IN THE CASE OF: BOARD DATE: 11 August 2015 DOCKET NUMBER: AR20150005437 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 reconsideration of his earlier request for an upgrade of his undesirable discharge to a general discharge under honorable conditions. 2. The applicant states: * he has had mental and physical problems since he was 7 years old * he witnessed his father's suicide at the age of 7 years and he was taken from his mother at 10 years of age due to neglect * he has been trying to get his discharge upgraded for over 30 years * he refused a direct order and he was absent without leave (AWOL) 3. The applicant provides: * two letters from the Army Board for Correction of Military Records (ABCMR) * DD Form 293 (Application for the Review of Discharge or Dismissal from the Armed Forces of the United States) * U.S. Army Medical Department Activity, Fort Jackson, SC, certificate/ statement, dated 14 October 1971 * Orange Memorial Hospital history, dated 1953 * death certificate * crime report * two letters from the Atlantic County Veterans Services * Jewish Family Service of Atlantic and Cape May Counties Clinical Workstation Report Progress Notes CONSIDERATION OF EVIDENCE: 1. Incorporated herein by reference are military records which were summarized in the previous consideration of the applicant's case by the ABCMR in Docket Number AC90-06343 on 14 November 1990. 2. The applicant presented new evidence showing he was diagnosed with a personality disorder while he was serving on active duty and a diagnosis of post-traumatic stress disorder (PTSD) after his discharge from active duty which were not previously considered by the Board and warrants consideration at this time. He also provided letters from the Atlantic County Veterans Services which forwarded his applications to the ABCMR and states he still suffers from PTSD and sleep disorder. He also provided Jewish Family Service of Atlantic Progress Notes and Cape May Counties Clinician Workstation Reports which show he was diagnosed with: * PTSD * type II diabetes, hyperlipidemia * alcohol abuse 3. The applicant was inducted into the Army of the United States on 16 April 1971. 4. He accepted nonjudicial punishment under the provisions of Article 15, Uniform Code of Military Justice, on the following occasions: * 28 July 1971 – * for being AWOL on or about 14 July 1971 until on or about 15 July 1971 * for disobeying a lawful order on or about 21 July 1971 * for being AWOL on or about 23 July 1971 until on or about 25 July 1971 * 18 August 1971 – for being AWOL on or about 9 August 1971 until on or about 16 August 1971 * 17 September 1971 – for being AWOL on or about 22 August 1971 until on or about 26 August 1971 5. The specific facts and circumstances surrounding his request for discharge are not available for review. It appears they were available when the Army Discharge Review Board (ADRB) denied his requests for an upgrade of his discharge on 5 July 1977 and 9 September 1981. The ADRB summary of the facts and circumstances concerning his discharge shows: a.  On or about 29 September 1971, charges were preferred against him for three specifications of willfully disobeying a lawful order from a superior noncommissioned officer. b.  On 6 October 1971, he consulted with counsel who advised him of the rights available to him. He submitted a request for discharge for the good of the service in lieu of trial by court-martial and he elected not to submit statements in his own behalf. c.  On 6 October 1971, his immediate commander and battalion commander recommended approval of his request with an undesirable discharge. d.  On 7 October 1971, he completed a separation physical. e.  On 14 October 1971, he completed a psychological evaluation. This evaluation is available for review and shows he was found free of mental defect, disease, or derangement as to be able to distinguish right from wrong and adhere to the right, and he possessed sufficient mental capacity to understand and participate in board proceedings. He was diagnosed with: * severe chronic passive-aggressive personality manifested by inability to train and self-destructive behavior – in the line of duty – existed prior to service * maladaptive pattern of behavior reflecting a long-standing, deeply ingrained personality disorder f.  On 18 October 1971, his brigade commander recommended approval of his request with an undesirable discharge. g.  On 21 October 1971, the separation authority approved his request and directed the issuance of an undesirable discharge. 6.  On 1 November 1971, he was discharged accordingly. His DD Form 214 shows he was administratively discharged for the good of the service under the provisions of Army Regulation 635-200 (Personnel Separations – Enlisted Personnel), chapter 10. He completed 6 months and 16 days of creditable active service. His service was characterized as under other than honorable conditions. 7. On 14 November 1990, the ABCMR denied his request for an upgrade of his discharge. The Board determined he had not presented and his records did not contain sufficient justification to conclude that it would be in the interest of justice to grant relief. His previous requests for reconsideration were administratively closed without action due to lack of new evidence on the following dates: * 29 January 1991 * 27 September 2006 * 19 August 2008 * 22 June 2009 * 11 February 2011 8. PTSD can occur after someone goes through a traumatic event like combat, assault, or disaster. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA) and provides standard criteria and common language for the classification of mental disorders. In 1980, the APA added PTSD to the third edition of its DSM nosologic classification scheme. Although controversial when first introduced, the PTSD diagnosis has filled an important gap in psychiatric theory and practice. From a historical perspective, the significant change ushered in by the PTSD concept was the stipulation that the etiological agent was outside the individual (i.e., a traumatic event) rather than an inherent individual weakness (i.e., a traumatic neurosis). The key to understanding the scientific basis and clinical expression of PTSD is the concept of "trauma." 