DEPARTMENT OF THE ARMY ARMY REVIEW BOARDS AGENCY 251 18TH STREET SOUTH, SUITE 385 ARLINGTON, VA 22202-3531 SAMR-RB 24 May 2017 MEMORANDUM FOR Case Management Division, US Army Review Boards Agency, 251 18th Street South, Suite 385, Arlington, VA 22202-3531 SUBJECT: Army Board for Correction of Military Records Record of Proceedings for AR20160000469 1. .Reference the attached Army Board for Correction of Military Records Record of Proceedings, dated 9 May 2017, in which the Board members unanimously recommended denial of the applicant's request 2. I have reviewed the findings, conclusions, and Board member recommendations. I find there is sufficient evidence to grant relief. Therefore, under the authority of Title 10, United States Code, section 1552, I direct that all Department of the Army Records of the individual concerned be corrected by reissuing the applicant a DD Form 214 showing his characterization of service as general, under honorable conditions. I direct no further correction be made to the record of the individual concerned. 3. Request necessary administrative action be taken to effect the correction of records as indicated no later than 24 September 2017. Further, request that the individual concerned and counsel, if any, as well as any Members of Congress who have shown interest be advised of the correction and that the Army Board for Correction of Military Records be furnished a copy of the correspondence. BY ORDER OF THE SECRETARY OF THE ARMY: /,/14->,(41? .d_ ilu Encl Deputy Assistant Secretary of the Army (Review Boards) CF: ( ) OMPF BOARD DATE: 9 May 2017 DOCKET NUMBER: AR20160000469 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: 9 May 2017 DOCKET NUMBER: AR20160000469 BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined that the overall merits of this case are insufficient as a basis to amend the decision of the ABCMR set forth in Docket Number AR20140016291, dated 21 April 2015. ___________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: 9 May 2017 DOCKET NUMBER: AR20160000469 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 discharge under other than honorable conditions (UOTHC) to general under honorable conditions. 2. The applicant states: a. Under his current service characterization, he cannot receive Department of Veterans Affairs (VA) benefits. b. He entered the Army at age 17 with the intention of serving as a volunteer. After serving for 1 year, he realized he was an alcoholic and needed help. He told his platoon sergeant he needed help, but he was told to deal with it and get back to work. He continued to seek help, but was turned down. He felt like he wasn't wanted and he wanted to get out of the Army. c. He had problems participating in parades and other functions. He suffered from headaches, blackouts, trauma, and alcoholic withdrawals, but he never had any problem performing his special forces training or while performing temporary duty tours to Germany. He just felt betrayed. d. He was stabbed while serving on active duty. 3. The applicant provides: * service personnel records * certificates of training and appreciation * service medical records * discharge proceedings * VA medical records * DD Form 214 (Report of Separation from Active Duty) 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 Army Board for Correction of Military Records (ABCMR) in Docket Number AR20140016291 on 21 April 2015. 2. The applicant's contentions are new arguments that were not previously considered by the Board and warrant consideration at this time. 3. The applicant was born on 15 November 1956. He enlisted in the Regular Army for a period of 3 years on 10 June 1974. He was 17 years, 6 months, and 27 days of age at the time of his enlistment. He completed his training and was awarded military occupational specialty 63B (light wheel vehicle mechanic). 4. Between January 1975 and November 1976, nonjudicial punishment was imposed against him on six occasions for: * failing to go to his place of duty on two occasions * being absent without authority for 5 days * failing to go to his place of duty and being absent without authority for 2 days * being absent without authority for 2 days * being absent without authority for 2 days * being absent without authority for 4 days, breaking restriction, and failing to go to his place of duty on five occasions 5. On 12 December 1976, he underwent a separation physical examination and was found qualified for separation. His Standard Form 88 (Report of Medical Examination) and Standard Form 93 (Report of Medical History), dated 12 December 1976, show he sustained multiple stab injuries to his abdomen in April 1976. His Standard Form 93 also shows he denied depression, excessive worry, and nervous trouble. 6. On 8 February 1977, his unit commander initiated action to separate him under the provisions of Army Regulation 635-200 (Personnel Separations – Enlisted Personnel), paragraph 13-5a(1), due to involvement in frequent incidents of a discreditable nature with civil or military authorities. 7. After consulting with counsel and being advised of his recommended separation for misconduct, he waived consideration of his case by a board of officers. He acknowledged he understood he might be deprived of many or all rights as a veteran under both Federal and State laws and he might encounter substantial prejudice in civilian life if an undesirable discharge were issued. He also elected not to submit a statement in his own behalf. 8. On 28 February 1977, the separation authority approved the recommendation for separation under the provisions of Army Regulation 635-200, paragraph  13-5a, and directed the issuance of a Discharge Certificate UOTHC. 9. On 14 April 1977, he was discharged UOTHC under the provisions of Army Regulation 635-200, paragraph 13-5a(1). He completed 2 years, 7 months, and 12 days of active service with 83 days of lost time. 10. There is no evidence showing he was diagnosed with alcohol dependency prior to his discharge. 