IN THE CASE OF: BOARD DATE: 15 August 2013 DOCKET NUMBER: AR20130006508 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, in effect, correction of her DD Form 214 (Certificate of Release or Discharge from Active Duty) to show her narrative reason for separation as something other than personality disorder. 2. The applicant states while serving in the military she had no problems with mental stability until she returned from Iraq in November 2004. She was a great Soldier. She was promoted to sergeant and she received multiple achievement/ commendations and good conduct awards. She questions how a person with a personality disorder could have achieved such highly established honors. She adds that during her first tour in Iraq (May through November 2003), she was sexually assaulted by a senior noncommissioned officer (NCO). She was on a daily convoy to Baghdad and many more cities. The threat was there. She passed several convoys that had been hit with improvised explosive devices. She saw several wounded civilians and Soldiers. When she returned to Germany, due to a permanent change of station (PCS), she was always jumpy, on edge, and paranoid of everyone around her. She did not receive post-deployment support because she returned by herself due to a PCS. 3. She started having nightmares during her first deployment to Iraq and the nightmares were always about being in combat and sexual trauma. When she rotated to Fort Lewis, WA, her unit had just returned from Iraq the day she arrived at the unit. She was to return to Iraq in 90 days. She tried to seek help for the first time in 2004 for the problems she was facing mentally. She was told she needed to make some friends and adapt to the new surroundings. She felt if she continued to seek help, her unit would treat her differently. She could barely sleep and her nightmares continued. When she decided to seek help in 2005, her unit decided to discharge her instead. During 5 years and 6 months of military service she was a highly motivated Soldier who was determined to do her best. Once she began having problems, it seems her unit no longer wanted her and decided to separate her for personality disorder. Her military records support that she only began to have issues after her first deployment. If she had a personality disorder, the problems would have been obvious earlier in her career. She has been diagnosed with PTSD and she receives service-connected disability compensation at the rate of 80 percent. 4. The applicant provides her DD Form 214 and Department of Veterans Affairs (VA) psychiatry notes. 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 she enlisted in the Regular Army on 28 April 2000 and she held military occupational specialty 25L (Cable Systems Installer/Maintainer). She also reenlisted on 26 July 2003. 3. She served in Kuwait/Iraq from 4 May to 9 November 2003 and from 1 June 2004 to 15 January 2005. She was promoted to SGT/E-5 on 1 April 2004. She was awarded or authorized the Army Commendation Medal (2nd Award), National Defense Service Medal, Iraq Campaign Medal, Global War on Terrorism Service Medal, Global War on Terrorism Expeditionary Medal, Army Service Ribbon, Army Good Conduct Medal, three Overseas Service Bars, and Overseas Service Ribbon. 4. On 29 July 2005, she underwent a mental status evaluation. Her records contain a Report of Mental Status Evaluation that shows the following: a. She was evaluated at the Commander's request on 29 July 2005 in the Behavioral Health Clinic at Madigan Army Medical Center to support administrative discharge processing. The command reports that she continues to experience ongoing mental health problems which made her unsuitable for military service. b. Her evaluation revealed: A history of mental disturbance including emotional lability and depression. Despite comprehensive treatment, little improvement had been made and her prognosis was guarded at best. c. She was considered mentally responsible for her behavior, able to distinguish right from wrong, and she possessed the sufficient mental capacity to participate in any administrative proceeding. d. In accordance with Army Regulation 635-200 (Personnel Separations), she manifests a long-standing disorder of character, behavior and adaptability that is of such severity as to preclude adequate military service. e. The proposed treatment was to follow up at a Behavioral Health Clinic for individual or group treatment. She was recommended for expeditious administrative separation. She met the criteria for administrative separation under paragraph 5-13, Army Regulation 635-200 for a personality disorder. The condition and problems are not amenable to hospitalization, treatment, transfer, disciplinary action, training or reclassification into another specialty. She does not have a severe mental disorder and is not considered mentally disordered. However, she manifests a long-standing disorder of character, behavior and adaptability that is of such severity so as to preclude adequate military service. f. Although not currently at significant risk for suicide or homicide, due to her lifelong pattern of maladaptive responses to routine personal and/or work-related stressors, she may become dangerous to herself or others in the future. Her personality disorder will not respond to command efforts at rehabilitation (such as transfer, disciplinary action, or reclassification) or to any treatment methods currently available in any military mental health facility. g. She met the retention requirements of Army Regulation 40-501 (Standards of Medical Fitness) (she does not have an unfitting condition). Her diagnosis was as follows: * Axis I: 311.00 Depressive Disorder Not Otherwise Specified (NOS) * Axis II: 301.9 Personality Disorder - NOS 5. On 2 August 2005, she underwent a separation physical at Okubo Health Clinic, Madigan Army Medical Center, Fort Lewis, WA. She was found fully qualified for service with a PULHES of "1-1-1-1-1-1." 