BOARD DATE: 29 August 2017 DOCKET NUMBER: AR20160002043 BOARD VOTE: _________ _______ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ____X____ ____X____ ____X____ DENY APPLICATION 2 Enclosures 1. Board Determination/Recommendation 2. Evidence and Consideration BOARD DATE: 29 August 2017 DOCKET NUMBER: AR20160002043 BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined 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. BOARD DATE: 29 August 2017 DOCKET NUMBER: AR20160002043 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: The applicant defers to counsel. COUNSEL'S REQUEST, STATEMENT, AND EVIDENCE: 1. Counsel requests correction of the applicant's records to show he was medically discharged/retired with at least a 30-percent disability rating due to post-traumatic stress disorder (PTSD) or, in the alternative, retroactive placement on the Temporary Disability Retired List (TDRL) based on his post-service diagnosis of PTSD. 2. Counsel states the applicant's medical records indicate he had PTSD, not an adjustment disorder. 3. Counsel provides: * undated 7-page legal brief * service personnel and medical records * Department of Veterans Affairs (VA) records * excerpts from the Diagnostic and Statistical Manual of Mental Disorders (DSM) 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 enlisted in the Regular Army on 10 June 1998 and remained on active duty through continuous reenlistments. He was promoted to sergeant effective 1 August 2001. He deployed to Iraq on 26 March 2003 in support of Operation Iraqi Freedom. 3. Counsel provided a DA Form 4856 (Developmental Counseling Form), dated 28 July 2003, showing the applicant was counseled for attempted suicide on 27 July 2003. 4. The applicant departed Iraq on 7 September 2003. 5. On 12 September 2003, he underwent a psychiatric evaluation and was diagnosed with an adjustment disorder. The psychiatrist determined he met retention standards, he was mentally responsible, and there was no psychiatric disease or defect that warranted a medical board. He was psychiatrically cleared for any administrative action deemed appropriate by his command. The examining psychiatrist noted the psychiatric factors indicated administrative separation under the provisions of Army Regulation 635-200 (Personnel Separations – Enlisted Personnel), paragraph 5-17, would be in the best interests of the applicant and the military. 6. On 16 October 2003, his commander initiated action to separate him for other designated physical or mental conditions under the provisions of Army Regulation 635-200, paragraph 5-17. 7. On 22 October 2003, the separation authority approved the recommendation for separation and directed characterization of his service as honorable. 8. On 14 November 2003, he was honorably discharged by reason of a condition, not a disability, under the provisions of Army Regulation 635-200, paragraph 5-17. He completed 5 years, 5 months, and 5 days of net active service during this period. 9. There is no evidence showing he was diagnosed with PTSD or any other condition that would have warranted his entry into the Physical Disability Evaluation System prior to his discharge. 10. There is no evidence showing he had a medical condition that did not meet retention standards. 11. Counsel provided: a. a VA medical record, dated 20 March 2004, showing the applicant was diagnosed with PTSD; b. documentation from the VA, dated 17 May 2004, showing the applicant was granted service-connected disability compensation effective 15 November 2003 for: * history of rotator cuff tear of the right shoulder with continued pain – 10 percent * PTSD – 10 percent * left ear hearing – 0 percent * tinnitus – 0 percent c. a VA medical record, dated 4 February 2006, showing the applicant was diagnosed with chronic, moderate PTSD; d. a VA Rating Decision, dated 22 February 2006, showing the applicant's evaluation of PTSD was increased to 70 percent effective 17 October 2005; and e. a VA Rating Decision, dated 16 August 2010, showing the applicant's entitlement to individual unemployability was granted effective 10 May 2010. 12. Counsel also provided an undated 7-page legal brief wherein he stated: a. The applicant was administratively separated from the Army following a suicide attempt in July 2003 while he was deployed to Iraq. Following the suicide attempt, he received a psychiatric evaluation and was diagnosed with "adjustment disorder, not otherwise specified (related to military service)." The psychiatric evaluation recommended the applicant's administrative separation. Based on that recommendation, his commanding officer initiated an administrative separation in October 2003 and he had been administratively separated from the Army by November 2003 with an honorable discharge. b. Following the applicant's discharge, he applied for VA benefits. As part of this process, he received a VA psychiatric evaluation in March 2004. The VA examiner determined he met the full criteria for PTSD. He was granted service connection for PTSD and assigned a 10-percent disability rating. In February 2006, the VA increased his disability rating for PTSD from 10 percent to 70 percent. c. Because the applicant's medical records indicate he should have been medically discharged, or at least placed on the TDRL rather than administratively discharged for an alleged adjustment disorder, the applicant requests correction of his records to indicate he was found unfit for service and medically discharged for PTSD at a 30-percent or higher disability rating. d. Alternatively, the applicant