IN THE CASE OF: BOARD DATE: 14 December 2017 DOCKET NUMBER: AR20170000775 BOARD DETERMINATION/RECOMMENDATION: The Board determined the evidence presented is 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 reissuing the applicant's DD Form 214 for the period ending 12 June 2014 to show his character of service as "General under Honorable Conditions." 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. IN THE CASE OF: BOARD DATE: 14 December 2017 DOCKET NUMBER: AR20170000775 BOARD VOTE: Mbr 1 Mbr 2 Mbr 3 :RCJ :DRA :DT GRANT FULL RELIEF : : : GRANT PARTIAL RELIEF : : : GRANT FORMAL HEARING : : : DENY APPLICATION 2 Enclosures 1. Board Determination/Recommendation 2. Evidence and Consideration IN THE CASE OF: BOARD DATE: 14 December 2017 DOCKET NUMBER: AR20170000775 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 Assistant Secretary of the Army (Manpower and Reserve Affairs) (ASAMRA) submits an application on behalf of a group of Soldiers requesting that the Army Board for Correction of Military Records: a. consider whether a potential violation of Title 10, U.S. Code, section 1177 (Members Diagnosed with or Reasonably Asserting Post-Traumatic Stress Disorder (PTSD) or Traumatic Brain Injury (TBI): Medical Examination Required before Administrative Separation), occurred during these Soldiers' separation processing; and b. determine whether a diagnosis of PTSD and/or TBI should result in an upgrade of these Soldiers' characterizations of service. 2. The group application states the ASAMRA was unable to confirm that these Soldiers' PTSD and TBI diagnoses were considered by the separation authority during separation processing. 3. The ASAMRA provides an attached list of Soldiers who may have been affected by a potential violation of Title 10, U.S. Code, section 1177. CONSIDERATION OF EVIDENCE: 1. The applicant enlisted in the Regular Army on 22 July 2010 and held military occupational specialty 11B (Infantryman). 2. Records indicate he served in Afghanistan from 28 April 2012 through 1 December 2012. 3. His records contain multiple DA Forms 4187 (Personnel Action) showing his duty status changed on the following dates in the following manner: * 14 August 2013, from present for duty (PDY) to absent without leave (AWOL) * 13 September 2013, from AWOL to dropped from the rolls (DFR) * 23 September 2013, from DFR to PDY * 1 October 2013, from PDY to AWOL * 2 October 2013, from AWOL to DFR 4. An Army Substance Abuse Program memorandum, dated 7 October 2013, provided his command guidance about required actions as a result of a positive urinalysis and enclosed laboratory confirmed biochemical test results. 5. Additional DA Forms 4187 show his duty status changed on the following dates in the following manner: * 19 November 2013, from DFR to returned to military control (RMC) * 21 November 2013, from RMC to PDY 6. On 25 November 2013, his immediate commander initiated discharge action against him for misconduct – abuse of illegal drugs – under the provisions of Army Regulation 635-200 (Active Duty Enlisted Administrative Separations), paragraph 14-12c. The memorandum initiating separation action stated the specific reasons for the proposed action were his wrongful use of marijuana on or about 23 August 2013 and on or about 23 September 2013. Additionally, on or about 13 April 2013, he was apprehended in Southampton County, Virginia, for driving under the influence of alcohol and he absented himself from his unit on or about 1 October 2013 until 19 November 2013. 7. On 25 November 2013, he acknowledged receipt of the notice from his commander informing him of the basis for the contemplated action to separate him under the provisions of Army Regulation 635-200, paragraph 14-12c, and the rights available to him. He was advised of his right to consult with counsel prior to submitting his Election of Rights. 8. A DA Form 3822 (Report of Mental Status Evaluation), dated 5 December 2013, shows the reason for the evaluation was clearance for administrative separation under the provisions of Army Regulation 635-200, chapter 14. His mental status evaluation shows: a. From a behavioral health standpoint, he was found fit for full duty, including deployment. He had no obvious cognitive impairments, was cooperative, had normal perceptions, was unlikely to be impulsive, and was not deemed dangerous. b. It was the impression of the behavioral health provider that the applicant could understand and participate in administrative proceedings, appreciate the difference between right and wrong, and met medical retention requirements. c. He was diagnosed with PTSD and a screening for mild TBI was positive. After screening, these conditions were deemed not to meet the criteria of Army Regulation 40-501 (Standards of Medical Fitness) for a medical evaluation board. The command was advised to consider the influence of these conditions, if present, when determining final disposition. He was screened for substance use disorders and did not indicate problematic use of substances. d. He previously sought treatment for PTSD but declined to re-engage in therapy at the time of the evaluation. He reported he did not find his symptoms impairing and he