IN THE CASE OF: BOARD DATE: 9 June 2015 DOCKET NUMBER: AR20150005816 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 an upgrade of his under honorable conditions (general) discharge. 2. The applicant states he was an exemplary Soldier but the Army failed to treat his medical conditions (post-traumatic stress disorder (PTSD)). The Army used disciplinary actions to decide his discharge, despite medical evidence that explained his behavior. 3. The applicant provides: * a listing of enclosures with explanation * Standard Form (SF) 515 (Consultation Sheet), dated 23 February 1971 * SF 600 (Chronological Record of Medical Care), dated 25 February 1971 * a letter from his commander, dated 16 March 1971 * a letter from a doctor, dated 4 May 1971 * Air Medal Certificate * Army Commendation Medal (ARCOM) Citation * DA Form 759 (Individual Flight Record and Flight Certificate – Army) * DA Form 137 (Installation Clearance Record), dated 29 January 1971 * DD Form 214 (Armed Forces of the United States Report of Transfer or Discharge) * a Veterans Administration (VA) certificate and a VA Form 21-6782 (Original Disability Compensation), dated 17 May 1972 * a letter from the VA, dated 1 July 1972 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 22 September 1969, held military occupational specialty 67N (UH-1 Helicopter Repairman), and attained the rank/grade of specialist five (SP5)/E-5. 3. His DA Form 20 (Enlisted Qualification Record) shows he served in Vietnam from 22 May 1970 to 22 April 1971, and he had “excellent” conduct and efficiency ratings prior to and during his service in Vietnam. 4. He provides an Air Medal Certificate, dated 20 July 1970, which announced his award of the Air Medal for meritorious achievement while participating in aerial flight in the Republic of Vietnam, during the period 31 May 1970 to 17 June 1970. 5. He provides an ARCOM Citation that does not contain an issuance date, but does indicate the award was presented for meritorious service in the Republic of Vietnam between May 1970 and May 1971. Unfortunately, his record does not contain orders. Additionally, a review of the Awards and Decorations Computer-Assisted Retrieval System, an index of general orders issued during the Vietnam era between 1965 and 1973 maintained by the U.S. Army Human Resources Command, failed to reveal any orders that awarded him the ARCOM. 6. He provides an SF 513, dated 23 February 1971, which shows he was referred for a psychiatry consultation. a. The referring physician stated in the reason for the report: (1) The patient has been mute since he witnessed an aircraft accident in which his friends were killed. This started about 45 minutes after the accident occurred. (2) He began talking after he was given 100mg of Pentothal in an IV. He stated that he wanted to see a psychiatrist and feels that something is taking over his mind. The physician's impressions were listed as, "combat fatigue, mutism, catatonic." b. The applicant stated he would like to begin seeing a psychiatrist in the near future, but states he will be alright and that he wants go with his friends. The psychiatrist stated that this type of problem usually responds to a return to the unit after the hysteria has cleared. 7. He provides an SF 600, dated 25 February 1971, which shows he had been under a psychiatrist's care for three days following an aircraft accident in which his friends were killed. 8. He provides a letter, dated 16 March 1971, which his commander wrote to his parents in reference to his mail being accidently returned to their address. He provided the applicant's parents with a new forwarding address and stated "I have had the opportunity to talk with [the applicant] on many occasions and have found him to be an exemplary Soldier." 9. He provides a letter, dated 4 May 1971, which his family doctor addressed to the commanding officer of the Martin Army Hospital, Fort Benning, GA. His family doctor states the applicant, who had been a long-time patient, was currently home on leave from Vietnam. The doctor stated he had known the applicant and his family for a "good many years" and was anxious to help with a problem that "seems to be reasonably serious." The doctor further stated, "in February 1971, [the applicant] witnessed a helicopter accident and 'went into shock.' There is a note in his medical service records indicating he had an attack of acute hysteria. Shortly after that the patient had acute appendicitis and was hospitalized. Since that time [applicant] has had episodes of hearing humming noises followed by a freezing of the body in which he cannot see but is able to hear noises. He is unable to move during these episodes. He finds that it is very difficult for him to sleep because he is afraid that one of these attacks will occur. He is certain that this represents emotional strain after witnessing this helicopter accident in February." 10. His record contains an SF 600 showing he was hospitalized at the Walter Reed Army Medical Center (WRAMC) from 18 June 1971 to 25 June 1971: a. The Diagnosis stated, "Passive-Aggressive personality, severe, manifested by chronic difficulty with authority figures, anti-social acting out, threats of violence; stress, mild routine duty: predisposition severe, difficulty with authority figures prior to military service; impairment for military duty, none; impairment for social and industrial adapt., none." This condition was not considered to be in the line of duty as the attending physician indicated it was a condition that existed prior to service. b. His treatment involved hospital observation and no medication. During the hospital course he maintained good social interaction, no persistent depression, and displayed extremely manipulative behavior. c. The attending physician also stated the applicant was mentally responsible, capable of distinguishing right from wrong, and of adhering to the right, and he had the capacity to understand and participate in board proceedings. It was felt that in view of the applicant's lack of motivation, it was strongly recommended that administrative action be taken by the command, and the applicant be separated under the provisions of Army Regulation 635-212 (Discharge, Unfitness and Unsuitability). 11. His record contains two Mental Hygiene Consolation Service Reports, dated 1 July 1971 and 8 July 1971, which stated the applicant was diagnosed with a "Character and Behavior Disorder: Passive-Aggressive Personality" and that this condition was not considered to be in the line of duty as the attending physician indicated it was a condition that existed prior to service. a. The psychiatrist stated "This condition represents a basic character and behavior disorder and is not amenable to hospitalization, treatment in a military setting, disciplinary action, training or reclassification to another type of duty." b. The psychiatrist medical official stated the applicant had a history of a pattern of chronic difficulty relating to authority figures which impeded his adjustment to the regimented routine of the Army. His poor attitude and apparent lack of motivation combined to construct a poor prognosis for his being able to complete his military obligation. If he was not separated from military service, it was opined that he would cause further problems in his command. It was recommended the applicant be separated from service as expeditiously as possible under the provisions of Army Regulation 635-212. 