requests retroactive placement on the TDRL. Had he been placed on the TDRL, the Army would have been required to reevaluate the applicant to determine if he should have been permanently retired. There is ample evidence to support a finding that the applicant's disability is both permanent in nature and at least 30-percent disabling under the standard schedule of rating disabilities. e. The applicant's enlistment physical was completed on 21 April 1998. According to his examination report, he had a normal psychiatric profile upon his entrance in the Army and the military examiner did not note any personality deviations in the examination report. As a result, he was found qualified for enlistment in the Army. f. While deployed in Iraq in 2003, the applicant attempted suicide. He was not able to complete the suicide attempt because a member of his unit was able to disarm his rifle. Following the suicide attempt, he was evacuated to Kuwait for a mental health evaluation and treatment. During his deployment, he was exposed to direct land-based combat in which he discharged his weapon and coalition and enemy Soldiers were wounded or killed. In a post-deployment health assessment, dated 4-5 August 2003, he reported he was involved in combat in which he felt in danger of being killed. The military examiner who interviewed the applicant determined he was exposed to traumatic events in Iraq and that there were concerns about his mental status and ability to stay in the Army. g. According to the applicant's VA examination report, he described numerous traumatizing events from his deployment, including being exposed to rocket-propelled grenades and other enemy weapons. He described one situation in which a rocket-propelled grenade landed near him and blew the foot off another Soldier. The VA examiner noted the series of events the applicant described, taken in conjunction with his Combat Infantryman Badge and score on the Combat Exposure Scale, indicating moderate to heavy combat exposure, all suggest the applicant was exposed to a high level of combat-related stress. The VA examiner determined the applicant satisfied the full criteria for PTSD. h. A review of the applicant's medical records indicates he should have been diagnosed with PTSD, not an adjustment disorder. According to the DSM, 4th edition, the edition utilized by the Army at the time of the applicant's discharge from the Army, the "essential feature of an adjustment disorder is a psychological response to an identifiable stressor or stressors that result in the development of clinically significant emotional or behavioral symptoms" and "[b]y definition, an [a]djustment [d]isorder must resolve within 6 months of the termination of the stressor..." The essential feature of PTSD is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury or witnessing an event that involves death, injury, or a threat to the physical integrity of another person. By contrast, the stressor triggering an adjustment disorder may be a single event or there may be multiple stressors. An adjustment disorder diagnosis should not be used if the disturbance meets the criteria for another specific Axis I disorder (PTSD). i. The applicant did not have a mental health condition prior to his enlistment in the Army. While in Iraq, he was exposed to severe combat stressors that led to his suicide attempt and the development of PTSD symptoms. A week after his suicide attempt, he was evacuated to Kuwait for a mental health evaluation. The Army clearly recognized the applicant was suffering from a mental condition that was interfering with the performance of his duties and was based on his stressors from combat. Per Army Regulation 40-400 (Patient Administration), the applicant should have been referred to a medical evaluation board (MEB) if his medical fitness for return to duty was questionable, problematic, or controversial. Instead, the applicant was administratively separated under the provisions of Army Regulation 635-200, paragraph 5-17. j. PTSD is an anxiety disorder. An anxiety disorder that interferes with effective military performance is cause for referral to an MEB. The Army believed the applicant's PTSD was interfering with the effective performance of his duties when it chose to separate him. k. The Army did not allow the applicant's condition to develop over time to see if the condition would resolve itself or if his symptoms persisted for longer than 6 months and his condition would need to be recharacterized as PTSD. l. A similar situation arose in Cowles versus McHugh. In the Cowles case, the plaintiff sued the ABCMR after it denied his application to correct his records to reflect he was separated for PTSD rather than for adjustment disorder. The plaintiff argued the Army's decision to separate him for an adjustment disorder without giving him up to 6 months to recover violated Army Regulation 635-200, paragraph 5-17, which states a Soldier must be given ample opportunity to overcome any deficiencies caused by his adjustment disorder before being separated from the military. The court agreed, concluding it was an error for the Army to separate the plaintiff for adjustment disorder without allowing him up to 6 months from the onset of his symptoms to determine if he did suffer from an adjustment disorder. m. The Army did not allow the applicant ample opportunity to recover from an adjustment disorder when the onset of his symptoms were in July 2003, he was diagnosed with the condition in September 2003, and he was separated by the Army in November 2003. If the