD was confirmed by DVA mental health evaluation but apparently the Bipolar Disorder Diagnosis was not maintained.  The applicant’s psychiatric history while on active duty is clearly disqualifying for continued service and disqualifying for reentry even if his symptoms have improved and his current diagnosis is only the PTSD.  Bipolar Disorder is a chronic illness characterized by recurrent symptoms over many years.  PTSD likewise is a chronic disorder in many.

PTSD is a very complex syndrome resulting from psychological trauma resulting in significant somatic, cognitive, affective, and behavioral effects.  PTSD is characterized by intrusive thoughts, nightmares, flashbacks of traumatic events, and avoidance of reminders of trauma, hypervigilence, and sleep disturbance.  These symptoms lead to considerable social, occupational and interpersonal dysfunction.  Previous trauma increases the risk for developing PTSD with subsequent traumatic events.  Psychiatric co-morbidity is high, especially depression, anxiety disorder, and substance abuse.  Substance abuse is often due to the patient’s attempts to self medicate symptoms.  Diagnosis is difficult as a result of the heterogeneity of presentation and reluctance of affected individuals to discuss the traumatic events.  PTSD is a chronic condition, only a third recover after one year, and one-third are still symptomatic after ten years.  Individuals with one or more PTSD symptoms are more likely to experience marital difficulties and occupational problems.  Treatment is complex, individualized, and often, long term requiring psychotherapy and medications.  Action and disposition in this case are proper and equitable reflecting compliance with Air Force directives that implement the law.

The evaluation is at Exhibit C.

AFPC/DPPD recommended denial.  They indicated that the disability processing records indicate an MEB was initiated at McGuire AFB, New Jersey on 11 July 2001, and the results referred to the IPEB.  The Board found his medical condition for Bipolar Disorder as unfitting for continued military service and recommended he be discharged with severance pay with a 10 percent disability rating.  His migraine headaches were also addressed at this time; however, they were not considered unfitting at the time of the MEB.  The service member agreed with the Board’s findings, and officials within the Office of the Secretary of the Air Force directed he be discharged with entitlement to severance pay with a 10 percent disability rating under the provisions of Title 10, USC, Section 1203.

Having reviewed the BCMR Medical Consultant’s assessment, they conclude the applicant was treated fairly throughout the Air Force Disability Evaluation System (DES), that he was afforded the opportunity for further review in which he elected not to do so, and that he was properly rated under current Federal disability laws and policy.  To change the RE code would appear to be counter productive towards the disability process already finalized, and possibly allow an unfit member to reenlist after he was already found unacceptable for the rigors of military service.  The BCMR Medical Consultant explicitly explains the medical aspects of this case; they wholeheartedly concur with his comments and recommendation.  The applicant has not provided sufficient documentation to indicate an injustice occurred at the time of his process through the Air Force DES.

The evaluation is at Exhibit D.

AFPC/DPPAE recommended denial.  They indicated that the RE code the applicant received 2Q is correct.

The evaluation is at Exhibit E.

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

On 3 July 2003, copies of the Air Force evaluations were forwarded to the applicant for review and response within 30 days.  As of this date, no response has been received by this office.

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THE BOARD CONCLUDES THAT:

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

2.	The application was timely filed.

3.	Insufficient relevant evidence has been presented to demonstrate the existence of an error or injustice that would warrant a change to his RE code.  After a thorough review of the evidence of record and the applicant’s submission, it is our opinion that given the circumstances surrounding his separation from the Air Force, the RE code assigned was proper and in compliance with the appropriate directives.  The applicant has not provided any evidence which would lead us to believe otherwise.  The BCMR Medical Consultant indicates that following the applicant’s discharge his diagnosis of PTSD was confirmed by DVA mental health evaluation but apparently the Bipolar Disorder Diagnosis was not maintained.  As the Medical Consultant states, the applicant’s psychiatric history while on active duty was clearly disqualifying for continued service and disqualifying for reentry even if his symptoms improved and the current diagnosis is only the PTSD.  We note that Bipolar Disorder and PTSD are chronic illnesses characterized by recurrent symptoms over many years.  Therefore, we agree with the Air Force offices of primary responsibility and adopt their rational as the basis for our conclusion that he has not been the victim of an error or injustice.  In the absence of persuasive evidence to the contrary, we find no compelling basis to recommend granting the relief sought.

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THE BOARD DETERMINES THAT:

The applicant be notified that the evidence presented did not demonstrate the existence of an error or injustice; that the application was denied without a personal appearance; and that the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application.

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The following members of the Board considered this application in Executive Session on 14 August 2003, under the provisions of AFI 36-2603:

The following documentary evidence pertaining to AFBCMR Docket Number BC-2003-03817 was considered:

   Exhibit A.  DD Form 149, dated 26 November 2002, w/atchs.
   Exhibit B.  Applicant's Master Personnel Records.
   Exhibit C.  Letter, BCMR Medical Consultant,
		       dated 17 March 2003.
   Exhibit D.  Letter, AFPC/DPPD, dated 2 May 2003.
   Exhibit E.  Letter, AFPC/DPPAE, dated 27 June 2003.
   Exhibit F.  Letter, SAF/MRBR, dated 3 July 2003.