12. On 28 July 1971, the applicant's immediate commander notified him of his intent to discharge him under the provisions of Army Regulation 635-212. The basis for the proposed discharge was unsuitability. His commander advised him of his right to present his case before a board of officers, submit statements in his own behalf, and receive representation by counsel before a board of officers. The applicant acknowledged receipt of this notification the same day. 13. On 30 July 1971, he consulted with counsel, waived consideration of his case by a board of officers and waived a personal appearance. He also acknowledged that he understood he might expect to encounter substantial prejudice in civilian life in the event a general under honorable conditions discharge was issued to him. 14. On 3 August 1971, the separation authority approved his discharge under the provisions of Army Regulation 635-212 by reason of unsuitability and directed the issuance of a General Discharge Certificate. 15. His DD Form 214 shows he was discharged, on 13 August 1971, under the provisions of Army Regulation 635-212 for unsuitability with an under honorable conditions (general) character of service. He completed a total of 1 year, 10 months and 22 days of creditable active service. 16. There is no indication that the applicant applied to the Army Discharge Review Board (ADRB) to upgrade his discharge. 17. Army Regulation 635-212, in effect at the time, set forth the basic authority for the separation of enlisted personnel for unfitness and unsuitability. This regulation provided the authority for the separation of enlisted personnel for unsuitability based on inaptitude, character and behavior disorder, apathy, enuresis and alcoholism. Members separated under these provisions could receive either an under honorable conditions (general) discharge or an honorable discharge. 18. On 23 November 1972, Army Regulation 635-200 was published and became the governing regulation for the administrative separation of enlisted personnel, which included the categories of separations previously governed by Army Regulation 635-212. A Department of the Army (DA) message number 302221Z, dated March 1976, changed "character and behavior disorder" to "personality disorder" and Army Regulation 635-200 was revised on 1 December 1976. 19. A Department of the Army Memorandum dated 14 January 1977, and better known as the Brotzman Memorandum, was promulgated. It required retroactive application of revised policies, attitudes and changes in reviewing applications for upgrade of discharges based on personality disorders. A second memorandum, dated 8 February 1978, known as the Nelson Memorandum, expanded the review policy and specified that the presence of a personality disorder diagnosis would justify upgrade of a discharge to fully honorable except in cases where there are "clear and demonstrable reasons" why a fully honorable discharge should not be given. Conviction by general court-martial or by more than one special court-martial (SPCM) was determined to be "clear and demonstrable reasons" which would justify a less than fully honorable discharge. 20. Army Regulation 635-200, currently in effect, paragraph 5-13, provides when separation is because of a personality disorder, the service of a Soldier separated per this paragraph will be characterized as honorable unless an entry level separation is required under chapter 3, section III. A characterization of service of under honorable conditions may only be awarded to a Soldier separating under these provisions if they had been convicted of an offense by general court-martial or convicted by more than one SPCM during the current enlistment. 21. 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-III nosologic classification scheme. Although controversial when first introduced, the PTSD diagnosis has filled an important gap in psychiatric theory and practice. From an 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." 22. 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. 23. The DSM-5 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 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. (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. (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. (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). (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 (6) Sleep disturbance f. Criterion F, duration: Persistence of symptoms (in Criteria B, C, D, and E) for more than one 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. 24. 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 Soldier's 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 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. 25. In view of the foregoing, on 3 September 2014 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 the applicant's service. 26. 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? 27. 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 record 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. Corrections Boards 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. Corrections Boards 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. DISCUSSION AND CONCLUSIONS: 1. The evidence of record confirms the applicant was separated under the unsuitability (character and behavior disorder) provisions of Army Regulation 635-212. The characterization of his discharge was commensurate with the reason for discharge and overall record of military service in accordance with the governing regulations in effect at the time. 2. The evidence in his military medical records show he suffered from "combat fatigue" and sleeplessness, and an hysterical episode following his witnessing a helicopter crash that killed several of his friends. He was later diagnosed with a character and behavior disorder diagnosed as a behavior disorder. While it is unclear if he suffers from PTSD or has had an official PTSD diagnosis, many of the symptoms described in the available record could be classified as PTSD-like symptoms. 3. At the time of his discharge, PTSD was largely unrecognized by the medical community and DOD. Currently, 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. 4. Furthermore, he was discharged prior to the implementation of the Nelson Memorandum, which specified that the presence of a personality disorder diagnosis would justify upgrade of a discharge to fully honorable except in cases where there are "clear and demonstrable reasons" why a fully honorable discharge should not be given. Under current regulations, members separated by reason of personality disorder (character and behavior disorder) must be issued an honorable discharge unless they have been convicted by a general court-martial or more than one special court-martial. 5. Based on the foregoing evidence, the applicant is entitled to an upgrade of his discharge, not specifically because of his PTSD-like symptoms, but because his discharge meets the criteria stipulated in the implementation of the Nelson Memorandum in that there is no record of a court-martial and there are no "clear and demonstrable reasons" why a fully honorable discharge should not be given. BOARD VOTE: ____x___ ____x___ ____x___ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ________ ________ ________ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The Board determined that the evidence presented was sufficient to warrant a recommendation for relief. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by showing he received an honorable discharge on 13 August 1971 and by issuing him a new DD Form 214 that reflects this change. _______ _ _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) AR20150005816 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20150005816 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1