Army had allowed for the proper 6-month period to evaluate the applicant's condition, then it would have discovered the appropriate diagnosis for his condition was PTSD. The applicant's condition has not improved and he has been receiving treatment for PTSD since he was diagnosed with PTSD by the VA in March 2004. n. If the applicant had been properly referred to an MEB, the MEB most likely would have determined the applicant's PTSD had caused him to fall below the Army's standards for medical fitness. o. The Army's decision to administratively separate the applicant is evidence that the Army believed his mental health condition was interfering with his ability to effectively perform his military duties. p. The VA's 10-percent disability rating is questionable. According to the March 2004 VA examination report, the applicant reported symptoms of depressed mood, periodic crying spells, insomnia with up to seven nightmares a night, social isolation, panic-like symptoms, irritability, hypervigilance, and emotional coldness. The VA examiner found moderate level of psychosocial impairment in that the symptoms are limiting his social interaction via isolation, avoidance, panic-like episodes, and fatigue secondary to sleep problems. The symptoms described along with his suicidal conduct prior to his discharge from the Army should have been sufficient to support at least a 30-percent disability rating. The criteria for a 30-percent evaluation is occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks due to such symptoms as depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, and mild memory loss. Based on the March 2004 examination report, the applicant satisfied the criteria for a 30-percent evaluation. q. The applicant's increased disability rating of 70 percent was based on VA treatment records and a VA examination which contained evidence of widespread paranoia and distrust, hyper-startle and hypervigilance, poor sleep due to fear of nightmares, and the examiner's assessment of severe impairment of psychosocial function. r. If the ABCMR finds the applicant should not have been medically discharged for PTSD, he should be retroactively placed on the TDRL in accordance with Title 38, Code of Federal Regulations, section 4.129, which provides that when a mental disorder that develops in service as a result of a highly stressful event is severe enough to bring about the applicant's release from active military service, the rating agency shall assign an evaluation of not less than 50 percent and schedule an examination within the 6-month period following the applicant's discharge to determine whether a change in evaluation is warranted. The applicant developed a mental disorder during service that caused him to be separated from the Army and active military service. Pursuant to Title 38, Code of Federal Regulations, section 4.129, he should have been assigned an evaluation of not less than 50 percent and evaluated 6 months later. If the applicant had been afforded this evaluation after a 6-month waiting period, it would have been clear that his symptoms had not resolved themselves and were therefore not symptomatic of an adjustment disorder, but rather were evidence of PTSD. s. Once placed on the TDRL, the Army would have been required to reevaluate the applicant to determine if he should be permanently retired. A physical examination is required at least once every 18 months to determine if there has been a change in the disability for which the Soldier was temporarily retired. This required physical examination would have shown the applicant was suffering from PTSD and not an adjustment disorder. The February 2006 decision by the VA to rate the applicant as 70-percent disabled is also a strong indicator of the severity of the disability 18 to 36 months from his date of discharge. A disability rating of 70 percent for his PTSD would have required transfer to the Permanent Disability Retired List. t. All of the evidence and documentation overwhelmingly shows the applicant should have been medically retired or at least placed on the TDRL and then permanently retired for PTSD rather than being administratively discharged for an alleged adjustment disorder. An adjustment disorder, by definition, must resolve itself within 6 months of termination of the stressor. The applicant's mental health condition did not resolve itself within 6 months, but rather continued to worsen over time. The proper diagnosis for the applicant's condition was PTSD, not an adjustment disorder. However, the Army did not grant the applicant enough time to evaluate his condition fairly before he was administratively discharged. His military record should be corrected to reflect that he was found unfit and medically retired for PTSD with at least a 30-percent disability rating. 13. With regard to the ABCMR case referenced by counsel, the following information is provided: a. The applicant in the referenced case was diagnosed with PTSD less than 2 months following his discharge, initially rated at 30-percent disabling. b. On 21 July 2015, the ABCMR concluded the applicant in the referenced case "was not retained on active duty for a sufficient period of time to permit his recovery or to be diagnosed with having a mood disorder or PTSD warranting referral into the IDES [Integrated Disability Evaluation System]." 