expected a decline in symptoms upon his discharge from the military. He was encouraged to return to the embedded behavioral health clinic should he reconsider and wish to engage in therapy. e. He was previously diagnosed and reported current symptoms consistent with a diagnosis of PTSD; however, he denied occupational impairment due to these symptoms. Per Army Regulation 40-501, paragraph 3-33, it was unclear whether he was retainable and further assessment would be required to determine his fitness for duty, including additional psychological testing and/or consultations. He was not cleared from a psychological perspective for administrative processing per Army Regulation 635-200. He was previously diagnosed with a concussion following an off-post bar fight in January 2013 and was treated by the Madigan Army Medical Center TBI Clinic at the time. He reported he is no longer experiencing symptoms consistent with TBI and feels he has fully recovered; however, this will also need to be considered in his final disposition. 9. There is no indication the discharge packet under the provisions of Army Regulation 635-200, paragraph 14-12c, was further endorsed by the remainder of the applicant's chain of command. 10. Additional DA Forms 4187 show his duty status changed on the following dates in the following manner: * 20 December 2013, from PDY to AWOL * 21 December 2013, from AWOL to DFR * 20 January 2014, from RMC to PDY * 20 January 2014, from PDY to confined by civil authorities * 31 January 2014, from confined by civil authorities to PDY * 31 January 2014, from PDY to confined by military authorities * 4 April 2014, from pretrial confinement to PDY 11. A DD Form 458 (Charge Sheet), dated 5 February 2014, shows court-martial charges were preferred against him under the Uniform Code of Military Justice (UCMJ) for: a. being AWOL from his unit with the intent to remain away therefrom permanently from on or about 20 December 2013 until his apprehension on or about 20 January 2014; b. being AWOL from his unit from on or about 14 August 2013 until on or about 23 September 2013; c. being AWOL from his unit from on or about 1 October 2013 until on or about 19 November 2013; d. failing to go at the time prescribed to his appointed place of duty on divers occasions between on or about 20 June 2013 and on or about 14 August 2013; e. using marijuana between on or about 23 August 2013 and on or about 23 September 2013; f. dereliction in the performance of his duties in that he willfully refused to train, to wit: qualify with his M-4 for Expert Infantryman Badge training, as it was his duty to do, on or about 30 July 2013; g. being disrespectful in language toward a noncommissioned officer by saying to him, "meet me outside, motherf___," on or about 7 August 2013; and h. wrongfully and recklessly engaging in conduct, to wit: pulling the fire alarm in Building 11664 on or about 25 July 2013, conduct likely to cause death or grievous bodily harm to people quickly exiting the building believing there was a fire or those officials responding to the scene of the incident. 12. A Madigan Army Medical Center memorandum, dated 9 May 2014, shows a sanity board was ordered by a military judge on 6 March 2014 and conducted by a forensic psychiatrist, Dr. W____ K____, and a clinical neuropsychologist, Dr. C____ G____, on 24 and 29 April 2014. It shows: a. The forensic psychiatric interview was conducted on 24 April 2014 and lasted approximately 4 hours. Neuropsychological testing was conducted on 29 April 2014 for an additional 6 hours. b. The board found at the time of the alleged criminal conduct the applicant did NOT have a severe mental defect. c. His psychiatric diagnoses were alcohol dependence, PTSD, and cluster B personality elements. d. At the time of the alleged criminal conduct, he was able to fully appreciate the nature, quality, and wrongfulness of his conduct. e. He did have sufficient mental capacity to understand the nature of the proceedings against him and to conduct or cooperate intelligently in the defense. 13. On 15 May 2014, he voluntarily requested discharge for the good of the service in lieu of trial by court-martial under the provisions of Army Regulation  635-200, chapter 10. He consulted with counsel and was advised of the basis for the contemplated trial by court-martial, the maximum permissible punishment authorized under the UCMJ, the possible effects of a discharge under other than honorable conditions (UOTHC), and the procedures and rights available to him. He submitted statements in his own behalf. 