RECORD OF PROCEEDINGS
         AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2008-03027
		INDEX CODE:  110.00, 136.00

		COUNSEL:  XXXXXXXXXX

		HEARING DESIRED: NOT INDICATED

___________________________________________________________________

APPLICANT REQUESTS THAT:

She be medically retired from the Air Force.

___________________________________________________________________

APPLICANT CONTENDS THAT:

While being treated for an anxiety disorder at a facility in Okinawa, Japan, she was brutally raped.  This resulted in a downward spiral in her condition and in her desire to separate early from the military.  Prior to the incident, she served as a Chinese flight linguist and was recognized as a former airman of the quarter and Airmen Leadership School Levitow award winner.  However, her psychological state at the time of her discharge clearly showed that she was unable to stay in the military and perform any job then or in the future.

Since her discharge, she has received treatment from a civilian residential treatment facility and support from the local Department of Veterans Affairs (DVA) office.

In support of her appeal, the applicant submits a copy of her DVA submission for disability compensation; copies of letters to her member of congress, and senior members of the Joint Chiefs of Staff; documents from her VA Service Center, and a civilian residential treatment facility.

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

___________________________________________________________________

STATEMENT OF FACTS:

Based on the available records, the applicant enlisted in the Regular Air Force on 3 Jan 02 for a period of six years.  She was progressively promoted to the rank of staff sergeant.  She served as an Airborne Cryptologic Linguist with a Duty Title of Airborne Cryptologic Operator.

A resume of applicant’s enlisted performance report (EPR) profile follows:

	      PERIOD CLOSING			OVERALL EVALUATION

			18 Jul 03							5
			15 Nov 05							5
			15 Nov 06							4
			31 Oct 07							5

On 27 Feb 07, she was medically disqualified from further flying duties.  The applicant was experiencing blockage in her Eustachian tube and an inability to clear both ears grounded her from flight duties.  

On 31 Oct 07, the applicant was honorably discharged under the provisions of AFI 36-3208, with a reason for separation of Miscellaneous/General Reasons, and a reentry code of 1J.  She was credited with 5 years, 9 months, and 29 days of active duty service.

The remaining relevant facts pertaining to this application are contained in the evaluation prepared by the BCMR Medical Consultant, which is attached at Exhibit C.

___________________________________________________________________

AIR FORCE EVALUATION:

The BCMR Medical Consultant recommends the applicant’s name be placed on the Temporary Disability Retired List (TDRL), with a 50 percent disability rating, for anxiety disorder, under Veterans Administrative Schedule for Rating Disabilities (VASRB) code 9413.

The Medical Consultant notes that in preparation for her discharge, a medical examination was mandated, in accordance with AFI 48-123 “when certain conditions exist.”  The applicant signed an undated document indicating her desire not to undergo an environmental medical examination in conjunction with her scheduled separation.  The document also indicates an understanding that if she does not elect to undergo a medical examination, the decision may be waived only by approval of the Medical Standards Division, Headquarters, Air Force Personnel Center (AFPC/DPAM) upon presentation of substantial medical information to warrant changing separation or retirement processing.  The record reflects the applicant completed a Report of Medical Assessment, where she acknowledged attendance at physical therapy, Life Skills, and the OB/GYN clinic since her last Periodic Health Assessment (PHA).  She also indicated her intent to seek a DVA disability, for her foot and back, mental health, and osteoporosis, if that becomes an issue.  No further recommended referrals were made by the military healthcare provider.

The applicant requests a medical retirement; however, in order to receive a medical basis for separation/retirement, there must be evidence of an illness or injury that has interfered with a service member’s ability to perform the duties of his or her office, grade, rank, or rating, by virtue of the imposition of long-standing duty restrictions (usually 12 months or more), prohibitions against deployment or PCS assignment, or for certain conditions that impose an unreasonable health and safety risk to the individual, the mission, and those in the immediate environment, among other factors.  Under such circumstances a Medical Evaluation Board (MEB) would be conducted and the case referred to a Physical Evaluation Board (PEB) for a determination of the service member’s fitness to serve.  If the member is found fit for duty, then, he or she would be returned to duty.  If found unfit, a determination would then be made whether the condition is compensable (that is, whether or not it was in the line of duty and unrelated to misconduct or an unauthorized absence from duty).  In addressing the applicant’s fitness for duty, none of her efficiency reports reflect a deficiency in duty performance.  Similarly, the applicant’s annual Physical Profile Serial Reports (AF Form 422) covering the period beginning on 10 Dec 04 and updated on 26 Jun 07, do not reveal a physical or mental impediment, or restrictions to duty, that would warrant a referral to an MEB.  The real tragedy in the case stems from the applicant’s alleged sexual assault at a point approaching the end of her career and her decision to electively foreshorten her career further, by several weeks, without the benefit of continued care and completion of an investigation of the alleged sexual assault.  The question is whether, at the time of her separation physical assessment, conducted on 27 Sep 07, the applicant’s flight surgeon should have pursued further questioning regarding the applicant’s sexual assault and mental wellness, or, as a minimum, documenting that this effort was made and declined in the medical file.  The BCMR Medical Consultant opines there is shared culpability between the applicant and her healthcare provider in electing not to pursue further intervention.  The applicant has since been released from military service and she has been given the opportunity to attend therapy sessions at a civilian medical installation, with the aid of her parents, with the recommended approval by two DVA mental health specialists; both who acknowledged the undesirable gender mix of patients and therapists at the DVA facility, which was believed to be a possible impediment to her recovery, or a concept to that effect.