6. On 16 August 2005, the applicant's immediate commander notified the applicant of his intent to initiate separation action against her under the provisions of paragraph 5-13, Army Regulation 635-200 because of a personality disorder which prevented her from performing her military duties. 7. On 17 August 2005, the applicant acknowledged receipt of the notification of separation action, consulted with legal counsel and was advised of the basis for the contemplated separation, and of the rights available to her in connection with the action. Subsequent to receiving legal counsel, the applicant elected consideration of her case by an administrative separation board but did not make an election regarding appearing or not appearing before an administrative separation board. She also elected not to submit statements in her own behalf. 8. Subsequent to this acknowledgement, the immediate commander initiated separation action against the applicant under the provisions of Army Regulation 635-200, paragraph 5-13, by reason of personality disorder. Her immediate commander stated that the noted emotional and personality disturbance would not likely respond to efforts of rehabilitation (such as transfer, disciplinary action, or reclassification) or to any treatment method currently available in the military. Her intermediate commander recommended approval. 9. The separation authority approved the applicant's separation under the provisions of paragraph 5-13, Army Regulation 635-200, by reason of personality disorder and directed the applicant be issued an honorable characterization of service. On 26 August 2005, the applicant was discharged accordingly. 10. Her DD Form 214 shows she was discharged under the provisions of chapter 5-13, Army Regulation 635-200 by reason of "Personality Disorder" with an honorable character of service. She completed 5 years, 3 months, and 29 days of active service. She was assigned a separation code of "JFX" and Reentry (RE) Code 3. 11. On 26 June 2013, in connection with the processing of this case, an advisory opinion was obtained from the Office of The Surgeon General (OTSG), Director of Health Care Delivery. The OTSG official states conclusions for this advisory opinion are drawn solely based on available documentation from the applicant's active service unless otherwise noted. a. [The applicant] deployed for approximately 6 months in 2004. She sought assistance from the Behavioral Health Clinic about 4 months after she returned. She reported depressed feelings, irritability, nightmares, low self-esteem, excessive sleeping, and isolating herself from others. She reported these symptoms began to increase about a month prior to redeployment. She reported a history of depression prior to service and feeling her mother runs her life. At this visit, she received a diagnosis of Adjustment Disorder with depressed mood, and personality disorder traits with a rule out of a disorder. She did not attend further appointments at that time, returning following her second, approximately 6-month deployment. At this appointment in February 2005, she reported worsening depressed mood over the past month related to a family situation and the death of a friend back home. She described feeling depressed during her second deployment, reporting feeling sad, lacking interest in pleasurable activities, fluctuating energy and appetite, mood lability, irritability and anger, poor concentration, and low self esteem. Possible post-traumatic stress disorder (PTSD) symptoms included some increased arousal symptoms and war dreams, as well as the depressive symptoms which overlap with PTSD criteria. She also reported isolating from others. She reported superficially cutting her wrist at age 14 with an intent to die, resulting in a 2-week psychiatric hospitalization, followed by counseling during much of her adolescence. She stated her diagnoses were possibly depression and a personality disorder. The provider looked at a differential diagnosis of Adjustment Disorder with depressed mood versus a depressive disorder and "Cluster B Traits/PD," suggesting a dramatic, emotional, or erratic pattern of behaving and reacting. b. At the next appointment, Borderline Personality Disorder was diagnosed, and though the list of criteria was listed, sufficient support was documented for only two of the five required criteria for the diagnosis. Seen also by a Psychiatric Nurse Practitioner, [the applicant] reported a history of self-mutilation during high school. As she was 23 years old at the time of this appointment, there is no indication of her continuing with that behavior during her 5 years of service. Also, the note does not describe frequency or ages, so it's unclear whether she engaged in this behavior beyond the aforementioned suicide attempt. She also reported a second hospitalization for suicidal ideation, later in the same year mentioned above. This provider diagnosed [the applicant] with Depressive Disorder NOS and prescribed Celexa and Trazodone for depressive symptoms and better sleep. She attended three group sessions to learn more effective ways of thinking and coping, carrying the diagnosis Personality Disorder NOS. At her follow-up appointment with the nurse practitioner in March 2005, she reported a 75% improvement in her depressive symptoms, including feeling more safe and being more social. In July, approximately 4 months later, she was seen again after a stressful work situation in which she discussed her sexuality with her command, and she was diagnosed with Adjustment Disorder NOS. Returning the next day, she and the provider discussed the command's consideration of a command-directed