ADDENDUM TO
RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF: 			DOCKET NUMBER: BC-2008-01653
						
COUNSEL:  NONE

						HEARING DESIRED:  NO 

APPLICANT REQUESTS THAT:

His honorable discharge be changed to a medical retirement. 

RESUME OF CASE:

On 30 Sep 08, the AFBCMR notified the applicant that his 8 Apr 08, application for correction of military records was going to be administratively closed based on unsuccessful attempts to obtain copies of his service medical records (SMR) and Department of Veterans Affairs (DVA) records.  

Subsequent to receipt of required documents and reopening of the applicant’s case, on 6 Oct 11, the Board considered and denied the applicant’s original request to change his honorable discharge to a medical discharge or a medical retirement.  In the original request the applicant contended he did not have a personality disorder when he enlisted in the military service.  He was made aware of his personality disorder while he was appealing his DVA claim.  The military was aware of his mental condition and did nothing about it prior to his discharge.  

The Board found insufficient evidence of error or injustice to warrant corrective action.  They considered his assertion that his numerous instances of misconduct and pattern of behavior may have been the result of undiagnosed Post Traumatic Stress Disorder (PTSD).  However, while the applicant had decades later been diagnosed with PTSD, given the history of exposure to at least one traumatic event, the evidence provided was insufficient to invalidate the accuracy of assessments by competent medical authorities who more than once assessed his pattern of behavior and did not find a medical condition qualifying for processing through the military Disability Evaluation System.  The Board acknowledged the DVA found it reasonable to establish a nexus between the applicant’s experience in Vietnam and a delayed diagnosis of PTSD, however, they did not consider this finding proof that PTSD existed at the time of his separation nor that it should have been the cause for career termination.  Therefore, in the absence of evidence to the contrary, they found no basis to recommend granting the relief sought by the applicant.  For an accounting of the facts and circumstances surrounding the applicant’s original request and rationale of the earlier decision by the Board, see the Original Case File with exhibits A through F at Exhibit G.

On 11 Oct 14, the applicant submitted a request for reconsideration for his honorable discharge to be changed to a medical retirement.  In support of his request for reconsideration, the applicant contends that he qualifies for a medical retirement.  In 1974 the Air Force diagnosed him with a personality disorder, and at the time of his discharge, his degree of impairment was 100 per cent.  Later, on 30 Nov 09, the DVA diagnosed his personality disorder as PTSD, related to his combat experiences during the Vietnam War.  In support of his contention he submitted a copy of an AF medical form listing his personality disorder, paranoid personality, and a copy of a 30 Nov 09, DVA Progress Notes, listing a 3 Dec 08 DVA diagnosis of  PTSD, which is related to his combat experiences in the Vietnam War (Exhibit H).  

The remaining relevant facts pertaining to this application are described in the original case file at Exhibit G, and the memorandum prepared by the AFBCMR Psychiatric Advisor, which is included at Exhibit I.

AIR FORCE EVALUATION:

The AFBCMR Psychiatric Advisor recommends denial indicating there is no evidence of an error or an injustice warranting the requested relief.  The applicant’s records reveal he had been an outstanding airman during his first enlistment between 1968 and 1972; and he did not start exhibiting problematic conduct until the second half of 1973.  His disciplinary infractions beginning Sep 73 include: possession of a deadly weapon, attempt to elude civil police, disorderly conduct, resisting arrest, possession of marijuana and drug equipment, disrespect of a superior officer, failure to report to place of duty, violent resistance to attempts of medical personnel to help him, absent without leave (AWOL), resisting arrest, attempted murder, and threatening to kill his commander, unit personnel, and himself.  

The pattern of behavior or more importantly its absence prior to 1973 discredits the previous diagnosis of personality disorder.  Per Diagnostic and Statistical Manual of Mental Disorders II (DSMII) Personality Disorders are defined as a “group of disorders characterized by deeply ingrained maladaptive patterns of behavior that are perceptibly different in quality from psychotic and neurotic symptoms.  Generally, these are life-long patterns, often recognizable by the time of adolescence or earlier.”  The current version of DSM has made some changes, but the core feature of personality disorders remain the same, deeply ingrained, life-long.  The Advisor opined the pattern does not apply in this case, as the applicant’s behaviors in 1973 and 1974 drastically contrasted his previous exemplary service record.  If he truly had a personality disorder it would have manifested itself considerably earlier.  The Advisor surmises the applicant did deploy to Vietnam between 1972 and 1973 and combat exposure could serve as a possible trigger; however, this does not automatically prove the applicant has suffered from PTSD at the time of discharge, or that PTSD could explain his misconduct.   

The Advisor, with thorough knowledge of PTSD, couldn’t attest that the applicant suffered from PTSD at the time of his discharge.  The Advisor opines that it appears his behaviors were erratic, aggressive and in some cases bizarre, more consistent with psychosis or drug abuse.  Records revealed three different psychiatrists only weeks to a month apart, could not fully agree on the diagnosis, but the three of them mentioned possible substance abuse as the underlying reason for the applicant’s presentation.  The Advisor supports the conclusions of the 1970s providers.  The applicant admitted to the use of marijuana and alcohol, but not any other drugs, which most likely had to do with the wider social acceptance of those substances in the armed forces during the Vietnam era.  The Advisor concludes that use of illegal substances would certainly explain many of the applicant’s behaviors.  

