Personality disorders are often the deathknell of VA compensation claims and so its important to know if it has been correctly diagnosed. 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 personality disorder (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.
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, Cluster B is dramatic, emotional or erratic and Cluster C is anxious and fearful behavior. For some of these behaviors the symptoms of these personality traits include:
Angry outbursts
Introversion
Feeling emotionally cold or distant
Aggressiveness
Depression
Obsessive compulsive
Difficult 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 specific event and outcome of the episode. Symptoms include:
Fatigue, irritability,
Memory problems and
Problems paying attention
Sleep disturbances
Slowed thinking
Feeling anxious
Feeling depressed
Irritability
Mood swings
The difficulty that providers face to correctly medically discharge men and women from their branch of service if their performance becomes subpar or a danger to themselves or 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 our men and women 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 both physically and mentally 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 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 has saved nearly $8 billion in disability compensation and $4.5 billion in medical care by discharging members with PD. Of course, not all PD diagnosis are incorrect but when an “internal review concluded that in 2008-09, only “8.9% of [PD discharges] were processed properly..;” it does make your eyebrows raise a little.
Not only can misdiagnosis make it more difficult for the veteran to have their claim approved for compensation and pension benefits, but they also have to suffer with a 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 claim. While those who evaluate your case to determine your benefit eligibility are not supposed to look at your separation codes only, it can have a negative impact on how they view your case on a whole.
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, its 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. Please contact us with questions.
Sources:
http://www.vva.org/PPD-Documents/WhitePaper.pdf
http://www.mentalhealthamerica.net/conditions/personality-disorder
http://dvbic.dcoe.mil/about-traumatic-brain-injury/article/tbi-basics http://statesidelegal.org/sites/default/files/Discharge%20Problems%20Associated%20with%20Traumatic%20Brain%20Injury.pdf
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