BOARD DATE: 8 October 2013 DOCKET NUMBER: AR20130005730 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 the narrative reason for separation and the separation code be changed from "Personality Disorder" and "JFX" to medical discharge – post-traumatic stress disorder (PTSD). 2. The applicant states he is unable to be bonded for his job because he has a "JFX" separation code and "personality disorder" as the reason for his discharge. He had been diagnosed with PTSD by the Department of Veterans Affairs (VA) and he has PTSD due to his first combat deployment to Iraq. He is being treated through the VA mental health services due to being classified as having a personality disorder. 3. The applicant provides his DD Form 214 (Certificate of Release or Discharge from Active Duty). 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. With prior service in the U.S. Air Force (3 December 1992 to 2 August 1996), the applicant enlisted in the Regular Army (RA) on 1 April 1998 and he held military occupational specialty 11B (Infantryman). He served in Kuwait/Iraq from 1 September 2003 to 1 September 2004. 3. He served through multiple reenlistments or extensions in the RA and he attained the rank/grade of sergeant (SGT)/E-5. 4. On 17 January 2006, he underwent a command-directed mental status evaluation at the Mental Health Clinic, Fort Drum, NY. The DA Form 3822-R (Report of Mental Status Evaluation) shows: a. The applicant had been treated at Fort Drum mental health from 25 October 2005 through the present. His evaluation and treatment had revealed significant personality traits that were not conductive to a career within the military. He possessed affective instability, chronic feelings of self-doubt, high level of dependency on others and a need to please others, and feelings of rage when he freaks out. He remorsefully related a situation while deployed during which he was under stress and he lost it. He reported that he took power over one of his subordinate Soldiers and cut off his air supply before others intervened. b. The applicant was tearful while describing this incident and stated he did not know why he got irritated so easily. He was hospitalized in Germany and transferred to Walter Reed Army Medical Center before he was transferred back to Fort Drum. He denied any past hospitalization or psychiatric history. However, he reported other impulsive behavior. He stated that at one point while sitting in a government vehicle, he thought a bug landed on him. He reacted and punched his hand through the vehicle window, breaking the glass and hurting his hand. His personality traits prevented him from adequately fulfilling his occupational duties and presents substantial risk to mission readiness and safety. Consequently, separating him appeared to be in the best interest of the Army and the Soldier. His diagnosis was: * Axis I: Personality Disorder, Not Otherwise Specified (NOS) * Axis II: Personality Disorder (NOS) with Borderline Dependent Features (primary Diagnosis) * Axis III: Self-reported Lyme Disease and Joint Pain c. His condition was not amenable to hospitalization, short-term treatment, rehabilitative transfer, training, or reclassification to another type of duty within the military. It was unlikely that efforts to rehabilitate him or develop him into a satisfactory member would have been successful. He was mentally responsible, had the capacity to understand and participate in proceedings, and he met the retention standards of chapter 3, Army Regulation 40-501 (Standards of Medical Fitness). He was recommended for administrative separation under Army Regulation 635-200 (Active Duty Enlisted Administrative Separations), paragraph 5-13. 5. On 20 January 2006, the applicant's immediate commander notified the applicant of his intent to initiate separation action against him under the provisions of paragraph 5-13, Army Regulation 635-200 because of personality disorder with borderline dependency features. His ability to function in a military environment was significantly impaired and the problem was long-standing and not treatable in the context of military service. He recommended an honorable character of service. 6. On 20 January 2005, after the applicant acknowledged receipt of the notification of separation action, he was provided with an opportunity to consult with counsel but he declined this opportunity. He was advised of the basis for the contemplated separation and of the rights available to him in connection with the action. He waived his right to an administrative separation board and he elected not to submit statements in his own behalf. 7. 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. His intermediate commander recommended approval. 8. On 2 February 2006, 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 17 February 2006, the applicant was discharged accordingly. 9. His DD Form 214 shows he was discharged under the provisions of paragraph 5-13 of Army Regulation 635-200 with an honorable character of service. He completed 7 years, 10 months, and 17 days of active service. He was assigned separation code "JFX." 10. In connection with the processing of this case, an advisory opinion was obtained on 10 June 2013 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 his time in active service unless otherwise noted. a. None of the notes in the available record reference sufficient symptoms to determine whether criteria were met for any of his given diagnoses. The medical record indicated that in October 2005 the applicant was sent from Iraq for a mental health evaluation at Landstuhl Regional Medical Center (LRMC) with the diagnosis Acute PTSD. The psychiatry note at LRMC referenced an event in Iraq where in state of fury, the applicant assaulted a subordinate. At