Even though the DVA has granted compensation for the applicant’s medical condition (PTSD), their diagnosis does not indicate his PTSD was present in 1974 or that it was unfitting, which is based upon the diagnostic distinction present at the “snap shot” time of the applicant’s release from military service.  There is not enough evidence to support the desired change to a medical retirement.  Instead, the Advisor recommends use of the Secretarial Authority by the Board to remove personality disorder as the reason for discharge.   

A complete copy of the AFBCMR Psychiatric Advisor evaluation is at Exhibit I.

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

The applicant refutes virtually every point made by the AFBCMR Psychiatric Advisor and argues that the evaluation is proof and evidence the Board erred in denying his original application and subsequent appeals.  In support of his response, he contends the AFBCMR Psychiatric Advisor’s evaluation continuously states “the applicant received an honorable discharge under the provision of AFM 39-12, due to a personality disorder.”  He provides copies of Air Force and DVA medical documents he contends prove his combat experiences in the Vietnam War resulted in his PTSD.  He alleges his unit commander and supervisor conspired with the base commander to discharge him to prevent him from being promoted to staff sergeant (E-6) and reenlisting.  Also, he mentions that the AFBCMR Psychiatric Advisor’s evaluation failed to say anything about his Purple Heart Medal that he should have received as a result of his unit coming under mortar attack during his tour in Vietnam.  

A complete copy of the applicant’s response to the Air Force evaluation is at Exhibit K.

Additionally, on behalf of the applicant, his brother responds to the AF Evaluation, refutes virtually every point made by the AFBCMR Psychiatric Advisor and contends Vietnam changed his brother.  He argues that the Air Force discharged his brother when he was totally unfit for active duty and incapable of employment in the real world.  He opines that the Air Force evaluation makes many speculations and opinions that are decades beyond the actual problems that occurred in the 1970s.  In support of his response, he offers his opinion as a firsthand witness of his brother’s behavior, mental status, and transition from mental stability to psychiatric instability.  

A complete copy of the applicant’s brother’s response to the Air Force Evaluation is at Exhibit L.  

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 warranting the applicant’s honorable discharge be changed to a medical retirement.  We took notice of the applicant’s complete submission in judging the merits of the case, to include the responses to the Air Force Evaluation; however, we agree with the opinion and recommendation of the AFBCMR Psychiatric Advisor and adopt the rationale expressed as the basis for our conclusion the applicant’s honorable discharge should not be changed to a medical retirement. Based upon a preponderance of medical evidence at or about the time of his release from military service we are not persuaded the applicant would have qualified for a medical retirement.  In his rebuttal, the applicant states the AFBCMR Psychiatric Advisor’s evaluation failed to address the Purple Heart (PH) medal he should have received because of his unit coming under mortar attack during his tour in Vietnam.  On 22 July and 26 August 2010, the applicant’s request for award of the PH was considered and denied in a separate AFBCMR application.  He did not request reconsideration for award of the PH in this current application.  Accordingly, the applicant’s request for a medical retirement is not favorably considered.  

4.  Notwithstanding our findings above, we believe sufficient evidence has been presented to warrant partial relief with respect to the applicant’s narrative reason for separation.  In this regard, we note the AFBCMR Psychiatric Advisor’s comments that per the Diagnostic and Statistical Manual of Mental Disorders II (DSMII), personality disorders are characterized by deeply ingrained maladaptive patterns of behavior that are perceptibly different in quality from psychotic and neurotic symptoms and   generally, these are life-long patterns, often recognizable by the time of adolescence or earlier.”  The evidence indicates the applicant was an outstanding airman during his first enlistment between 1968 and 1972; and did not start exhibiting problematic conduct until the second half of 1973.  We agree this pattern of behavior or more importantly, its absence prior to 1973 discredits the previous diagnosis of personality disorder.  As such, we believe the applicant's reason for discharge (personality disorder) is not representative of his behaviors at the time of his separation.  Therefore, we accept the AFBCMR Psychiatric Advisor assessment and recommend the applicant’s records be corrected to the extent indicated below.  

THE BOARD RECOMMENDS THAT:

The pertinent military records of the Department of the Air Force relating to the APPLICANT be corrected to show that on 27 November 1974, he was honorably discharged with a narrative reason for separation of “Secretarial Authority.”  

The following members of the Board considered AFBCMR Docket Number BC-2008-01653 in Executive Session on 19 May 16 under the provisions of AFI 36-2603:

All members voted to correct the records as recommended.  The following documentary evidence pertaining to AFBCMR Docket Number BC-2008-01653 was considered:
:

	Exhibit G.  Original Case file, dated 9 Jan 12.
	Exhibit H.  RECON DD Form 149, dated 11 Oct 14, w/atchs.
	Exhibit I.  Memorandum, AFBCMR Psychiatric Advisor,
			  dated 2 Mar 16. 
	Exhibit J.  Letter, SAF/MRBR, dated 4 Mar 16.
	Exhibit K.  Letter, Applicant, dated 18 Mar 16.
	Exhibit L.  Letter, Applicant’s Brother, dated 20 Mar 16.