ADDENDUM TO RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2012-03342 COUNSEL: HEARING DESIRED: NO ________________________________________________________________ APPLICANT REQUESTS THAT: 1. Her records be corrected to reflect her diagnosis of post- traumatic stress disorder (PTSD)/major depressive disorder is combat-related. 2. Her personality disorder diagnosis be removed from her records. ________________________________________________________________ APPLICANT CONTENDS THAT: 1. Her PTSD/major depressive disorder is combat-related. She performed aircrew duties in hostile skies over Iraq and Afghanistan under combat conditions during a period of war and was subjected to enemy surface-to-air weapons while performing said duties. 2. Her personality disorder diagnosis was corrected by the Air Force Board for Correction of Military Records (AFBCMR) in 2010 because factual errors, omissions and prejudicial documentation resulted in an erroneous diagnosis. The applicant’s complete submission, with attachments, is at Exhibit F. ________________________________________________________________ STATEMENT OF FACTS: On 24 Aug 09, the Board considered the applicant’s request to correct her records to reflect that she was not discharged for physical disability with entitlement to severance pay, but was permanently retired for physical disability with a combined compensable disability rating of 70 percent. After considering all the facts and circumstances in this case, the Board determined the evidence was sufficient to conclude the applicant was the victim of an error or injustice and recommended her records be corrected to reflect that on 11 April 2009, 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; that the diagnosis in her case as major depressive disorder associated with PTSD, VASRD Code 9434, rated at 30 percent; that the degree of impairment was permanent; that the disability was not due to intentional misconduct or willful neglect; and that the disability was not incurred during a period of unauthorized absence; and that the disability was not received in the line of duty (LOD) as a direct result of armed conflict or caused by instrumentality of war. Further, she was not discharged by reason of physical disability with entitlement to disability severance pay on 12 April 2009, but on that date her name was removed from the Temporary Duality Retired List and she was permanently retired by reason of physical disability, with a 30 percent compensable disability rating. For a complete accounting of the facts and circumstances of the original case, see the Record of Proceedings at Exhibit E. The remaining relevant facts pertaining to this application are described in the letter prepared by the AFBCMR Medical Consultant which is attached at Exhibit G. ________________________________________________________________ AIR FORCE EVALUATION: The AFBCMR Medical Consultant recommends denial, indicating the fact the applicant may have incurred a disability during a period of war or in an area of armed conflict or while participating in combat operations is not sufficient to support that her diagnoses were combat-related. There must be a direct causal relationship between the instrumentality of war and the disability. In the applicant’s case, a definite causal relationship between armed conflict and her diagnosis of PTSD/major depressive disorder must be shown. The applicant’s record is absent a direct cause that pertains to a combat- related event or any exposure to such as it relates to the applicant’s unfitting medical condition. While two Air Medals describe the applicant’s meritorious service which occurred in a combat environment, her operational duties do not necessarily constitute a direct causal relationship between her disability and either combat or an instrumentality of war. There is documented mental health history which supports other life stressors and significant stressful events that could have been the precipitating cause of her unfitting condition. Although the Department of Veterans Affairs (DVA) diagnosed the applicant with service connected PTSD and depressive disorder, their criteria to establish service connection merely requires documentation of the disorder (PTSD and depressive disorder) and location (combat zone) and duty with in an area to establish service connection. The Department of Defense combat- relatedness criteria requires more detailed involvement to establish combat-relatedness. As for her request to remove her borderline personality disorder (BPD) diagnosis from her records, there is no evidence of an error or injustice in this regard. The applicant’s mental health records, comments from the Secretary of the Air Force Personnel Council, the Formal Physical Evaluation Board, and the pre-Medical Evaluation Board, all have documented confirmation of signs and symptoms of BPD. Such entries and assessments that are consistent with BPD should not be deleted from official records. The documentation represents historical mental health information which was documented by competent and certified mental health professionals and, thus, should remain as a part of an established medical record. A complete copy of the AFBCMR Medical Consultant’s evaluation is at Exhibit G. ________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: Counsel reiterates the applicant’s argument that her disabilities are combat-related and disputes the medical advisory’s opinion that there is no direct cause which was identified as it pertains to an identified combat-related event or exposure. A review of the applicant’s flying history report, Air Medals, and DVA rating determination supports a finding of combat-related connection with her disabilities. Also, the medical consultant’s analysis of the applicant’s borderline personality disorder diagnosis is disputable. The AFBCMR’s previous decision indicates the applicant successfully raised a reasonable doubt as to her personality disorder diagnosis; as such, it should be removed from her records. A complete copy of the applicant’s response, with attachments, is at Exhibit I. ________________________________________________________________ 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. We took notice of the applicant's complete submission in judging the merits of the case; however, we agree with the opinion and recommendation of the AFBCMR Medical Consultant and adopt his rationale as the basis for our conclusion the applicant has not been the victim of an error or injustice. Counsel disputes the conclusions of the AFBCMR Medical Consultant and argues the applicant has raised doubt as to whether there was a causal connection between her operational duties and her unfitting conditions; however, argument and conjecture are not a sufficient basis for us to conclude that her unfitting conditions are related to combat or an instrumentality of war. Therefore, in the absence of evidence to the contrary, we find no basis to recommend granting the relief sought in this application. ________________________________________________________________ THE BOARD DETERMINES THAT: The applicant be notified the evidence presented did not demonstrate the existence of material error or injustice; the application was denied without a personal appearance; and the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application. ________________________________________________________________ The following members of the Board considered AFBCMR Docket Number BC-2012-03342 in Executive Session on 23 May 2013, under the provisions of AFI 36-2603: Panel Chair Member Member The following documentary evidence was considered: Exhibit E. Record of Proceedings, dated 27 October 2010, w/atchs. Exhibit F. DD Form 149, dated 30 July 2012, w/atchs. Exhibit G. Letter, AFBCMR Medical Consultant, dated 18 January 2013. Exhibit H. Letter, SAF/MRBR, dated 22 January 2013. Exhibit I. Letter, Counsel, dated 21 February 2013, w/atchs. Panel Chair