this LRMC visit his diagnosis was Chronic PTSD and Depressive Disorder - NOS. Further LRMC session notes refer to extreme difficulty with flying, needles, and his resulting impaired ability to join the flight to his home station. The record appeared to reflect psychiatric hospitalization at Walter Reed Army Medical Center enroute to his home station. The available inpatient record was sparse, showing he received psychological testing and a clinical interview; however, only the date and procedure were available in the electronic record, not the results. He received the diagnoses Anxiety Disorder NOS and Personality Disorder NOS, though again there were no symptoms available to reference. b. The record included one final Behavioral Health note on 4 January 2005, a follow-up to a crisis session the previous day after he awoke feeling overwhelmed and shaking. He stated he was feeling better saying, "I've made a lot of progress." One post-traumatic stress symptom was noted, a flashback on New Year's Eve. His diagnosis was Personality Disorder NOS and Anxiety Disorder NOS. The note referenced continuing with weekly therapy, the recommendation to reconnect with his stress management group, and a November Report of Mental Status Evaluation that was not received by command, so it was re-accomplished. c. The Report of Mental Status Evaluation listed Anxiety Disorder NOS and the primary diagnosis Personality Disorder NOS with Borderline and Dependent Features. While some characteristics of a personality disorder were noted in the report, the examples were from his deployment. There is no specific reference to concerning behaviors predating his deployment to indicate a long-standing pattern. Further, the Anxiety Disorder NOS diagnosis is documented though not discussed, with no explanation as to why a Medical Evaluation Board (MEB) was not considered. d. Approximately 2 months following his discharge, he was seen by a psychiatrist at the VA and diagnosed with PTSD. The psychiatrist did not note any personality disorder issues. Seen about two weeks later by a different provider, the PTSD symptoms were confirmed and some dependent personality traits were noted. According to his Report of Mental Status Evaluation, the applicant did have an anxiety condition that could have been referred to an MEB; however, with no diagnostic notes to review, it could not be determined if that diagnosis met the requirement for referral to an MEB. There was insufficient information to know if an MEB would have been indicated at the time of his discharge, and insufficient information to determine whether or not his noted personality disorder features met criteria for the diagnosis. If he has additional documentation related to his Behavioral Health treatment during his time in service, that documentation could be considered. 11. On 3 July 2013, an addendum to the 10 June 2013 advisory opinion for the applicant was submitted. It states the applicant's 11 October 2005 medical record indicated he experienced joint pain associated with Lyme disease. Laboratory results for Lyme disease are evident in his record beginning November 2004. His symptoms included depression, anxiety, irritability, difficulty concentrating, irritability, poor short-term memory, and difficulty sleeping. These symptoms can in some cases be associated with Lyme disease. Additionally, documented physical symptoms that may have been associated with Lyme disease included but were not limited to shortness of breath, headaches, numbness or tingling, weight change, dizziness, and chest pain. Lyme disease is a potentially boardable condition. Recommend a review of the applicant's medical condition at the time of his military separation to determine if an MEB prior to discharge may have been indicated. Moreover, to more clearly comment on the issue of personality disorder, the available record did not validate the diagnosis of Personality Disorder-NOS. 12. On 22 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. To date, he has failed to reply. 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. DISCUSSION AND CONCLUSIONS: 1. The applicant's requests to change the narrative reason for separation has been carefully considered; however, there is insufficient evidence to support this claim. 2. The applicant underwent a mental status evaluation that led to a diagnosis of a personality disorder. Accordingly, his chain of command initiated separation action against him. His 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. 3. The evidence of record contains a mental status evaluation completed on the applicant that confirmed a diagnosis of personality disorder not amounting to 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 his discharge. As confirmed by the OTSG advisory opinion, while it is possible he may have developed PTSD at a later date, there is no evidence he met full criteria for PTSD at the time of his separation and that diagnosis is not recorded in his available record during his time of active service. There is insufficient medical evidence to support an unfitting PTSD finding at the time of discharge. 4. In view of the foregoing, absent any evidence of error or injustice in the separation process or medical evidence confirming the applicant was suffering from an unfitting PTSD condition at the time of his discharge, there is an insufficient evidentiary basis to support granting the requested relief. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING _X____ ___X_____ __X______ 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. _______ _ 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) AR20130005730 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20130005730 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1