ADDENDUM TO RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2014-03590 COUNSEL: NONE HEARING DESIRED: NOT INDICATED APPLICANT REQUESTS THAT: He be granted a medical retirement. APPLICANT CONTENDS THAT: He was discharged from the Air Force with a psychiatric disorder (paranoid delusional disorder). His commanders realized he was acting “strange” starting in 1986 and eventually deemed him “psychiatrically unfit for flying duties.” His psychiatric problems began after flying Top Secret missions to Central America in support of the Central Intelligence Agency (CIA). On 14 August 1986, he was returned to flying duties and the evaluating physician noted “normal findings.” A psychiatric evaluation at Brooks AFB, TX conducted 23 September to 1 October 1986 found him to be psychiatrically qualified for flying class II duties. However, at this time, he was growing increasingly paranoid about being followed and monitored because of his flight duties in Central America in support of the CIA. On 13 January 1989, he was transferred to Altus AFB, OK to enter C-5 qualification training. Soon after arriving, he began receiving threats from his wife. This along with his increasing paranoia made it impossible to concentrate on his studies. Although he requested to resign his commission in 1989, he was not mentally capable to make any decisions concerning his life, career or personal situation. Several doctors have alluded to this fact and he was thoroughly confused and scared by the end of July 1989, before his discharge in August 1989. He was given a 12-hour notice to get out of the Air Force as he continued to act erratic and psychotic. His medical records from April 1989 reveal he was not psychiatrically qualified for flying duties. He was deemed a risk to mission completion and was permanently grounded. The doctors said he had a personality disorder but he provides evidence which shows he resigned his commission as a result of his paranoid delusions which he did not disclose because he thought they worked for the CIA. This is the direct result of his involvement in the Iran-Contra missions. His psychological problems then and now were the result of his job as a transport pilot. He still receives therapy from the Birmingham Veterans Affairs (VA) Hospital and is on anti-psychotic medicine, which he will likely have to take for the rest of his life. The ex parte order dated 10 August 1989 (a mere nine days after his discharge) shows he was scared, confused and that he believed the CIA was trying to kill him. He provides letters of support attesting to his mental health condition. His previous request for a medical discharge, AFBCMR Docket Number BC-1990-01019, was denied per AFBCMR letter dated 25 February 1991. However, the letter stated he could submit newly discovered relevant evidence for consideration. In an e-mail dated 17 November 2015, the applicant states he is willing to return to active duty in the grade of O3-E in any Air Force Specialty Code (AFSC) he is qualified to perform despite his disabilities and extensive medical record. He earned many Military Occupational Specialties (MOS) and AFSCs during his 17 and a half years of service as an enlisted member, warrant officer and commissioned officer in the Army and Air Force. He requests the Board review his military records starting in 1972 when he volunteered for Vietnam as an airborne paratrooper. The applicant’s complete submission, with attachments, is at Exhibit A. STATEMENT OF FACTS: On 28 March 1981, the applicant entered this period of active duty. In a letter dated 4 May 1989, the applicant voluntarily requested disqualification from aviation service. The reason for his request was a self-initiated elimination from the C-5 initial qualification course as a result of extreme marital difficulties which caused profound stress in his life. On 5 May 1989, his commander recommended approval of his request that he be voluntarily disqualified from aviation service in lieu of a Flying Evaluation Board (FEB). The letter states that after a month of counseling regarding divorce and custody of his son, the applicant requested to be eliminated from the C- 5 initial pilot qualification course. The letter further states that a mental health evaluation of the applicant on 13 April 1989 indicated he was not psychiatrically qualified for flying class II duties In Accordance With (IAW) AFR 160-143, Medical Examinations and Standards. The applicant was also considered to be a risk to mission completion as his pattern of inflexibility and perfectionistic style would probably persist, particularly without psychotherapy. In a letter dated 17 July 1989, the Headquarters United States Air Force Deputy Director of Operations (HQ USAF/XOO) approved the recommendation the applicant be voluntarily disqualified from aviation service in lieu of a FEB. Per Aeronautical Order 58 dated 27 July 1989, the applicant was permanently disqualified from aviation service in lieu of a FEB. On 2 August 1989, he was honorably discharged with a narrative reason for separation of “Voluntary Resignation: Miscellaneous Reasons.” He was credited with 8 years, 4 months and 5 days of active duty service this period. He was also credited with 6 years, 5 months and 15 days of prior active service. On 5 February 1991, the Board denied the applicant’s initial application that his miscellaneous reason for separation be void, he be retroactively reinstated to active