14. He submitted a statement through counsel, dated 15 May 2014, which states: a. Staff Sergeant (SSG) A____ B____, who was tasked with the care and custody of the applicant, effectively baited or entrapped him into leaving the unit. SSG B____ promised the applicant that he would be administratively separated via a "proxy clearance." SSG B____ assured him there would be no warrant issued for his arrest. In stark contrast to SSG B____'s assurances, upon which he relied, the applicant was apprehended by a game warden for fishing on a Virginia river without a license and was subsequently arrested because his command issued a warrant for his arrest. As a consequence, he was confined in a Virginia county jail for 10 days prior to being repatriated to military authorities. He subsequently served 63 days in military pre-trial confinement at the Regional Confinement Facility at Joint Base Lewis-McChord. In December 2013, SSG B____ inexplicably led the applicant to believe that if he left the unit, he would be "proxy cleared" from the military without further incident or consequences and he confirmed this assertion under oath at the preliminary hearing. During the hearing, it was also recommended that the command not refer the desertion charge to a court-martial. It was this desertion charge that led to the applicant's placement in pre-trial confinement. b. He enclosed text messages from SSG B____ that confirm he gave the applicant authorization to leave in order to complete the separation processing under the provisions of chapter 14 of Army Regulation 635-200. Had SSG B____ not baited the applicant into leaving and instead chose to expeditiously process the misconduct discharge that had already been pending for 6 months, the command would not have had to spend the time and energy needed for this pending court-martial. 15. Medical notes, taken during an outpatient appointment at the Madigan Army Medical Center on 29 May 2014, show the applicant was command-referred for a 60-minute mental status evaluation for administrative separation under the provisions of chapter 10, Army Regulation 635-200. a. His prior psychiatric treatment was reviewed. He had been seen at the Embedded Behavioral Health Clinic on 31 May 2013 and was diagnosed with PTSD. He attended two sessions of sleep hygiene group therapy before discontinuing the therapy. He was most recently seen on 12 July 2013 by the TBI Internal Medicine Clinic for insomnia and on 27 June 2013 for nightmare disorder. He reported he stopped attending treatment because he did not find it worthwhile and he just "learned to live with" his symptoms. He declined further therapy at the time. b. The psychological assessment showed he completed a PTSD screening, which was positive for symptoms of PTSD. He completed a TBI screening as well, which indicated potential issues related to a TBI. A referral to the Neuropsychology/TBI Clinic was indicated as further assessment was needed. c. The mental health provider completed a DA Form 3822 indicating the screenings for PTSD and mild TBI were positive and cleared him for administrative processing from a behavioral health standpoint. 16. On 2 June 2014, trial counsel stated he spoke with the battalion and brigade commanders regarding the applicant's request for discharge under the provisions of Army Regulation 635-200, chapter 10. They both recommended approval of the request. 17. On 3 June 2014, the officer exercising general court-martial convening authority approved his discharge in lieu of trial by court-martial under the provisions of Army Regulation 635-200, chapter 10, and directed the issuance of a discharge UOTHC. He found the applicant had been diagnosed with PTSD or TBI, or reasonably alleged he had either condition, based on service while deployed. He acknowledged he reviewed the applicant's medical examination in making his determination. 18. His DD Form 214 shows he was discharged in lieu of trial by court-martial on 12 June 2014 under the provisions of Army Regulation 635-200, chapter 10. He completed 3 years, 4 months, and 8 days of active service during this period. His service was characterized as UOTHC. 19. There is no evidence indicating he applied to the Army Discharge Review Board for an upgrade of his discharge within that board's 15-year statute of limitations. 20. The Army Review Boards Agency Medical Advisor/Psychiatrist provided an advisory opinion on 24 January 2017 wherein she stated: a. She reviewed the applicant's available records in the Armed Forces Health Longitudinal Technology Application and Department of Veterans Affairs (VA) records available in the Joint Legacy Viewer. b. The applicant was seen at the Madigan Army Medical Center TBI Clinic on 25 January 2013 where he reported a history of two concussions. He again presented to the TBI Clinic on 29 January 2013, complaining of headaches and insomnia which were treated by a low dose antidepressant. c. On 31 May 2013, he presented to the Embedded Behavioral Health Clinic with complaints of anxiety, restlessness, and depression beginning after his return from Afghanistan. During this appointment, he reported that he was exposed to multiple improvised explosive device explosions while deployed, he picked up the body parts of his fallen comrades, and he killed six enemy combatants. Since returning from Afghanistan, he had begun drinking alcohol during the day and had recently been apprehended by civilian police for driving under the influence of alcohol. During this visit to the Embedded Behavioral Health Clinic, he was screened for PTSD and scored positive. d. On 21 May 2013, he presented to the Behavioral Health Clinic with symptoms of sleep disturbance, irritability/anger, increased startle reaction, nightmares, intense reactivity upon exposure to external cures, numbing, feelings