14. An advisory opinion was rendered by the Chief, Behavioral Health Division, Office of the Surgeon General, dated 23 September 2016, wherein he stated: a. Following a suicide attempt in Iraq in July 2003, the applicant was diagnosed with an adjustment disorder, not otherwise specified (related to military service), and psychiatrically cleared for any administrative action deemed appropriate by his command. b. In a 20 March 2004 VA mental disorders examination, he was found to meet the criteria for chronic, moderate PTSD, but he did not seek treatment until October 2005. In a 17 May 2004 VA Rating Decision, he was granted service connection for PTSD with a disability rating of 10 percent effective 15 November 2003. Following his February 2006 PTSD review examination, his disability rating was increased to 70 percent effective 17 October 2005. c. Although the applicant clearly struggles with PTSD, eligibility for medical retirement is determined by fitness for duty at the time of discharge. The psychiatric evaluation conducted on 12 September 2003 clearly states, "This individual meets the retention standards as prescribed in CHAP 3, AR 40-501 [Chapter 3, Army Regulation 40-501], and there is no psychiatric disease or defect that warrants medical board." While it is plausible that his suicide attempt was triggered by an acute stress reaction that later developed into PTSD, there is insufficient information to make a more definitive determination. 15. A copy of the advisory opinion was provided to the applicant for comment and/or rebuttal. On 22 November 2016, counsel responded and stated: a. The advisory opinion ignores that the applicant was administratively separated from the Army for an adjustment disorder without allowing a 6-month period to determine whether the adjustment disorder would resolve. b. The advisory opinion's reliance on the psychiatric evaluation conducted on 12 September 2003 is incorrect and misplaced. c. The advisory opinion ignores that the applicant should have been referred to an MEB. d. The advisory opinion does not address the applicant's request to be retroactively placed on the TDRL. 16. A second advisory opinion was rendered by the Army Review Boards Agency staff psychiatrist, dated 6 December 2016, wherein she stated: a. The VA documentation submitted by counsel indicates the applicant was found to meet criteria for PTSD in his VA mental disorder examination on 20 March 2004. He did not, however, seek treatment for his PTSD until 18 months later (October 2005). On 17 May 2004, he was found to be 10-percent service connected for PTSD by the VA effective 15 November 2003. Following his 2006 PTSD review examination, his disability rating was increased to 70 percent effective 17 October 2005. VA medical documentation indicates the applicant is currently being treated for PTSD by the VA with medication management and psychotherapy. b. His military records indicate he was hospitalized after making a suicide attempt in Iraq on 27 July 2003. At that time, he was hospitalized and subsequently diagnosed with adjustment disorder, not otherwise specified (related to military service), and psychiatrically cleared for any administrative action deemed appropriate by his command. A psychiatric evaluation performed on 12 September 2003 clearly stated the applicant met retention standards and there was no psychiatric disease or defect that warranted a medical board. However, criteria for administrative separation was present. c. The applicant contends he should have been diagnosed with PTSD while serving on active duty and referred to an MEB, which he feels would have found his condition to be medically unfitting. Alternatively, he feels he should be retroactively placed on the TDRL. He feels the Army's decision to administratively discharge him was in error. d. The applicant's contentions notwithstanding, a review of the available documentation indicates the applicant was medically fit as indicated by his 12 September 2003 psychiatric evaluation which clearly stated he met retention standards and there was no psychiatric disease or defect that warranted a medical board. Meeting retention standards indicates medical fitness. e. Moreover, a review of the applicant's PTSD history indicates his PTSD has progressed over time. While in the military, no definitive signs of PTSD were documented and he was diagnosed with an adjustment disorder. After leaving the military, he was diagnosed with PTSD by the VA, but awarded only a 10-percent service connection for PTSD. In accordance with this 10-percent service connection, he apparently did not require treatment for this mild to moderate level of PTSD until October 2005, even though he had been diagnosed with PTSD by the VA on 20 March 2004. On 17 October 2005, the VA reevaluated his PTSD and increased his service connection to 70 percent for PTSD. Clearly, the applicant's PTSD has worsened over time. f. Based on the available information, it is clear the applicant did not meet the criteria for PTSD at the time of his discharge from the Army. Rather, it appears the onset of his PTSD was delayed. The applicant meets the criteria for chronic, delayed-onset PTSD as indicated by: (1) the diagnosis of PTSD by the VA approximately 8 months after his suicide attempt in the Army; and (2) the increasing severity of his PTSD symptoms over time as indicated by his progressively increasing VA service connection ratings for PTSD and his VA medical documentation. While the VA medical documentation supports the applicant's post-service diagnosis of PTSD, it does not retroactively provide evidence of an in-service PTSD diagnosis, nor does it support the applicant's assertion that a military medical discharge/retirement is warranted. It is important to understand the VA