RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2012-04240 COUNSEL: NONE HEARING DESIRED: NO ________________________________________________________________ APPLICANT REQUESTS THAT: His narrative reason for separation be changed from “adjustment disorder” to “service related disability.” ________________________________________________________________ APPLICANT CONTENDS THAT: He was discharged for a service related disability. Specifically, depression severely worsened by his service to the point of counseling, medication, and eventual discharge from the Air Force. He has been denied certain medical benefits because he only served two years before his medical discharge and his reason for separation does not state that he had a “service related disability.” In support of his request, the applicant submits his Department of Veterans (DVA) file “claim number” in item 10 on his DD Form 149. The applicant’s complete submission is at Exhibit A. ________________________________________________________________ STATEMENT OF FACTS: 1. According to copies of documents extracted from the Automated Records Management System (ARMS), the applicant enlisted in the Regular Air Force on 4 October 2005 and was discharged on 1 November 2007, with an honorable characterization of service and was credited with 2 years and 28 days of active duty service. 2. Administrative documentation pertaining to the applicant’s involuntary separation under AFI 36-3208, Administrative Separation of Airmen, paragraph 5.11.9, Mental Disorders, is not provided in the case file. ________________________________________________________________ AIR FORCE EVALUATION: 1. The AFBCMR Medical Consultant recommends denial. The Medical Consultant states an “Adjustment Disorder” is listed among mental conditions not considered a disability under Department of Defense Instruction (DoDI) 1332.80 and AFI 36- 3208, as noted in the following extract from AFI 36-3208, paragraph 5.11.9. Mental Disorders, “a recommendation for discharge under this provision must be supported by a report of evaluation by a psychiatrist or clinical psychologist that confirms the diagnosis of a disorder listed below, as contained in the Diagnostic and Statistical Manual of Medical Disorders (DSM-IV). This report must state the disorder is so severe that the member's ability to function effectively in the military environment is significantly impaired. This report may not be used as, or substituted for, the explanation of the adverse effect of the condition on assignment or duty performance.” 2. The Medical Consultant further states diagnostic nomenclature assigned to a given set of psychiatric symptoms and stressors, as reported by a patient at a given point in time (during a military evaluation), not uncommonly may change over time; or may be reported differently at subsequent point in time, e.g., post-service DVA Compensation & Pension (C&P) evaluation. Therefore, with disclosure of a different clinical history or set of symptoms, a new mental health provider may reach a different diagnostic conclusion, as is likely in the case under review. Professional diagnostic opinions may even vary between two different providers when given the same set of clinical symptoms from the same patient; and during the approximate same period of time. Furthermore, a change in diagnosis may legitimately occur following a greater period of observation and treatment; notwithstanding the fact that individuals may also experience symptoms that are shared (overlapped) by one or more other clinical diagnoses (pl.), e.g., the depressed mood seen in Adjustment Disorder, Major Depressive Disorder, Dysthymic Disorder, Anxiety Disorder, PTSD, and secondary to Alcohol Dependence; and mood swings seen in Cyclothymic Disorder, Bipolar Disorder and Borderline Personality Disorder. Yet two or more mental disorders [Axis I and/or Axis II diagnoses] may even co-exist concurrently, as co- morbid mental disorders in the same individual, often times making it difficult or inappropriate to attempt to separate the two due to their close association and shared clinical features. 3. The applicant has supplied no service medical documentation addressing a mental condition, e.g., profile restrictions or narrative summaries warranting referral for a Medical Evaluation Board, other than his separation physical examination form, which does indicate existence of depression at the time of his release from service. Nevertheless, the fact that the applicant has been given a different diagnosis by the DVA provider, some three years post-service (and only made effective two years post-service), is insufficient to invalidate the accuracy or appropriateness of the conclusions reached by equally competent military mental health authorities who were most familiar with the applicant's pattern of behavior at the "snap-shot" time of his release from military service. Thus, the Medical Consultant opines the applicant has not sufficiently met the burden of proof of error or injustice that warrants the desired change of the record. The complete AFBCMR Medical Consultant evaluation is at Exhibit C. ________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: A copy of the Air Force evaluation was forwarded to the applicant on 13 March 2013 for review and comment within 30 days (Exhibit D). To date, a response has not been received. ________________________________________________________________ THE BOARD CONCLUDES THAT: 1. The applicant has exhausted all remedies provided by existing law or regulations. 2. The application was not timely filed; however, it is in the interest of justice to excuse the failure to timely file. 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 note there was insufficient evidence within the applicant’s military personnel record to confirm the circumstances and facts surrounding his discharge. Absent the documentation, there is a presumption of regularity in which the applicant was afforded due process and the discharge was consistent with procedural and substantive requirements of the discharge regulation. The applicant has provided no evidence, which would lead us to believe his discharge was contrary to the provisions of the governing regulation. Therefore, we are in agreement with the BCMR Medical Consultant’s assessment of the case that the applicant has not sufficiently met the burden of proof of error or injustice that warrants the desired change of the record. Accordingly, in the absence of evidence to the contrary, we find no compelling basis to recommend granting the relief sought in this application. ________________________________________________________________ THE BOARD DETERMINES THAT: The applicant be notified that the evidence presented did not demonstrate the existence of material error or injustice; that the application was denied without a personal appearance; and that 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 this application in Executive Session on 2 July 2013, under the provisions of AFI 36-2603: , Panel Chair , Member , Member The following documentary evidence was considered in AFBCMR Docket Number BC-2012-04240: Exhibit A. DD Form 149, dated 27 August 2012. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, BCMR Medical Consultant, dated 5 March 2013. Exhibit D. Letter, SAF/MRBC, dated 13 March 2013. AFBCMR 1500 West Perimeter Road Joint Base Andrews NAF Washington, MD 20762 Dear: Reference your application submitted under the provisions of AFI 36-2603 (Section 1552, 10 USC), AFBCMR Docket Number BC-2012-04240. After careful consideration of your application and military records, the Board determined that the evidence you presented did not demonstrate the existence of material error or injustice. Accordingly, the Board denied your application. You have the right to submit newly discovered relevant evidence for consideration by the Board. In the absence of such additional evidence, a further review of your application is not possible. BY DIRECTION OF THE PANEL CHAIR Attachment: Record of Board Proceedings DEPARTMENT OF THE AIR FORCE WASHINGTON, DC Office of the Assistant Secretary