BOARD DATE: 1 August 2013 DOCKET NUMBER: AR20130005284 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documents provided, if any). 2. Military Personnel Records and advisory opinions (if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests correction of the narrative reason for separation and corresponding Separation Code shown on his DD Form 214 (Certificate of Release or Discharge from Active Duty) from "Personality Disorder" and "JFX" to something more favorable. 2. The applicant states he was released from the Army when he was 29 years of age. Never at any time prior to his enlistment or after his separation was he labeled as having a personality disorder. As he moves from aerospace engineering to law enforcement, he has undergone psychological tests and evaluations. At no time was he labeled with any type of personality disorder. He lives a healthy life with his wife and son and they have another child on the way. But the gross injustice remains. He was never told of these "labels" which makes them very suspicious. 3. The applicant provides a letter from the Office of the Assistant Secretary of the Army (Manpower and Reserve Affairs). CONSIDERATION OF EVIDENCE: 1. Title 10, U.S. Code, section 1552(b), provides that applications for correction of military records must be filed within 3 years after discovery of the alleged error or injustice. This provision of law also allows the Army Board for Correction of Military Records (ABCMR) to excuse an applicant's failure to timely file within the 3-year statute of limitations if the ABCMR determines it would be in the interest of justice to do so. While it appears the applicant did not file within the time frame provided in the statute of limitations, the ABCMR has elected to conduct a substantive review of this case and, only to the extent relief, if any, is granted, has determined it is in the interest of justice to excuse the applicant's failure to timely file. In all other respects, there are insufficient bases to waive the statute of limitations for timely filing. 2. The applicant's record shows he enlisted in the Regular Army on 12 July 2005 and he held military occupational specialty (MOS) 11B (Infantryman). He served in Kuwait/Iraq from 30 January 2006 to 25 February 2006. 3. His Mental Status Evaluation Report is not available for review with this case. He was assigned to the 1st Battalion, 7th Infantry Regiment, Fort Wainwright, Alaska. 4. On 8 June 2006, the applicant's immediate commander notified the applicant of his intent to initiate separation action against him under the provisions of paragraph 5-17, Army Regulation (AR) 635-200 (Enlisted Active Separations) because of a bipolar disorder (other designated physical or mental conditions). The immediate commander advised the applicant of his rights and he recommended an honorable character of service. 5. On 8 June 2006, the applicant acknowledged receipt of the notification of separation action, under the provisions of paragraph 5-17, AR 635-200. He consulted with legal counsel and was advised of the basis for the contemplated separation action to separate him for other designated mental condition under AR 635-200, and its effects, of the rights available to him, and the effects of any action taken by him in waiving those rights. The applicant elected not to submit statements in his own behalf. 6. Subsequent to this acknowledgement, the immediate commander initiated separation action against the applicant under the provisions of AR 635-200, paragraph 5-17, by reason of other designated physical or mental condition (Bipolar II Disorder). The immediate commander stated the applicant had been seen by Mental Health and he had been counseled on his behavior. He was also referred to the Combat Stress Clinic for counseling. 7. On 21 June 2006, the applicant's intermediate commander recommended approval of the discharge action under the provisions of paragraph 5-17 of AR 635-200 by reason of other designated mental condition. He recommended an honorable discharge. 8. The separation authority approved the applicant's separation under the provisions of paragraph 5-17, AR 635-200, by reason of other designated mental condition and directed the applicant be issued an honorable characterization of service. On 30 June 2006, the applicant was discharged accordingly. 9. His DD Form 214 shows he was discharged on 30 June 2006 with an honorable character of service. He completed 11 months and 19 days of active service. His DD Form 214 also shows in: * Item 25 (Separation Authority) – AR 625-200, Paragraph 5-13 * Item 26 (Separation Code) - "JFX" * Item 27 (Reentry Code) - "3" * Item 28 (Narrative Reason for Separation) – "Personality Disorder" 10. In connection with the processing of this case, an advisory opinion was obtained on 30 April 2013 from the Office of The Surgeon General (OTSG), Director of Health Care Delivery. The OTSG official states: a. Though the DD Form 214 reflected a discharge in accordance with (IAW) AR 635-200, Paragraph 5-13, Personality Disorder, [Applicant's] paperwork reflected separation lAW Paragraph 5-17, Other Designated Physical or Mental Conditions. The exact condition appeared to have changed over time. The psychiatrist's note of 15 March 2006 stated [Applicant] was pending administrative separation under paragraph 5-17 for substance-induced mood disorder. When the Mental Status Evaluation paperwork was accomplished again on 23 