RECORD OF PROCEEDINGS
         AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2004-02430
		INDEX NUMBER:  110.00
	XXXXXXX	COUNSEL:  None

	XXXXXXX	HEARING DESIRED:  No

MANDATORY CASE COMPLETION DATE:  8 Feb 06

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APPLICANT REQUESTS THAT:

His DD Form 214 be amended in Block 28, “Narrative Reason for Separation,” to read “anxiety disorder,” rather than “personality disorder.”

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APPLICANT CONTENDS THAT:

The fact that his DD Form 214 reflects he was discharged for “personality disorder” has caused him extreme financial hardship.  He has since been evaluated by the Department of Veterans Affairs (DVA) and has been granted service connected disability for an “anxiety disorder.”

In support of his appeal, applicant provides a copy of his DVA related medical paperwork.

The applicant’s complete evaluation, with attachment, is at Exhibit A.

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STATEMENT OF FACTS:

The applicant entered active duty on 26 Apr 00, and received an initial enlistment bonus in the amount of $13,000.  On 21 Apr 03, his squadron commander notified him he was recommending his discharge from the Air Force for a condition that interferes with military service, specifically, an adjustment disorder with mixed anxiety and depressed mood and borderline personality disorder.  The commander recommended the applicant receive an honorable discharge.

The reason for the commander’s action was the result of a mental health evaluation that determined the applicant suffered from a disorder so severe that his ability to function effectively in the military environment was significantly impaired.  Additionally, the commander considered actions taken against the applicant for a number of incidents and offenses.  The applicant acknowledged receipt of the commander’s intended action and waived his right to consult counsel and to submit statements in his behalf.  The proposed discharge was found legally sufficient by the wing staff judge advocate.  On 23 Apr 03, the wing commander directed that the applicant be separated from the Air Force for a condition that interferes with military service, specifically, an adjustment disorder with mixed anxiety and depressed mood and borderline personality disorder.  It was also directed that he be issued an honorable discharge.  The applicant was discharged on 24 Apr 03 with an honorable discharge.  The narrative reason for discharge reflected on his DD Form 214 was “Personality Disorder.”

The applicant received two enlisted performance reports during his time in the Air Force, one with an overall rating of “5” and a second, referral report, with an overall rating of “3.”  The referral report was due to a marking of “1” in the performance factor dealing with off/on duty conduct.  The referral report also contained comments related to the applicant’s disciplinary problems.

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AIR FORCE EVALUATION:

The AFBCMR Medical Consultant recommends denial of the applicant’s request to change the narrative reason for his discharge.  Members discharged for unsuitability due to Personality Disorder or Adjustment Disorder are required to reimburse the government for the unearned portion of enlistment bonuses.  Members discharged for disability such as Anxiety Disorder are not required to reimburse the government for such bonuses.  The applicant contends his post-service diagnosis of Anxiety Disorder not otherwise specified is the correct diagnosis for symptoms he experienced while in service and requests change of his discharge documents to reflect discharge based on this unfitting condition in order to avoid recoupment of the unearned portion of his enlistment bonus.

Personality disorders or maladaptive personality traits are not medically disqualifying or unfitting but may render the individual unsuitable for further military service and may be cause for administrative action by the individual’s unit commander.  Personality disorders are considered significant risk factors for subsequent development of mental illness including depression, bipolar disorder, anxiety disorder, and schizophrenia.

Adjustment Disorder is characterized by marked psychological distress in response to identifiable stressors that overcome the individual’s ability to cope and is frequently associated with significant impairment in social and occupational functioning.  Adjustment Disorders when severe enough are unsuiting for continued military service and cause for administrative discharge.

In this case, a three month gap in mental health care between Jan and Mar 03 appears to indicate that symptoms were episodic in response to occupational stressors rather than a prolonged condition regardless of the presence of stressors favoring Adjustment Disorder over anxiety disorder.  The applicant’s diagnosis is complicated by the presence of personality disorder, which was viewed as the principle diagnosis producing the majority of his symptoms that interfered with duty performance.

