Many veterans have been unable to access to VA benefits for mental health problems simply because they may have been branded as someone with a “personality disorder” (PD) which is considered by many to be genetically derived and therefore could not be related to service. Most often these disorders were not correctly diagnosed and were merely doled out to soldiers based on the military wishing to discharge, but often were not at all affected PD. Anecdotally psychologists often mention that it is quite difficult to make a correct/accurate PD diagnosis and so any. Often it has not. Most veterans also know that when they are released from active duty, they receive a DD214, a Certificate of Release or Discharge from Active Duty. Some may not know that the honorable/dishonorable conduct code, and other codes on the DD214 that are just as important.
During the Fiscal Year (FY) 2001 to 2010, the military separated more than 31,000 service members on the alleged diagnoses of PD. PD by itself is not incompatible with military service. That is, if a service member has PD, and can perform their duties appropriately, then they cannot be discharged on a personality disorder diagnosis alone. However, if it is found that their PD is affecting their job performance then only after formal counseling and annotation in their personnel file, along with the proper medical evaluations, can the member be discharged. Based on a number of different media reports and in our practice, many veterans have legitimate PTSD, Traumatic Brain Injury or other mental illnesses, and were instead discharged based on bogus PD diagnoses. This can be dealt with in a number of different ways. What is a personality disorder though?
Types of Personality Disorders
There are three categories or clusters that a person can be grouped into when being diagnosed with personality disorder. Cluster A is odd or eccentric behavior, Cluster B is dramatic, emotional, or erratic and Cluster C is anxious and fearful behavior. For some of these behaviors, the symptoms of personality traits include angry outbursts, introversion, feeling emotionally cold or distant, aggressiveness, depression, obsessive-compulsive, and difficulty with interpersonal relationships.
TBIs and Personality Disorders
Traumatic Brain Injury (TBI) is a blow or jolt to the head that disrupts the normal function of the brain. TBI can be classified as mild, moderate, or severe depending on the specific event and outcome of the episode. Common symptoms include fatigue, irritability, memory problems, attention deficit, sleep disturbances, slowed thinking, anxiousness, and depression.
The difficulty that medical providers face to properly discharge soldiers from their branch of service if performance becomes subpar or a danger to themselves /others is sometimes necessary. The margin for error to correctly distinguish between TBI and PD is enormous. Many of the symptoms for both problems are so close in nature and will often begin to present at the same time when TBI has occurred.
A significant problem with TBI in the battlefield is that it often goes undocumented and untreated. TBI has been called the signature injury of the Iraq and Afghanistan war and yet the VA could have let thousands of soldiers slip through the system under a poor/incorrect diagnosis. This is a disservice to our men and women on so many levels. Not only do they lose their deserved medical benefits, but they can be stripped of their good standing often times being forced out under other than honorable conditions. Making them ineligible for all VA benefits.
Misdiagnosis is Rampant
The behavioral lines between the two illnesses are so similar that it is difficult to figure out which one is which sometimes. Potentially thousands of vets are going without proper medical treatment based on physical and mental problems because it was easier to discharge an individual on a personality discharge versus a medical discharge.
It also can cause huge debts on the part of the Veteran as well. If they allege PD instead of TBI, then the government can say it was a preexisting condition and have the Veteran not only is discharged without any benefits but may also have them pay back any enlistment bonuses they may have received. It has been estimated that since 2001 the DoD saved nearly $8 billion in disability compensation and $4.5 billion in medical care by discharging members with PD. Of course, not all PD diagnoses are incorrect but when an “internal review concluded that in 2008-09, only “8.9% of [PD discharges] were processed properly.;” it does create cause for concern. Not only can misdiagnosis make it more difficult for the veteran to have their claim approved for compensation and pension benefits, but they also must suffer with the stigma of an incorrect personality disorder diagnosis on their paperwork which may prevent them from future employment opportunities. Receiving the wrong diagnosis, and therefore having the wrong separation/re-entry eligibility code on your DD214 can have devastating effects on your VA benefits.
What Can You Do?
If you or a loved one has been discharged on charges related to behavioral problems and you feel that this has been in error you should file a complaint with the appropriate Discharge Review Board. Most importantly, it’s critical that you work with a psychologist to get the proper diagnosis and medical evidence before the review board or the VA if you have a disability claim. Usually, personality disorder is not a simple diagnosis and is often given as a diagnosis improperly so that the government can save money. One psychologist’s suggestion of this diagnosis is not the final word and other doctors would often have a strong difference of opinion. This has been our experience. Please contact us with questions.