of detachment, and restricted range of affect. He was diagnosed with PTSD. On 29 July 2013, he was prescribed a medication (Prazosin) to help treat his nightmares. e. On 5 December 2013, he underwent a command-directed mental status evaluation for administrative separation under the provisions of chapter 14, Army Regulation 635-200. His mental status examination indicated normal cognitive function, cooperative behavior, and normal perceptions. Although the examiner checked the "Meets medical retention requirements" box, she also stated it is unclear whether the applicant was retainable and further assessment would be required to determine his fitness for duty. He was not cleared for administrative separation processing from a psychological perspective. f. He underwent a "sanity board" on 9 March 2014 to determine his competency to stand trial and accept criminal responsibility. The board concluded he was able to fully appreciate the nature and quality of the wrongfulness of his conduct and was found to have sufficient mental capacity to understand the nature of the proceedings against him. His clinical diagnoses were alcohol dependence, PTSD, and cluster B personality elements. g. A second command-directed mental status evaluation was completed on 29 May 2014. He was found to have a normal mental status. He was noted to have screened positive for PTSD and TBI. The examiner concluded the report by stating the applicant met the criteria for PTSD but refused to participate in further treatment as he "learned to live" with his symptoms to the point of being functional and politely refused further psychological testing. Therefore, he clearly did not meet his Medical Retention Decision Point and continues to meet retention standards in this regard. A medical evaluation board cannot be initiated without the Soldier meeting his Medical Retention Decision Point. He was cleared for administrative proceedings from a mental health perspective. h. It is clear from the medical documentation that the applicant suffers from both combat-related PTSD and mild TBI. Based on the information currently available, it the opinion of the agency psychiatrist that the applicant's PTSD is mitigating for the offenses which led to his discharge from the Army. (1) As PTSD is associated with avoidant behaviors, there is a nexus between his behavioral health condition and his offense of being AWOL. (2) As PTSD is associated with the use of alcohol and/or illicit substances to self-medicate PTSD symptoms, there is a nexus between his behavioral health condition and his illegal use of marijuana. (3) As PTSD and mild TBI are associated with irritability, anger, and oppositionality, there is a nexus between these two behavioral health conditions and the offenses of dereliction of duty (pertaining to his refusal to participate in training) and disrespectfulness toward a senior noncommissioned officer. 21. The applicant was provided a copy of the advisory opinion on 9 February 2017 and given an opportunity to respond. He did not respond. REFERENCES: 1. Title 10, U.S. Code, section 1177, states: a.  Medical Examination Required: (1) Under regulations prescribed by the Secretary of Defense, the Secretary of a Military Department shall ensure that a member of the armed forces under the jurisdiction of the Secretary who has been deployed overseas in support of a contingency operation, or sexually assaulted, during the previous 24 months, and who is diagnosed by a physician, clinical psychologist, psychiatrist, licensed clinical social worker, or psychiatric advanced practice registered nurse as experiencing PTSD or TBI or who otherwise reasonably alleges, based on the service of the member while deployed, or based on such sexual assault, the influence of such a condition, receives a medical examination to evaluate a diagnosis of PTSD or TBI. (2)  A member covered by paragraph (1) shall not be administratively separated under conditions other than honorable, including an administrative separation in lieu of court-martial, until the results of the medical examination have been reviewed by appropriate authorities responsible for evaluating, reviewing, and approving the separation case, as determined by the Secretary concerned. (3)  In a case involving PTSD, the medical examination shall be performed by a clinical psychologist, psychiatrist, licensed clinical social worker, or psychiatric advanced practice registered nurse. In cases involving TBI, the medical examination may be performed by a physician, clinical psychologist, psychiatrist, or other health care professional, as appropriate. b.  Purpose of Medical Examination. The medical examination required by subsection (a) shall assess whether the effects of PTSD or TBI constitute matters in extenuation that relate to the basis for administrative separation under conditions other than honorable or the overall characterization of service of the member as other than honorable. c.  