duty, his flight pay be reinstated and he receive a medical retirement. The Board was not convinced that at the time of his discharge, he was physically unfit or mentally incompetent to perform his duties. Although the record showed he had a diagnosed personality disorder and other medical problems, none of the conditions were considered medically unfitting for military service. On 7 July 1995, the DVA granted the applicant’s appeal he be granted service connection for his disability condition of Delusional Disorder. On 27 April 1999, the Board denied the applicant’s second appeal he be placed on the Temporary Disability Retired List (TDRL) or be medically discharged. As in the earlier findings, the Board determined the applicant was not found unfit at the time of his separation, that his resignation and disqualification from aviation service was not involuntary or that he was incompetent to make these decisions at the time his requests were submitted. The Board did not dispute the applicant’s unusual behavior less than two weeks following his release from active duty caused his family enough alarm that he was referred for a mental health assessment at a civilian facility and that his condition was diagnosed as Delusional Disorder. However, the Board agreed with the military medical authorities that the applicant was not unfit at the time of his service. The remaining relevant facts pertaining to this application are contained in the memorandums prepared by the Air Force Offices of Primary Responsibility (OPR), which are attached at Exhibits D and E. AIR FORCE EVALUATION: AFPC/DPFD recommends a medical board be convened to determine whether a medical discharge or retirement would have been appropriate based on the medical records available at the time of the applicant’s release from active duty. The preponderance of evidence reflects an injustice occurred by acceptance of the applicant’s resignation without benefit of a medical board. The documents provided indicate the applicant was misdiagnosed with Obsessive-Compulsive Disorder (OCD) in 1989 and this misdiagnosis prevented the discovery of the actual diagnosis of Delusional Disorder, for which he should have been medically boarded. A complete copy of the AFPC/DPFD evaluation is at Exhibit D. The BCMR Clinical Mental Health Consultant recommends denial. The applicant’s in-service clinical diagnosis (Personality Disorder) fell into a category of disorders not considered a disability by either the Military Department or the Department of Veterans Affairs (DVA). Consequently, he was not eligible for a medical discharge via Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB), under AFR 35-4, or today’s AFI 36-3212, Physical Evaluation for Retention, Retirement and Separation. From a mental health perspective, the applicant was appropriately diagnosed and dispositioned In Accordance With (IAW) the results of extensive and competent examination, and regulatory guidance in place at the time. On 13 April 1989, the applicant underwent a command directed mental health evaluation. The evaluating psychologist refers to the applicant’s “pattern of inflexibility and perfectionism” and further states “preoccupation with rules, efficiency and details interfered with his ability to take a broad view of situations. In addition, he appears excessively conscientious and moralistic. Interpersonal relations appear to be dysfunctional as evidenced by marital problems, which may be the result of his obsessive-compulsive style of interaction.” The applicant was diagnosed with marital problems and OCPD. Ultimately, the applicant requested and was granted voluntary separation effective 1 [sic] August 1989. Shortly after his separation, he demonstrated extreme paranoid behavior and was involuntarily hospitalized between August and September 1989. In October 1991, the applicant underwent a formal VA psychiatric examination and was diagnosed with severe adjustment disorder. In July 1992, he was diagnosed with major depressive disorder with severe paranoid process. The claim he suffered a significant emotional break around the time of his separation has been cited as reason to believe he suffered Delusional Disorder while still on active duty. This assertion is not supported by the mental health examination performed only months prior to his separation. What is extensively documented is the applicant’s penchant for rigidity and inflexibility. These very qualities, when amplified to a degree as to warrant a diagnosis of personality disorder could very plausibly (and likely did) lead to a period of extreme mental instability, and even psychosis, during a period of extreme duress, such as the interpersonal, financial and occupational stress suffered by the applicant during the time of his departure from active duty. He has subsequently been diagnosed with Delusional Disorder with paranoid features and has been granted service connection by the DVA, citing the applicant’s exposures to stress while serving as a military aviator. Per 38 U.S.C. § 4.125, Diagnosis of Mental Disorders, paragraph(b) which reads: “If the diagnosis of a mental disorder is changed, the rating agency shall determine whether the new diagnosis represents progression of the prior diagnosis, correction of an error in the prior diagnosis, or development of a new and separate condition. If it is not clear from the available records what the change of diagnosis represents, the rating