9. PTSD is unique among psychiatric diagnoses because of the great importance placed upon the etiological agent, the traumatic stressor. In fact, one cannot make a PTSD diagnosis unless the patient has actually met the "stressor criterion," which means that he or she has been exposed to an event that is considered traumatic. Clinical experience with the PTSD diagnosis has shown, however, that there are individual differences regarding the capacity to cope with catastrophic stress. Therefore, while most people exposed to traumatic events do not develop PTSD, others go on to develop the full-blown syndrome. Such observations have prompted the recognition that trauma, like pain, is not an external phenomenon that can be completely objectified. Like pain, the traumatic experience is filtered through cognitive and emotional processes before it can be appraised as an extreme threat. Because of individual differences in this appraisal process, different people appear to have different trauma thresholds, some more protected from and some more vulnerable to developing clinical symptoms after exposure to extremely stressful situations. 10. The fifth edition of the DSM was released in May 2013. This revision includes changes to the diagnostic criteria for PTSD and acute stress disorder. The PTSD diagnostic criteria were revised to take into account things that have been learned from scientific research and clinical experience. The revised diagnostic criteria for PTSD include a history of exposure to a traumatic event that meets specific stipulations and symptoms from each of four symptom clusters: intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. The sixth criterion concerns duration of symptoms, the seventh criterion assesses functioning, and the eighth criterion clarifies symptoms as not attributable to a substance or co-occurring medical condition. a. Criterion A – Stressor: The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows (one required): (1) direct exposure; (2) witnessing, in person; (3) indirectly, by learning that a close relative or close friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental; or (4) repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties (e.g., first responders collecting body parts, professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies, or pictures. b. Criterion B – Intrusion Symptoms: The traumatic event is persistently re-experienced in the following way(s) (one required): (1) recurrent, involuntary, and intrusive memories; (2) traumatic nightmares; (3) dissociative reactions (e.g., flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness; (4) intense or prolonged distress after exposure to traumatic reminders; or (5) marked physiologic reactivity after exposure to trauma-related stimuli. c. Criterion C – Avoidance: Persistent effortful avoidance of distressing trauma-related stimuli after the event (one required): (1) trauma-related thoughts or feelings; or (2) trauma-related external reminders (e.g., people, places, conversations, activities, objects, or situations). d. Criterion D – Negative Alterations in Cognitions and Mood: Negative alterations in cognitions and mood that began or worsened after the traumatic event (two required): (1) inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol, or drugs); (2) persistent (and often distorted) negative beliefs and expectations about oneself or the world (e.g., "I am bad," "The world is completely dangerous"); (3) persistent distorted blame of self or others for causing the traumatic event or for resulting consequences; (4) persistent negative trauma-related emotions (e.g., fear, horror, anger, guilt, or shame); (5) markedly diminished interest in (pre-traumatic) significant activities, feeling alienated from others (e.g., detachment or estrangement); and (6) constricted affect, persistent inability to experience positive emotions. e. Criterion E – Alterations in Arousal and Reactivity: Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event (two required): (1) irritable or aggressive behavior; (2) self-destructive or reckless behavior; (3) hypervigilance; (4) exaggerated startle response; (5) problems in concentration; and (6) sleep disturbance. f. Criterion F – Duration: Persistence of symptoms (in Criteria B, C, D, and E) for more than 1 month. g. Criterion G – Functional Significance: Significant symptom-related distress or functional impairment (e.g., social, occupational). h. Criterion H – Exclusion: Disturbance is not due to medication, substance use, or other illness. 11. As a result of the extensive research conducted by the medical community and the relatively recent issuance of revised criteria regarding the causes, diagnosis, and treatment of PTSD, the Department of Defense (DOD) acknowledges that some Soldiers who were administratively discharged UOTHC may have had an undiagnosed condition of PTSD at the time of their discharge. It is also acknowledged that in some cases this undiagnosed condition of PTSD may have been a mitigating factor in the Soldiers' misconduct which served as a catalyst for their discharge. Research has also shown that misconduct stemming from PTSD is typically based upon a spur of the moment decision resulting from a temporary lapse in judgment; therefore, PTSD is not a likely cause for either premeditated misconduct or misconduct that continues for an extended period of time. 12. On 3 September 2014 in view of the foregoing information, the Secretary of Defense directed the Service Discharge Review Boards (DRBs) and Service Boards for Correction of Military/Naval Records (BCM/NRs) to carefully consider the revised PTSD criteria, detailed medical considerations, and mitigating factors when taking action on applications from former service members administratively discharged UOTHC and who have been diagnosed with PTSD by a competent mental health professional representing a civilian healthcare provider in order to determine if it would be appropriate to upgrade the characterization of an applicant's service. 