evaluation based on her level of distress over the past few months. The diagnosis given was Adjustment Disorder with Mixed Emotional Features and an Occupational Problem. That same day, she also met with another provider whom she had seen in the past who for this visit diagnosed her with Adjustment Disorder with Depressed Mood and Cluster B traits. c. The final note in the record dated 29 July 2005 stated [the applicant] was seen for the evaluation, and she still exhibited significant depressive symptoms. Her diagnoses were Depressive Disorder NOS and as the primary diagnosis, Personality Disorder NOS with Cluster C Traits, indicative of anxious or fearful patterns of emotions or behaviors. The resulting memorandum stated her depressive symptoms were responding well to treatment and were not likely to cause a decrease in her functioning. Concern about the maladaptive personality traits led to the recommendation for discharge. She had attended three of ten groups to help learn coping skills, and she was noted to have been quiet, not participating in group discussion. d. Throughout her contacts with Behavioral Health, some PTSD symptoms were evident; however, the record did not indicate the presence of enough symptoms to warrant the diagnosis of PTSD. Approximately 5 months after her discharge, she participated in her VA Compensation and Pension Evaluation and received a depressive disorder diagnosis. The following year, she related she had been sexually assaulted prior to and during her first deployment. She also reported some other, war-related traumatic events, though she had not reported any events on her post-deployment health assessments and denied such events during her command-directed evaluation. There was also no record of her experiencing or disclosing Military Sexual Trauma (MST) during her time in service. However, that is not to say it did not occur. If indeed she did experience MST, it puts many of her symptoms into context particularly her withdrawal and distrust of others and even the recurrence of her depressive symptoms. e. Considering her record in its entirety, many factors impacted her functioning. The basis for the personality disorder diagnosis was not clearly documented. The long-standing pattern seems to be garnered mostly from her adolescence without examples of similar behaviors occurring during her 5 years in the Army. Many of the criteria listed as concerning do not include examples of how she met the criteria. For instance, unstable personal relationships are mentioned several times but not the characteristic alternating between idealization and devaluation required for that criteria. The switch from Cluster B to Cluster C traits without explanation left an unclear conceptualization of her issues. Many of her behavioral and emotional patterns were also well explained by her depressive disorder, and not necessarily indicative of a personality disorder. Her depressive issues appeared throughout her history and seemed to impact her functioning significantly. Her command was concerned about her level of distress and her interpersonal relationships were significantly impacted. While she did appear to be improving with treatment, her depressive symptoms were recurrent and reactive to life events suggesting that resolution of symptoms could be expected with a return of significant symptoms under stress. f. The available record did not clearly support the diagnosis of personality disorder. [The applicant] had a depressive diagnosis with a long history of recurrence of significant difficulties impacting her functioning and at the time of her command-directed evaluation, her symptoms interfered with her ability to function effectively as an NCO. A referral for a Medical Evaluation Board was indicated at the time of her discharge. 12. On 3 July 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. She responded by providing copies of her awards and evaluations. She also provided a rebuttal to the advisory opinion. She stated: a. Comments concerning MST: (1) While deployed in Kuwait in April-May 2003 with the 141st Signal Battalion, she reported to her chain of command for the first time; MST with Staff Sergeant (SSG) I---- D-----s, 1st Armored Division, Wiesbaden, Germany. On a number of occasions, he had placed his hands on her person; pinching of butt, unwanted sexual conduct, physical abuse by grabbing the back of her head and placing it on top of a car while whispering, "You just won't have sex with me because I'm a black man " While on a field exercise in 2002, she was asleep in her tent with her headphones on when SSG I---- D-----s came into her tent and proceeded to climb on top of her and proceed with unwanted sexual intercourse. She thought if she pretended to be asleep he would go away but he didn't, so she pushed him away and he continued to force himself upon her. As she continued to struggle and tell him to stop, he then continued to exit. She was fearful at the time because he was a superior to her and she did not know how to address the situation within her unit. At this time he was a section sergeant and best friends with their Platoon Leader, Sergeant First Class (SFC) H------b. She was only a specialist/E-4 at the time. (2) Her unit deployed to Kuwait in April 2003. It was during this time that MST was first reported to her chain of command. It was late at night and she had awakened to use the bathroom, their entire company had been sleeping in the same tent. There were no bathrooms, only port-a-potty, so she had to walk outside the tent area to use the bathroom. When she was approaching the port-a-potty, she noticed SSG D----s was standing outside having conversations with two other NCOs. As she walked by him, he approached her and grabbed her buttocks. He attempted to converse with her but she