RECORD OF PROCEEDINGS IN THE CASE OF: BOARD DATE: 14 November 2007 DOCKET NUMBER: AR20070008575 I certify that hereinafter is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in the case of the above-named individual. Ms. Catherine C. Mitrano Director Mrs. Nancy L. Amos Analyst The following members, a quorum, were present: Ms. Linda D. Simmons Chairperson Ms. Carmen Duncan Member Mr. Qawiy A. Sabree Member The Board considered the following evidence: Exhibit A - Application for correction of military records. Exhibit B - Military Personnel Records (including advisory opinion, if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests that his records be corrected to change his discharge for personality disorder to a medical retirement. 2. The applicant states that he was not given the opportunity to go through the medical evaluation board (MEB)/physical evaluation board (PEB) process despite the fact that he had been diagnosed with multiple, significant medical conditions. He was administratively separated under Personality Disorder to expedite his separation. 3. The applicant provides his DD Form 214 (Certificate of Release or Discharge from Active Duty); a VA Form 21-4139 (Statement in Support of Claim); and a copy of his service medical records. CONSIDERATION OF EVIDENCE: 1. The applicant enlisted in the Regular Army on 22 November 2004. 2. On 24 January 2005, the applicant was referred to radiology for pain in his right hip. X-rays revealed the bones, joints, and soft tissues to be normal. No fracture or dislocation was seen. 3. The applicant completed basic training and advanced individual training and was awarded military occupational specialty 11B (Infantryman). 4. On 17 August 2005, the applicant was treated for a complaint of right ear pain when his ear became infected after he went swimming. Loud noise at the firing range made it worse. The right ear was redder than the left, but his neck was supple with no tenderness and full range of motion. He was given medication. 5. On 15 December 2005, the applicant was treated for a complaint of a rash and sores for the past two days. He had red spots covering both arms and on his flanks, some of which had developed into small sores. He was diagnosed with a dermatitis. 6. On 10 March 2006, the applicant was treated for a near syncopal episode (the sudden and temporary loss of consciousness that is also described as fainting or passing out) while marching. The applicant admitted to drinking only one quart of water the previous day and to taking No Doz prior to exercise. An ECG (electrocardiogram) was abnormal, indicating a marked sinus bradycardia with first degree AV (atriovenricular) block with occasional premature atrial complexes. (Bradycardia is an abnormally slow heartbeat of 60 beats per minute or less. It can cause weakness, dizziness, or fainting spells. Some patients with less severe forms of AV block do not need to be treated. Patients with the most severe form of AV block (third degree AV block) can be treated with a pacemaker.) He was placed on quarters and instructed to return to the emergency room if he failed to improve in 24 to 48 hours or earlier if he had new or worsening symptoms. 7. On 13 March 2006, the applicant went for a follow-up. He reported “no problems since the incident.” 8. On 9 November 2006, the applicant was treated for a complaint of left knee pain down to his foot after he was hurt playing basketball. Sensory was intact, range of motion was limited due to pain, distal pulses were good. He was diagnosed with ankle sprain and knee strain. 9. On 22 November 2006, the applicant was promoted to Specialist, E-4. 10. On 8 January 2007, an audiogram found the applicant to have high frequency hearing loss. 11. On 17 February 2007, the applicant attempted suicide by cutting both of his wrists. 12. On or about 17 February 2007, the applicant completed a mental status evaluation. The staff psychiatrist determined that the applicant met psychiatric criteria for expeditious separation in accordance with paragraph 5-13, Army Regulation 635-200. He noted that the applicant was not currently at significant risk for suicide, but due to lifelong patterns of maladaptive responses to stress he could become dangerous to himself in the future. He had a longstanding disorder of character/behavior, not considered to be a mental disorder but which was of such severity so as to preclude adequate military service. During the interim, he would need mental health treatment and it would be beneficial for someone in his unit to be accessible to him for monitoring his concerns from time to time. 13. A Record of Inpatient Treatment, date of admission 17 February 2007, shows that the applicant was diagnosed with adjustment disorder with mixed anxiety and depressed mood; borderline personality disorder; open wound of the wrist without complication; suicide/self-inflicted injury by cutting/piercing instrument; and injury or poisoning occurring at/in the home. 14. On 14 March 2007, the applicant’s commander initiated separation action on the applicant under the provisions of Army Regulation 635-200, paragraph 5-13, Personality Disorder. 15. On 14 March 2007, the applicant consulted with counsel and was advised by consulting counsel of the basis for the contemplated separation action. He elected not to submit a statement in his own behalf. 16. On 22 March 2007, the appropriate authority approved the recommendation and directed the applicant be discharged with an Honorable Discharge Certificate. 17. The applicant completed a DD Form 2807-1 (Report of Medical History) on 27 April 2007. On this form, he indicated that he had multiple conditions (shortness of breath when he got dizzy; blackouts; trouble hearing (constant ringing), loss of vision during blackouts, frequent heartburn, anxiety and panic attacks, depression and excessive worry, and suicidal tendencies). He also stated in item 29 (Explanation of “Yes” Answers), “Been unable to stay in military because of suicidal tendancies (sic), anxiety, stress, depression, worry.” 18. The applicant’s DD Form 2808 (Report of Medical Examination), dated 27 April 2007, indicated that he was qualified for service/retention/separation. 19. On 11 May 2007, the applicant was honorably discharged, in pay grade E-4, under the provisions of Army Regulation 635-200, paragraph 5-13 for personality disorder. He had completed 2 years, 5 months, and 25 days of creditable active service with no lost time. 20. On 16 May 2007, the applicant applied to the Department of Veterans Affairs (VA), claiming service-connection for a spine condition, depression, anxiety disorder, a gastrointestinal condition, a neurological condition (sudden loss of consciousness accompanied by vision impairment), residuals of injury to reproductive organ, hearing loss, tinnitus, an endocrine condition, sleep apnea, and a bilateral foot condition. 