Inapplicability to Proceedings under UCMJ. The medical examination and procedures required by this section do not apply to courts-martial or other proceedings conducted pursuant to the UCMJ. 2. Army Regulation 635-200 sets forth the basic authority for the separation of enlisted personnel. a. Chapter 10, in effect at the time, provided that a member who had committed an offense or offenses for which the authorized sentence included a punitive discharge could submit a request for discharge for the good of the service in lieu of trial by court-martial. The request could be submitted at any time after charges were preferred. A discharge UOTHC was normally appropriate for a Soldier who was discharged in lieu of trial by court-martial. However, the separation authority could direct a general discharge if such were merited by the Soldier's overall record during the current enlistment. For Soldiers who completed entry-level status, characterization of service as honorable was not authorized unless the Soldier's record was otherwise so meritorious that any other characterization clearly would have been improper. b. 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. 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. 3. 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." 4. 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. 5. 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. 6. 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. 7. 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. 8. 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? 9. 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. 10. On 25 August 2017 the Office of the Undersecretary of Defense for Personnel and Readiness issued clarifying guidance for the Secretary of Defense Directive to DRBs and BCM/NRs when considering requests by veterans for modification of their discharges due in whole or in part to: mental health conditions, including PTSD; TBI; sexual assault; or sexual harassment. Boards are to give liberal consideration to veterans petitioning for discharge relief when the application for relief is based in whole or in part to those conditions or experiences. The guidance further describes evidence sources and criteria and requires boards to consider the conditions or experiences presented in evidence as potential mitigation for misconduct that led to the discharge. DISCUSSION: 1. The applicant's records show he was charged with being AWOL on three occasions, failing to go his appointed place of duty on multiple occasions, using marijuana, refusing to train, being disrespectful in language to a noncommissioned officer, and engaging in reckless conduct by pulling a fire alarm. These are offenses punishable under the UCMJ with a punitive discharge. 2. He consulted with counsel and was advised of the basis for the contemplated trial by court-martial and the maximum permissible punishment authorized under the UCMJ. Subsequent to receiving legal counsel, he voluntarily requested discharge for the good of the service in lieu of trial by court-martial. 3. Discharges under the provisions of Army Regulation 635-200, chapter 10, are voluntary requests for discharge in lieu of trial by court-martial. There is no evidence indicating he was not properly and equitably discharged in accordance with the applicable regulations. All requirements of law and regulations were met and his rights were fully protected throughout the separation process. 4. The characterization of his discharge as UOTHC was commensurate with the reason for his discharge and his overall record of military service in accordance with the governing regulations. 5. Nonetheless, Soldiers who suffer from PTSD and were separated solely for misconduct subsequent to a traumatic event warrant careful consideration for the possible recharacterization of their overall service. 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. 6. His military records available for review show he twice received a medical examination during his separation processing as required by Title 10, U.S. Code, section 1177, and both examinations show he was diagnosed with PTSD and mild TBI, which warranted consideration by the separation authority. 7. The Army Review Boards Medical Advisor/Psychiatrist concluded that it is clear from the medical documentation that the applicant suffers from both combat-related PTSD and mild TBI. Based on the information currently available, it the opinion of the agency psychiatrist that the applicant's PTSD is mitigating for the offenses which led to his discharge from the Army. (1) As PTSD is associated with avoidant behaviors, there is a nexus between his behavioral health condition and his offense of being AWOL. (2) As PTSD is associated with the use of alcohol and/or illicit substances to self-medicate PTSD symptoms, there is a nexus between his behavioral health condition and his illegal use of marijuana. (3) As PTSD and mild TBI are associated with irritability, anger, and oppositionality, there is a nexus between these two behavioral health conditions and the offenses of dereliction of duty (pertaining to his refusal to participate in training) and disrespectfulness toward a senior noncommissioned officer. //NOTHING FOLLOWS// ABCMR Record of Proceedings (cont) AR20170000775 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20170000775 15 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2