11. There is no indication he applied to the Army Discharge Review Board for an upgrade of his discharge within its 15-year statute of limitations. 12. He provided a VA medical record, dated 19 November 2009, showing he was diagnosed with chronic post-traumatic stress disorder (PTSD) based on the trauma of being stabbed while in the military. 13. On 21 April 2015, the ABCMR denied his request for a discharge upgrade to general under honorable conditions. 14. An advisory opinion was rendered by the Army Review Boards Agency Clinical Psychologist, dated 18 November 2016, wherein she stated: a. Medical records indicate the applicant suffered two stab wounds to his abdomen, a perforation of his small bowel, and laceration of anterior chest wall on 1 April 1976. The medical note indicated alcohol was involved in the incident. He was admitted for an emergency laparotomy and discharge on 7 April 1976 in satisfactory condition. A follow-up note from the surgical clinic, dated 10 May 1976, indicated the incision had healed and there were no complications. A Statement of Medical Condition, dated 14 April 1977, indicated the applicant underwent a separation medical examination and there had been no change to his medical condition. Regarding behavioral health symptoms, he completed a military examination on 12 December 1976 and denied depression, excessive worry, and nervous trouble. b. VA medical records indicate the applicant received treatment for PTSD, at least since 2004. Behavioral health services have included individual psychotherapy, group therapy, and use of psychiatric medication for sleep and mood. A PTSD evaluation summary, dated 19 November 2009, indicated the applicant's PTSD symptoms stemmed from the trauma of being stabbed while in the military. Primary symptoms included intrusive thoughts, avoidance, and hyperarousal. He also endorsed depression and a history of polysubstance abuse and binge drinking. c. Based on thorough review of available medical records, the evidence does not support that the applicant met the criteria for PTSD during his time in service. Although he received medical treatment for a stab wound during his time in service, the presence of this condition or potentially untreated PTSD does not mitigate his frequent behavioral infractions. Furthermore, there is no evidence his stab wound failed retention standards or warranted medical processing. No complications were noted post-surgery or at the time of separation in which he underwent a medical physical. This observation does not negate his post-service diagnosis of PTSD from the VA; however, the VA conducts evaluations based on different standards and regulations. There is no evidence the applicant's post-service diagnosis of PTSD mitigated his misconduct that led to an early separation from the Army. 15. A copy of this advisory opinion was provided to the applicant for comment and/or rebuttal. He did not respond. REFERENCES: 1. Army Regulation 635-200 sets forth the basic authority for separation of enlisted personnel. a. Paragraph 13-5a(1), in effect at the time, provided for discharge due to unfitness because of frequent incidents of a discreditable nature with civil or military authorities. b. Paragraph 3-7a, currently in effect, provides that 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. c. Paragraph 3-7b, currently in effect, provides that 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. 2. The Diagnostic and Statistical Manual of Mental Disorders (DSM), chapter 7, addresses trauma and stress or related disorders. The DSM is published by the American Psychiatric Association (APA) and provides standard criteria and common language for 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." 3. 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. 4. 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. 5. 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. 6. 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 the applicants' service. 7. 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? 8. 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. DISCUSSION: 1. The applicant contends he was young; however, age is not a sufficiently mitigating factor. He was almost 18 years of age when he enlisted and he successfully completed training. There is no evidence indicating he was any less mature than other Soldiers of the same age who successfully completed their military terms of service. 2. Although he contends he was an alcoholic, there is no evidence and he provided no evidence showing he was diagnosed with alcohol dependency prior to his discharge. 3. The VA medical record, dated 19 November 2009, showing the applicant was diagnosed with chronic PTSD based on the trauma of being stabbed while in the military was noted. The Army Review Boards Agency Clinical Psychologist determined: a. The evidence does not support the applicant met the criteria for PTSD during his time in service. b. Although he received medical treatment for a stab wound during his time in service, the presence of this condition or potentially untreated PTSD does not mitigate his frequent behavioral infractions. c. There is no evidence the applicant's post-service diagnosis of PTSD mitigated his misconduct that led to his early separation from the Army. 4. His administrative separation was accomplished in compliance with applicable regulations with no indication of procedural errors which would have jeopardized his rights. The type of discharge directed and the reasons were therefore appropriate considering all the facts of the case. 5. His record of service included six nonjudical punishments and 83 days of lost time. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20160000469 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20160000469 8 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2