In conclusion, the BCMR Medical Consultant recommends the applicant’s temporary retirement with a 50 percent disability rating, followed by a re-evaluation of her status in six months.  This remedy, currently established under DVA policies governing rating suspected mental condition, such as Post-Traumatic Stress Disorder (PTSD), assures our former service member gets the care she needs/deserves, while recognizing that a more appropriate action would have been to delay her separation in order to pursue a proper and complete mental health assessment.  Since the applicant’s preponderant diagnosis, beginning in Oct 2006 and continued up to the time of discharge was an Anxiety Disorder, the Medical Consultant recommends establishing this as her primary diagnosis for the purpose of her initial TDRL placement.  The Medical Consultant recommends the applicant be reevaluated in six months by a psychiatrist and the evaluation should conclude with a five (5) Axis diagnosis and the applicant’s level of impairment in civilian social and industrial adaptability; as these will be important in establishing the subsequent disposition of her case, e.g., retention of the TDRL, separation with severance pay, or permanent retirement.

The BCMR Medical Consultant’s complete evaluation is at Exhibit C.

___________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

In response to the BCMR Medical Consultant’s evaluation, the applicant feels the recommendation for TDRL, with re-evaluation in six months, is a fair compromise; however, she believes she should receive a full permanent retirement.

She has been out for 15 months, during which she has only been able to work part-time due to her emotional and mental issues.  She continues to have panic attacks and a general fear of men.  She is working through these issues and is thankful for the support she has received through her involvement in a DVA sponsored program for military victims of sexual assault.

Her mom and step-dad are currently her only support system.  She is uncertain as to whether she will ever be able to lead a fully functional life again.  She believes her mental state at the time of discharge was disintegrating rapidly and it was important for her to get back home to her support system.  It has been a long and difficult road back and each day brings her a little closer to a normal life.  However, she knows it’s going to take a very long time for her to recover.

The applicant’s complete response is at Exhibit E.

___________________________________________________________________

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 warranting corrective action.  The evidence of record indicates that during the course of her military service, the applicant was evaluated and treated for a number of medical conditions, to include an anxiety order.  She now asserts that she was also the victim of a brutal sexual assault.  Subsequently, her psychological state affected her ability to perform her duties, resulting in her discharge for miscellenous reasons.  The Medical Consultant notes the governing directive mandates a medical examination when certain medical conditions exist.  Based on the available evidence, the applicant signed a statement indicating her desire not to undergo a medical examination in conjunction with her scheduled separation.  However, she completed a Report of Medical Assessment, which was signed by a credentialed aerospace medicine physician.  Although it appears she was treated for various ailments, her ability to function in the military environment was never brought up as an issue for a possible medical basis for her discharge.  She now desires a medical retirement from the Air Force based on her allegation of sexual assault and deteriorating psychological state.  In the Medical Consultant’s view, the applicant’s flight surgeon should have pursued further questioning regarding her sexual assault and mental wellness or, as a minimum, documenting in the medical file this effort was made and declined.  He also believes there is shared culpability between the applicant and her health-care provider in electing not to pursue further intervention.  Nevertheless, he recommends the applicant’s temporary retirement, which he believes assures she gets the treatment she needs and desires.  He also recommends she be reevaluated in six months.  After a thorough review of the facts and circumstances of this case, we agree with the recommendation of the Medical Consultant, which we believe is the appropriate relief in this case.  Accordingly, we recommend the applicant’s records be corrected to the extent set forth below.  

___________________________________________________________________

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 30 October 2007, she was found unfit to perform the duties of her office, rank, grade, or rating by reason of physical disability, incurred while she was entitled to receive basic pay; the diagnosis in her case was anxiety disorder, VASRD Code 9413, rated at 50 percent; the compensable percentage was 50 percent; the degree of impairment may be permanent; the disability was not due to intentional misconduct or willful neglect; the disability was not incurred during a period of unauthorized absence; and that 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.  She was not honorably discharged from active duty on 31 October 2007, but, on that date, her name was placed on the Temporary Disability Retired List (TDRL).

		c.  She be immediately scheduled for a TDRL reevaluation.

___________________________________________________________________

The following members of the Board considered AFBCMR Docket Number BC-2008-03027 in Executive Session on 6 May 2009, under the provisions of AFI 36-2603:

Chair
Member
Member

All members voted to correct the records, as recommended.  The following documentary evidence was considered:

     Exhibit A.  DD Form 149, dated 25 Jul 08, w/atchs.
     Exhibit B.  Applicant's Master Personnel Records.
     Exhibit C.  Letter, BCMR Medical Consultant, 
                 dated 20 Feb 09.
     Exhibit D.  Letter, SAF/MRBR, dated 24 Feb 09.
     Exhibit E.  Letter, Applicant, dated 3 Mar 09.

                                   
                                   Chair

AFBCMR BC-2008-03027

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 APPLICANT, be corrected to show that:

		a.  On 30 October 2007, she was found unfit to perform the duties of her office, rank, grade, or rating by reason of physical disability, incurred while she was entitled to receive basic pay; the diagnosis in her case was anxiety disorder, VASRD Code 9413, rated at 50 percent; the compensable percentage was 50 percent; the degree of impairment may be permanent; the disability was not due to intentional misconduct or willful neglect; the disability was not incurred during a period of unauthorized absence; and that 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.  She was not honorably discharged from active duty on 31 October 2007, but, on that date, her name was placed on the Temporary Disability Retired List (TDRL).

		c.  She be immediately scheduled for a TDRL reevaluation.

		
		Director
		Air Force Review Boards Agency