operates under different rules, laws, and regulations when assigning disability percentages than the Department of Defense. In essence, the VA will compensate for all disabilities felt to be unsuiting. The Department of Defense, however, does not compensate for unsuiting conditions. It only compensates for unfitting conditions. The applicant's condition was not felt to be unfitting when he was serving on active duty as indicated by the fact that he was found to meet military retention standards. g. It is also important to note the Department of Defense does not compensate service members for anticipated future severity or potential complications of conditions that were incurred during active military service. This is a role reserved for the VA. h. Based on the information available for review at this time, there is insufficient evidence to support the applicant's contention that he should have been diagnosed with PTSD while serving on active duty and referred to an MEB. Additionally, there is insufficient evidence at this time to support the applicant's request to be placed on the TDRL. A review of the available documentation indicates the applicant did not meet the diagnostic criteria for PTSD at the time of his military discharge. Additionally, a review of his VA medical documentation indicates the applicant most likely suffers from chronic, delayed-onset PTSD as per DSM, 5th edition, criteria. A review of the applicant's service records indicates the applicant did not suffer from a medically unfitting condition and met medical retention standards while on active duty. Accordingly, a referral of his record for consideration of a military medical discharge or retirement is not warranted. 17. A copy of the advisory opinion was provided to the applicant for comment and/or rebuttal. On 5 January 2017, counsel responded and stated: a. The advisory opinion ignores that the applicant was administratively separated from the Army for an adjustment disorder without allowing a 6 month period to determine whether the adjustment disorder would resolve. b. The advisory opinion's reliance on the September 2003 psychiatric evaluation is misplaced. c. An adjustment disorder, by definition, must resolve within 6 months. d. Onset of the applicant's PTSD was not delayed. e. The advisory opinion fails to adhere to Cowles versus McHugh. f. The advisory opinion ignores that the applicant should have been referred to an MEB for PTSD under the provisions of Army Regulation 40-400. g. The advisory opinion improperly references the DSM, 5th edition. REFERENCES: 1. Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) governs the evaluation of physical fitness of Soldiers who may be unfit to perform their military duties because of physical disability. The unfitness must be of such a degree that a Soldier is unable to perform the duties of his or her office, grade, rank, or rating in such a way as to reasonably fulfill the purposes of his or her employment on active duty. 2. Title 10, U.S. Code, chapter 61, provides for disability retirement or separation for a member who is physically unfit to perform the duties of his or her office, rank, grade, or rating because of disability incurred while entitled to basic pay. 3. Title 38, U.S. Code, sections 310 and 331, permit the VA to award compensation for a medical condition that was incurred in or aggravated by active military service. The VA, however, is not required by law to determine medical unfitness for further military service. The VA, in accordance with its own policies and regulations, awards compensation solely on the basis that a medical condition exists and that said medical condition reduces or impairs the social or industrial adaptability of the individual concerned. Consequently, due to the two concepts involved, an individual's medical condition, although not considered medically unfitting for military service at the time of processing for separation, discharge, or retirement, may be sufficient to qualify the individual for VA benefits based on an evaluation by that agency. 4. Army Regulation 635-200 sets forth the basic authority for separation of enlisted personnel. a. Chapter 5 provides for separation for the convenience of the government. Paragraph 5-17 (Other Designated Physical or Mental Conditions) provides for discharge on the basis of other designated physical or mental conditions not amounting to disability under the provisions of Army Regulation 635-40 and excluding conditions appropriate for separation processing under paragraph 5-11 (Separation of Personnel Who Did Not Meet Procurement Medical Fitness Standards) or 5-13 (Separation Because of Personality Disorder) that potentially interfere with assignment to or performance of duty. b. Separation processing may not be initiated under this paragraph until the Soldier has been counseled formally concerning deficiencies and has been afforded ample opportunity to overcome those deficiencies as reflected in appropriate counseling or personnel records. c. At least one formal counseling session is required before separation proceedings may be initiated. d. Soldiers not in training status will be locally reassigned at least once, with a minimum of 3 months of duty in each unit. e. A Soldier separated for the convenience of the government will be awarded a character of service of honorable or under honorable conditions, or an uncharacterized description of service if in an entry-level status (first 180 days of continuous active duty). 