13. BCM/NRs are not courts, nor are they investigative agencies. Therefore, the determinations will be based upon a thorough review of the available military records and the evidence provided by each applicant on a case-by-case basis. When determining if PTSD was the causative factor for an applicant's misconduct and whether an upgrade is warranted, the following factors must be carefully considered: * is it reasonable to determine that PTSD or PTSD-related conditions existed at the time of discharge? * does the applicant's record contain documentation of the occurrence of a traumatic event during the period of service? * does the applicant's military record contain documentation of a diagnosis of PTSD or PTSD-related symptoms? * did the applicant provide documentation of a diagnosis of PTSD or PTSD-related symptoms rendered by a competent mental health professional representing a civilian healthcare provider? * was the applicant's condition determined to have existed prior to military service? * was the applicant's condition determined to be incurred during or aggravated by military service? * do mitigating factors exist in the applicant's case? * did the applicant have a history of misconduct prior to the occurrence of the traumatic event? * was the applicant's misconduct premeditated? * how serious was the misconduct? 14. Although DOD acknowledges that some Soldiers who were administratively discharged UOTHC may have had an undiagnosed condition of PTSD at the time of their discharge, it is presumed that they were properly discharged based upon the evidence that was available at the time. Conditions documented in the records that can reasonably be determined to have existed at the time of discharge will be considered to have existed at the time of discharge. In cases in which PTSD or PTSD-related conditions may be reasonably determined to have existed at the time of discharge, those conditions will be considered potential mitigating factors in the misconduct that caused the UOTHC characterization of service. BCM/NRs will exercise caution in weighing evidence of mitigation in cases in which serious misconduct precipitated a discharge with a characterization of service of UOTHC. Potentially mitigating evidence of the existence of undiagnosed combat-related PTSD or PTSD-related conditions as a causative factor in the misconduct resulting in discharge will be carefully weighed against the severity of the misconduct. PTSD is not a likely cause of premeditated misconduct. BCM/NRs will also exercise caution in weighing evidence of mitigation in all cases of misconduct by carefully considering the likely causal relationship of symptoms to the misconduct. 15. Army Regulation 635-200 sets forth the basic authority for the separation of enlisted personnel. a.  An honorable discharge is a separation with honor and entitles the recipient to benefits provided by law. The honorable characterization is appropriate when the quality of the member's service generally has met the standards of acceptable conduct and performance of duty for Army personnel or is otherwise so meritorious that any other characterization would be clearly inappropriate. b.  A general discharge is a separation from the Army under honorable conditions. When authorized, it is issued to a Soldier whose military record is satisfactory but not sufficiently meritorious to warrant an honorable discharge. c.  Chapter 10 provides that a member who had committed an offense or offenses for which the authorized sentence includes a punitive discharge may submit a request for discharge for the good of the service in lieu of trial by court-martial. The request may be submitted at any time after charges have been preferred. Although an honorable or general discharge is authorized, a discharge under other than honorable conditions is normally considered appropriate. DISCUSSION AND CONCLUSIONS: 1. The applicant was diagnosed with a character and behavior disorder by a psychiatrist and he was discharged for the good of the service in lieu of trial by court-martial. His administrative separation on 1 November 1971 was accomplished in accordance with regulations then in effect. 2. Nevertheless, at the time of the applicant's discharge, PTSD was largely unrecognized by the medical community and DOD. However, both the medical community and DOD now have a more thorough understanding of PTSD and its potential to serve as a causative factor in a Soldier's misconduct when the condition is not diagnosed and treated in a timely fashion. Soldiers who suffered from PTSD and were separated solely for misconduct subsequent to a traumatic event warrant careful consideration for the possible re-characterization of their overall service. 3. Although the applicant incurred a traumatic event prior to entry on active duty, it is reasonable to conclude the PTSD condition was aggravated by military service and a causative factor in the misconduct that led to his discharge. After carefully weighing that fact against the severity of his misconduct, there is sufficient mitigating evidence to warrant upgrading the character of his service to general under honorable conditions. BOARD VOTE: ___X_____ ___X_____ ___X_____ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ________ ________ ________ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The Board determined the evidence presented is sufficient to warrant amendment of the ABCMR's decision in Docket Number AC90-06343, dated 14 November 1990. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by issuing him a new DD Form 214 showing his character of service as general under honorable conditions and a General Discharge Certificate, dated 1 November 1971, in lieu of the DD Form 214 and Undesirable Discharge Certificate he now holds. _____________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) AR20150005437 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20150005437 6 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1