May, it likely went through with his diagnosis at that time, because a memorandum from the company commander to the applicant stated the intent to separate him because of the Bipolar II diagnosis. Bipolar II Disorder is a boardable condition and inappropriate for a 5-17 discharge. b. Shortly after arriving at his first duty station, the applicant deployed to join his unit in Iraq. His pre-deployment screening resulted in an interview with a psychologist because he had expressed significant distress on the instrument. He was cleared to deploy with the recommendation for wellness classes upon return from deployment to enhance his interpersonal skills. No information in the note explained the level of distress. Though theater notes are unavailable, subsequent notes refer to increasing depression prior to deployment and an episode of suicidal ideation during which he cut his wrist, and possibly wrists. In theater less than a month, he was medically evacuated to Landstuhl Regional Medical Center (LRMC) for inpatient treatment. Describing a history of depressed mood lasting more than a month at a time, sleep disruption, low energy, lower concentration, the applicant also described rapid thoughts, periods of distinctly higher mood lasting one to two days with accompanying decreased sleep and increased energy. In addition, he reported hearing voices telling him to harm himself and "look out." He was diagnosed with Bipolar II Disorder, Depressed, with Psychotic Features. After a week, with a recommendation for further stabilization as an inpatient and a medical board, he received an inpatient transfer to Walter Reed Army Medical Center where he was hospitalized for two weeks. The problem list during this hospitalization included the diagnoses Drug-Induced Mood Disorder, Bipolar Disorder, Unspecified and Narcissistic Personality Disorder. Accompanying notes were not accessible. Narcissistic features were not commented upon or documented in any way during the following course of outpatient treatment c. Back at his home station, 29-year-old [Applicant] engaged in care with a psychiatrist and the Alcohol and Substance Abuse Program from March through June, when he was discharged. His reported history included depressive episodes starting in his early 20s, lasting several weeks and occurring approximately five times a year, and excessive alcohol use when depressed. He reported frequent marijuana, cocaine, LSD, and mushroom use in his early 20s. He reported drinking excessively in an attempt to alleviate his depressive symptoms. At his first visit with the psychiatrist, he was diagnosed with Unspecified Substance Induced Mood Disorder given it was "difficult to clearly identify past periods of depression in (the) absence of alcohol or drug use. Further, Alcohol Dependence was diagnosed. The mood disorder diagnosis changed to Bipolar II Disorder, consistent with the diagnosis given at LRMC. While all the symptoms for the diagnosis were not documented, hypomanic symptoms are referred to, though not detailed. In other session notes, it appeared his most prominent hypomanic symptom was his irritability. Further, he reported his older sister had Bipolar Disorder. Through the approximately four-month course of his treatment, various psychotropic medications were prescribed, to include Ativan for anxiety and psychotic symptoms, Zyprexa for the psychotic symptoms of Bipolar Disorder, Effexor for depressive symptoms, Seroquel to assist with anxiety and sleep, and finally Risperdal, an atypical antipsychotic used to treat symptoms of Bipolar Disorder. He also took Naltrexone to help reduce his alcohol cravings. He had varying symptomatic relief, and while at times his symptoms were fairly stable, the right combination of medication and dosage was still being worked at the time of his discharge. d. Though on his Post-Deployment Health Assessment the applicant endorsed all the post-traumatic stress questions positively, there was no identified trauma. On the reassessment, he did not endorse any of the post-traumatic stress symptoms. There is no mention in his treatment of any post-traumatic stress issues. e. Personality Disorder was diagnosed during his inpatient stay at Walter Reed and may have been included on a Report of Mental Status Evaluation; however, those documents are not available for review, indicating the need for referral to a medical evaluation board (MEB). The record is quite clear in supporting a need for a referral to an MEB to assess his fitness for duty. He should have met an MEB prior to his discharge. 11. On 7 June 2013, the applicant was provided a copy of the OTSG advisory opinion in order to have the opportunity to respond to or rebut its contents. To date, he has failed to reply. 