agency shall return the report to the examiner for a determination. In the case of the applicant, no evidence is presented that proves or suggests that the diagnosis issued at the time of his military service was a diagnostic error. Addressing the applicant’s request for a medical separation/retirement, the Disability Evaluation System (DES), established to maintain a fit and vital fighting force, can by law under 10 U.S.C. only offer compensation for those service incurred diseases or injuries which specifically rendered a member unfit for continued active service and were the cause for career termination; and then only for the degree of impairment present at the time of separation and not based on future occurrences. The clinical evaluators at the time of the applicant’s service found no evidence of a disqualifying mental health disorder that warranted a MEB and processing via a PEB, as a compensable disability under AFR 35-4, today’s AFI 36-3212, Physical Evaluation for Retention, Retirement and Separation. Operating under a different set of laws, 38 U.S.C., with a different purpose, the DVA is authorized to offer compensation for any medical condition determined service incurred, without regard to, and independent of, its demonstrated or proven impact upon a service member’s retainability, fitness to serve, narrative reason for separation or length of time passed since discharge. This is the reason why an individual can be found fit for release from military service for one reason and yet sometime thereafter receive a compensation rating from the DVA for one or more service-connected, but not militarily unfitting condition. The DVA is also empowered to conduct periodic re- evaluations for the purpose of adjusting the disability rating as the level of impairment from a given service connected medical condition may vary over the lifetime of the veteran. A complete copy of the BCMR Clinical Mental Health Evaluation is at Exhibit E. APPLICANT'S REVIEW OF AIR FORCE EVALUATION: Copies of the Air Force evaluations were forwarded to the applicant on 4 January 2016 for review and comment within 30 days (Exhibit F). As of this date, no response has been received by this office. 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 an error or an injustice. We have thoroughly reviewed the evidence of record and considered the weight and relevance of the documentation provided by the applicant, and whether or not it was discoverable at the time of any previous application. We also note AFPC/DPFD recommends the applicant’s records be evaluated by a medical evaluation board. However, we do not believe the information submitted is sufficient to overcome the rationale expressed in the previous decisions of the Board (AFBCMR BC-1990-01019) or the assessment of the case by the BCMR Clinical Mental Health Consultant. Although we do not dispute the applicant was diagnosed with Delusional Disorder shortly after his separation and was subsequently rated by the DVA for compensable service connected disability for this condition; there is no evidence the applicant had an unfitting condition while on active duty and should have been processed through the DES, a prerequisite to a medical discharge. On the contrary, the preponderance of the evidence indicates the applicant voluntarily requested disqualification from aviation service and submitted his resignation as a result of marital discord and child custody issues which caused him significant stress. Moreover, as pointed out by the BCMR Mental Health Consultant, the applicant’s command directed mental health evaluation of 13 April 1989 included a diagnosis of Personality Disorder, a condition not ratable by the Military Department or the DVA; therefore, the applicant was not eligible for a medical separation. The applicant also contends he was not competent in making the request to separate; however, we find no evidence to indicate this to be the case. Lastly, the applicant requests the Board consider his record of service in the Army and Air Force and return him to active duty as an O3-E. Although we are not unsympathetic to the applicant’s situation, we do not view this request as reasonable given his post-service diagnosis of Delusional Disorder. Therefore, in view of the aforementioned and in the absence of evidence to the contrary, we find no basis to recommend granting the requested relief. 4. The applicant’s case is adequately documented and it has not been shown that a personal appearance with or without counsel will materially add to our understanding of the issues involved. Therefore, the request for a hearing is not favorably considered. THE BOARD DETERMINES THAT: The applicant be notified the evidence presented did not demonstrate the existence of material error or injustice; the application was denied without a personal appearance; and 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 AFBCMR Docket Number BC-2014-03590 in Executive Session on 10 February 2016 under the provisions of AFI 36-2603: , Panel Chair , Member , Member The following documentary evidence was considered: Exhibit A. DD Form 149, dated 14 August 2014, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Addendum to Record of Proceedings, BC-90-01019, 27 April 1999, w/atchs. Exhibit D. Memorandum, AFPC/DPFD, dated 9 December 2014. Exhibit E. Memorandum, BCMR Clinical Mental Health Advisor, 28 December 2015. Exhibit F. Letter, AFBCMR, dated 4 January 2016.