5. The DSM, 4th edition, states the "essential feature of an adjustment disorder is a psychological response to an identifiable stressor or stressors that result in the development of clinically significant emotional or behavioral symptoms" and "[b]y definition, an [a]djustment [d]isorder must resolve within 6 months of the termination of the stressor." 6. Army Regulation 15-185 (Army Board for Correction of Military Records) prescribes the policies and procedures for correction of military records by the Secretary of the Army acting through the ABCMR. The ABCMR considers individual applications that are properly brought before it. The ABCMR will decide cases on the evidence of record. It is not an investigative body. The ABCMR begins its consideration of each case with the presumption of administrative regularity. The applicant has the burden of proving an error or injustice by a preponderance of the evidence. DISCUSSION: 1. The evidence shows the applicant was diagnosed with an adjustment disorder by a psychiatrist on 12 September 2003. He was also found mentally responsible and psychiatrically cleared for any administrative action deemed appropriate by his command. Meeting retention standards indicates medical fitness. 2. Although counsel contends the applicant should have been medically discharged, the examining psychiatrist determined there was no psychiatric disease or defect that warranted medical board action in September 2003. 3. The applicant was discharged under the provisions of Army Regulation  635-200, paragraph 5-17, on the basis of other designated physical or mental conditions not amounting to disability. 4. Although counsel contends the applicant suffered from PTSD, not an adjustment disorder, there is no evidence showing the applicant met the criteria for a diagnosis of PTSD prior to his discharge on 14 November 2003. 5. The evidence of record supports counsel's contention that the DSM, 4th edition, states the "essential feature of an adjustment disorder is a psychological response to an identifiable stressor or stressors that result in the development of clinically significant emotional or behavioral symptoms" and "[b]y definition, an [a]djustment [d]isorder must resolve within 6 months of the termination of the stressor." 6. Counsel contends the Army did not allow the applicant ample opportunity to recover from an adjustment disorder and, if the Army had allowed for the proper 6-month period to evaluate his condition, the Army would have discovered the appropriate diagnosis for his condition was PTSD. 7. Counsel points out relief was granted by the ABCMR in a similar case (Cowles) wherein the plaintiff sued the ABCMR after the Board denied his application to correct his records to show he was separated for PTSD rather than an adjustment disorder. 8. The applicant's case is different from the Cowles case. a. The applicant was discharged on 14 November 2003 and he was diagnosed with PTSD on 20 March 2004, 4 months following his discharge, rated at 10-percent disabling. At that time his disability rating did not rise to the level required for disability retirement (30 percent or higher). b. His rating for PTSD was not increased to 70 percent until 17 October 2005, nearly 2 years following his discharge. There is no medical evidence showing his disability rating rose to 30 percent or higher, the level required for disability retirement, earlier than 17 October 2005, well outside the DSM 6-month window. This supports the medical advisor's opinion for delayed-onset PTSD. 9. The Army Review Boards Agency staff psychiatrist opined the applicant's PTSD history indicates his PTSD has progressed over time. While in the military, no definitive signs of PTSD were documented and he was diagnosed with an adjustment disorder. After leaving the military, he was diagnosed with PTSD by the VA, but awarded only a 10-percent service connection for PTSD. In accordance with this 10-percent service connection, he apparently did not require treatment for this mild to moderate level of PTSD until October 2005, even though he had been diagnosed with PTSD by the VA on 20 March 2004. On 17 October 2005, the VA reevaluated his PTSD and increased his service connection to 70 percent for PTSD. Clearly, the applicant's PTSD has worsened over time. 10. The evidence of record shows the applicant was counseled for his attempted suicide on 28 July 2003, he was diagnosed with an adjustment disorder on 12 September 2003, and discharge proceedings were initiated on 16 October 2003. 11. The advisory official contends the applicant did not meet the criteria for PTSD at the time of his discharge from the Army. Rather, the VA documentation indicates the onset of his PTSD was delayed. 12. The VA documentation provided by counsel was carefully considered. However, the VA rates veterans post-service and awards compensation based on a veteran's social or industrial ability to adapt after military service. The rating decision by the VA does not demonstrate an error or injustice on the part of the Army. The VA, operating under its own policies and regulations, assigns service-connected disability ratings based on its own specific criteria. 13. The applicant's administrative separation was administratively correct and in conformance with applicable regulations at the time of his discharge. 14. There is no evidentiary basis at this time to support counsel's request for the applicant's placement on the TDRL. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20160002043 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20160002043 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2