12. AR 635-200 provides the basic authority for the separation of enlisted personnel: a. Paragraph 5-13 provides the criteria for discharge because of a personality disorder. It states that a Soldier may be separated for personality disorders, not amounting to disability under AR 635-40 (Physical Evaluation for Retention, Retirement, or Separation), which interferes with assignment to or performance of duty. The diagnosis of a personality disorder must have been established by a physician trained in psychiatry and psychiatric diagnosis. Separation because of a 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 b. Paragraph 5-17 provided that a Soldier could be separated for personality disorder, not amounting to disability under AR 635-40, which interfered with assignment to or performance of duty. The regulation required that the condition be a deeply-ingrained maladaptive pattern of behavior of long duration that interfered with the Soldier's ability to perform duty. The regulation also directed that commanders would not take action prescribed in this chapter in lieu of disciplinary action, required that the diagnosis concluded the disorder was so severe that the Soldier’s ability to function in the military environment was significantly impaired, and stated that separation for personality disorder was not appropriate when separation was warranted under AR 635-40. 13. AR 635-40 governs the evaluation of physical fitness of Soldiers who may be unfit to perform their military duties because of a physical disability. It provides that the mere presence of an impairment does not, of itself, justify a finding of unfitness because of physical disability. In pertinent part, it states that although the ability of a Soldier to reasonably perform his or her duties in all geographic locations under all conceivable circumstances is a key to maintaining an effective and fit force, this criterion will not serve as the sole basis for a finding of unfitness. In each case, it is necessary to compare the nature and degree of physical disability present with the requirements of the duties the member may reasonably be expected to perform because of his or her office, rank, grade, or rating. DISCUSSION AND CONCLUSIONS: 1. The applicant's mental status evaluation is not available for review with this case. It is unclear how acute, chronic, mild, or severe his bipolar disorder was, and as such, a determination of his fitness for continued service at the time cannot be determined. 2. According to the OTSG review of his electronic medical records, he reported heavy drug use (frequent marijuana, cocaine, LSD) in his early 20s. He also reported heavy drinking in an attempt to alleviate his depressive symptoms. He was initially diagnosed with Unspecified Substance Induced Mood Disorder because it was difficult to clearly identify past periods of depression in (the) absence of alcohol or drug use. Further, Alcohol Dependence was diagnosed. 3. The mood disorder diagnosis then changed to Bipolar II Disorder, consistent with the diagnosis he received at LRMC. While all the symptoms for the diagnosis were not documented, hypomanic symptoms are referred to, though not detailed. In other session notes, it appeared his most prominent hypomanic symptom was his irritability. Further, he reported his older sister had Bipolar Disorder. 4. Throughout a 4-month course of his treatment, various psychotropic medications were prescribed, for anxiety and psychotic symptoms, psychotic symptoms of Bipolar Disorder, depressive symptoms, anxiety and sleep, and his alcohol cravings. He had varying symptomatic relief, and while at times his symptoms were fairly stable, the right combination of medication and dosage was still being worked at the time of his discharge. PTSD was neither reported nor diagnosed since there was no identified trauma. There is no mention in his treatment of any post-traumatic stress issues. Additionally, the Personality Disorder was diagnosed during his inpatient stay at Walter Reed and may have been included on a Report of Mental Status Evaluation; however, those documents are not available for review. 5. Administratively, it is clear that an error was committed in the processing of his separation: a. His notification of separation memorandum stated the immediate commander was initiating action under paragraph 5-17 (other designated mental conditions). He acknowledged this memorandum with the understanding he was being separated under paragraph 5-17. Yet, when the immediate commander forwarded the separation packet to through the chain of command, he indicated he was recommending the applicant for separation under paragraph 5-13 (Personality Disorder). b. The intermediate commander recommended approval of the separation action under paragraph 5-17. Furthermore, the separation authority approved the separation under paragraph 5-17. Yet, the DD Form 214 listed the narrative reason for separation as paragraph 5-13 (Personality Disorder). c. The applicant did not respond to the OTSG advisory opinion. Therefore, it would be appropriate to respond to his specific request, and as a matter of equity, change the narrative reason for his separation to Secretarial Authority with the corresponding separation code. BOARD VOTE: __X___ ___X_____ ____X____ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ________ ________ ________ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The Board determined that the evidence presented was sufficient to warrant a recommendation for relief. As a result, the Board recommends that the Department of the Army records of the individual concerned be corrected by voiding his DD Form 214 for the period ending 30 June 2006 and issuing him a new DD Form 214 to show he was discharged with an honorable characterization of service by reason of Secretarial Authority, with an SPD code of "JFF." _______ _ X______ ___ CHAIRPERSON I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. ABCMR Record of Proceedings (cont) AR20130005284 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20130005284 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1