informed him to stop and went about her business. The next day, this incident was reported to her chain of command. Her chain of command talked to both of them about this one incident. She was informed at the time that he has been warned and the behavior would stop. (3) The second time she reported to her chain of command was soon after arriving at Baghdad International Airport in May 2003 due to the fact that SSG D----s confronted her at the time, questioning her why she went to the chain of command. At the time, he was a section leader within her platoon, so they were always around one another. After reporting him harassing her about going to her chain of command, she then informed her unit of the prior MST. He was then brought in regarding harassment complaints. She was questioned multiple times by various people, including the battalion command sergeant major. During her deployment to Iraq in 2003, she came down on orders to go to Fort Lewis, so she left her unit while in Iraq. She left before the investigation was completed but was informed by an NCO within her former unit that SSG D----s was punished, demoted to an E-5, and he was left in charge of other Soldiers. b. Comments concerning "Not reporting events on post-deployment health assessment:" (1) When she left Baghdad Airport in November 2003, she manifested on a medical flight for Germany alone because her unit remained in Iraq. When she arrived to Germany, her former husband arrived at Ramstein airport to pick her up. He then drove her back to his apartment in Wiesbaden. She was in Germany about 30 days which was long enough for her to clear in order to move. She never went through the Soldier Readiness Processing sites during this time, and does not recall ever being asked to fill out any post-deployment information. She also would like to state that the majority of Soldiers, including herself, understand that if they were to report any type of issues, they would be frowned upon, looked down on for having any issues with what had happened to them. So for herself, as a Soldier who wanted to have a career in the military and as a Soldier who excelled in the military, she wanted to move forward with her career and try to put her Iraq deployment behind her. (2) She received an award in August 2003 which stated: "[the applicant] maintained an accident free record while being the lead driver on over twenty different convoys throughout the Baghdad area. She proved even more invaluable to convoy operations with her much needed skill as a combat life saver. She was also responsible for convoy communications by loading and maintaining the SINCGARS radio." She has included the copy of this award for review. c. Comments regarding Adjustment Disorder/Depressive Disorder: She has included a copy of her NCO Evaluation Report (NCOER) from April 2004 through April 2005 which reflects her dedication to the U.S. Military. She was viewed as a superb leader who excelled in positions of greater responsibility. Her struggles with adjustment began when she returned from her first deployment in December 2003. As a child, she faced struggles but she outgrew them and became an exceptional Soldier as illustrated through her various military wards, NCOER's, and Service School Academic Evaluation Reports. 13. Army Regulation 635-200 prescribes the policy for the administrative separation of enlisted personnel. Paragraph 5-13 provides for separating members by reason of personality disorder (not amounting to disability) that interferes with assignment or with performance of duty. 14. Army Regulation 635-5-1 (Separation Program Designator (SPD) Codes) states that the SPD codes are three-character alphabetic combinations, which identify reasons for, and types of separation from active duty. The SPD code of "JFX" SPD is the correct code for members separating under the provisions of paragraph 5-13 of Army Regulation 635-200 by reason of personality disorder. DISCUSSION AND CONCLUSIONS: 1. The applicant underwent a mental status evaluation that led to a diagnosis of personality disorder. Accordingly, her chain of command initiated separation action against her. Her separation processing was accomplished in accordance with the applicable regulation. All requirements of law and regulation were met and the rights of the applicant were fully protected throughout the separation process. 2. The evidence of record contains at least one mental status evaluation completed on the applicant that confirmed a diagnosis of personality disorder not amounting to a disability was made by proper medical authority. The record is void of any clear indication that the applicant was suffering from an unfitting PTSD condition at the time of discharge. 3. As for the MST, while the applicant's sincerity is not in question, she does not support her contention with any evidence in the form of a military police or Criminal Investigation Command report, a subsequent call to a pre-determined hotline or an Inspector General, a memorandum of record detailing the events that occurred, or any other documentary evidence to corroborate what occurred. 4. Nevertheless, a thorough review was conducted by OTSG of the applicant's case. The OTSG official opined that the available record did not clearly support the diagnosis of personality disorder. 5. In view of the foregoing and in response to her specific request, and as a matter of equity, the applicant should have the narrative reason for her separation changed 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 her DD Form 214 for the period ending 30 June 2006 and issuing her a new DD Form 214 to show she 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) AR20130006508 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20130006508 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1