21. Army Regulation 635-200 sets forth the basic authority for the separation of enlisted personnel. Paragraph 5-13 sets the policy and prescribes procedures for separating members with a personality disorder (not amounting to a disability) that interferes with assignment to or performance of duty. This condition is a deeply ingrained maladaptive pattern of behavior of long duration that interferes with the Soldier's ability to perform duty. The diagnosis of personality disorder must have been established by a psychiatrist or doctoral-level clinical psychologist with necessary and appropriate professional credentials who is privileged to conduct mental health evaluations for the Department of Defense components. Separation because of personality disorder is authorized only if the diagnosis concludes that the disorder is so severe that the Soldier's ability to function effectively in the military environment is significantly impaired. Separation processing may not be initiated under this paragraph until the Soldier has been counseled formally concerning deficiencies and has been afforded ample opportunity to overcome those deficiencies as reflected in appropriate counseling or personnel records. 22. Army Regulation 635-40 governs the evaluation of physical fitness of Soldiers who may be unfit to perform their military duties because of physical disability. The unfitness is of such a degree that a Soldier is unable to perform the duties of his office, grade, rank or rating in such a way as to reasonably fulfill the purpose of his employment on active duty. In pertinent part, it states that the mere presence of an impairment does not, of itself, justify a finding of unfitness because of physical disability. In each case, it is necessary to compare the nature and degree of physical disability present with the requirements of the duties the Soldier reasonably may be expected to perform because of his or her office, grade, rank, or rating. 23. Army Regulation 40-501 governs medical fitness standards for enlistment, retention and separation. Paragraph 3-10 states that trained and experienced personnel will not be categorically disqualified if they are capable of effective performance of duty with a hearing aid. Most Soldiers having a hearing defect can be returned to duty with appropriate assignment limitations. Soldiers incapable of performing duty with a hearing aid will be referred for MEB/PEB processing. Paragraph 3-21d states that heart block (second or third degree AV block) and symptomatic bradyarrthythmias is a cause for referral to an MEB. Paragraph 3-21l states that recurrent syncope or near syncope of cardiovascular etiology that is not controlled or when it interferes with the performance of duty, even if the etiology is unknown, is a cause for referral to an MEB. 24. Title 38, U. S. Code, sections 310 and 331, permits the VA to award compensation for a medical condition which was incurred in or aggravated by active military service. The VA, however, is not required by law to determine medical unfitness for further military service. DISCUSSION AND CONCLUSIONS: 1. The applicant contended that he was not given the opportunity to go through the MEB/PEB process despite the fact that he had been diagnosed with multiple, significant medical conditions. He provided a copy of his service medical records. 2. Those medical records showed that the applicant was referred to radiology for pain in his right hip in January 2005. X-rays found the bones, joints, and soft tissues to be normal, no fracture or dislocation was seen, and there is no evidence that he was later treated for this condition. In August 2005, he was treated for a complaint of right ear pain, and loud noise at the firing range made it worse. Shortly before he separated an audiogram found him to have high frequency hearing loss, but there is no evidence to show that his hearing loss prevented him from performing his duties. In December 2005, he was treated for a complaint of a rash and sores, but there is no evidence that he was later treated for this condition. On 10 March 2006, he was treated for a near syncopal episode. An ECG indicated a marked sinus bradycardia with first degree AV block with occasional premature atrial complexes. On 13 March 2006, he went for a follow-up, but he reported “no problems since the incident,” and there is no evidence that he was later treated for this condition. In November 2006, he was treated for a complaint of left knee pain and diagnosed with ankle sprain and knee strain, and there is no evidence that he was later treated for this condition. 3. There is no evidence in the applicant’s service medical records that he suffered from any condition that required referral to an MEB. The most significant condition, the bradycardia, appears to have been a one-time incident, and even then it was diagnosed as first degree bradycardia, not second or third degree. It appears he was performing his duties as an 11B sufficiently well more than six months after this incident to warrant his promotion to Specialist, E-4. There is no evidence that his hearing loss required him to wear a hearing aid or that his hearing loss prevented him from performing his duties. There is no evidence to show that he was ever given a physical profile. 4. The applicant was found to be qualified for service/retention/separation during his separation physical examination on 27 April 2007. The applicant himself noted on his DD Form 2807-1 that he was “unable to stay in military because of suicidal tendancies (sic), anxiety, stress, depression, worry.” There is no evidence of record to show and the applicant does not contend that his depression or anxiety was ever severe enough to require treatment. There is no evidence to show that his depression or anxiety prevented him from performing his duties. 5. The applicant was diagnosed as having a personality disorder by an Army staff psychiatrist, presumably a competent medical authority. He twice attempted suicide; therefore, retaining him in the Army any longer to overcome deficiencies would not have been in either his interest or the interest of the Army. As there is no evidence to show he met any criteria for referral to an MEB, it appears he was properly separated for personality disorder, and there is no basis for granting the relief requested. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING __lds___ __cd____ __qas___ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined that the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. __Linda D. Simmons____ CHAIRPERSON INDEX CASE ID AR20070008575 SUFFIX RECON DATE BOARDED 20071114 TYPE OF DISCHARGE DATE OF DISCHARGE DISCHARGE AUTHORITY DISCHARGE REASON BOARD DECISION DENY REVIEW AUTHORITY Ms. Mitrano ISSUES 1. 108.00 2. 3. 4. 5. 6.