Following discharge from military service, the applicant has experienced persistent and worsening symptoms with various diagnoses suggesting a pattern of an evolving mental illness that began while in service.  Despite the varying diagnoses, he has been consistently diagnosed with Personality Disorder as a major component of his problem.  The most recent evaluation rendered diagnoses of Anxiety Disorder not otherwise specified and Personality Disorder not otherwise specified.  The BCMR Medical Consultant does not conclude that the evidence in the service medical records support change of records to show disability discharge for anxiety disorder and notes that the predominant diagnosis interfering with duty at the time was the non-compensable personality disorder.

The BCMR Medical Consultant notes that although review of the records does not demonstrate an error, the Board may consider granting relief of the requirement for recoupment if it finds evidence of an injustice in this complex case.

The complete evaluation is at Exhibit C.

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

A response to the Air Force evaluation was provided on the applicant’s behalf from a Department of Veterans Affairs (DVA) staff psychiatrist.  The staff psychiatrist provides a summary of the applicant’s current working diagnoses.  Based on his review of the applicant’s medical file, he notes that the applicant’s problems in the Air Force seemed to surface in Jan 02 and continued until his separation.  He states the applicant reported the occurrence of a Closed Head injury with transient loss of consciousness sometime in 2001 and that he did seek medical attention several days later.  The staff psychiatrist indicates that it appears that the development of disciplinary issues occurred following this and is very likely related to the head injury.  He further notes that a brain MRI obtained on Jul 05 was essentially within normal limits, though this does not rule out possible post-head injury effects.  He states that neurological testing has been requested.

The DVA staff psychiatrist opines that the available information on the applicant is consistent with the conclusion that mood and behavioral problems developed following a closed head injury while he was on active duty in the Air Force.  An underlying genetic predisposition to mood swings may have been an additional factor or unmasked as a result.

It is the DVA staff psychiatrist’s best medical opinion that the behavioral changes leading to the applicant’s discharge were most likely secondary to the reported closed head injury.  He requests the Board consider favorable action on the applicant’s request not to repay the enlistment bonus he received.  He also opines that it would seem reasonable to consider establishing service connection for the applicant’s head injury and psychiatric residual.

The complete response is at Exhibit E.

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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 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 BCMR Medical Consultant and adopt his rationale as the primary basis for our conclusion that the applicant has not been the victim of an error or injustice warranting a change in the narrative reason for his discharge from the Air Force.  Additionally, we considered the recommendation of the DVA staff psychiatrist that the applicant be granted service connection for a closed head injury.  However, a review of the available medical records does not reveal sufficient information to support such a determination.  Therefore, in the absence of evidence to the contrary, we find no compelling basis to recommend granting this portion of the relief requested.

4.  Notwithstanding the above determination, we note that the BCMR Medical Consultant has stated that following discharge from military service, the applicant has experienced persistent and worsening symptoms with various diagnoses suggesting a pattern of an evolving mental illness that began while he was in service.  We also note that the DVA staff psychiatrist has indicated the applicant’s problems are “very likely” related to the closed head injury.  While we do not believe the available evidence supports granting the requests already discussed, we believe there is enough uncertainty in the applicant’s case that requiring him to repay the enlistment bonus could be viewed as an injustice.  As such, in the interest of equity and injustice, we believe the applicant’s debt should be waived.  Therefore, we recommend his records be corrected as indicated below.

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THE BOARD RECOMMENDS THAT:

The pertinent military records of the Department of the Air Force relating to APPLICANT be corrected to show that on 20 April 2003, he applied for and competent authority granted a waiver of the recoupment of the unearned portion of the initial enlistment bonus he received in conjunction with his 26 April 2000 enlistment.

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The following members of the Board considered Docket Number BC-2004-02430 in Executive Session on 21 September 2005, under the provisions of AFI 36-2603:

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

     Exhibit A.  DD Form 149, dated 19 Jul 05, w/atchs.
     Exhibit B.  Applicant's Master Personnel Records.
     Exhibit C.  Memorandum, BCMR Medical Consultant,
                 dated 30 Jun 05.
     Exhibit D.  Letter, SAF/MRBR, dated 12 Jul 05.
     Exhibit E.  Letter, DVA, dated 6 Sep 05, w/atchs.

AFBCMR BC-2004-02430

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 XXXXXXX, XXXXXXX, be corrected to show that on 20 April 2003, he applied for and competent authority granted a waiver of the recoupment of the unearned portion of the initial enlistment bonus he received in conjunction with his 26 April 2000 enlistment.