1. Applicant's Name: a. Application Date: 29 October 2015 b. Date Received: 7 March 2016 c. Counsel: 2. REQUEST, ISSUES, BOARD TYPE, AND DECISION: The applicant requests an upgrade of her general (under honorable conditions) discharge to honorable. The applicant seeks relief contending, in effect, that her characterization of service is improper and inequitable. The applicant contends that she was misdiagnosed by the Army medical staff as having depressive disorder and placed on antidepressants, which exacerbated her illness causing a multitude of medical-related issues, to include being placed on suicide watch. After her discharge she received civilian medical attention and was properly diagnosed with bi-polar disorder. She contends that if she had been diagnosed with bi-polar condition she could have received an honorable discharge. Per the Board's Medical Officer, based on the information available for review at the time, and the medical documentation provided by the applicant, it is clear she has been diagnosed with Bipolar Disorder by multiple providers. The applicant's contention that she was misdiagnosed in the Army and treated with antidepressants which worsened her condition and behaviors is credible. Bipolar Disorder is frequently misdiagnosed as depression when it first presents, resulting in patients being placed on antidepressants. Antidepressant use in many bipolar patients can worsen their condition, leading to increased mood instability, increased impulsivity and, potentially, hypomanic/manic behaviors. Moreover, antidepressant use in a Bipolar patient can lead to a symptom picture which can easily be confused with a Personality Disorder, especially Borderline Personality Disorder. Both of these conditions are characterized by mood lability, impulsivity and engagement in self-destructive behaviors. Therefore, based on the available documentation, the Agency psychiatrist finds that the applicant's Chapter 5-17 discharge and her basis for separation ("Other Medical Conditions", for emotional control and behavioral problems incompatible with military service) are improper. In a records review conducted at Arlington, VA on 3 May 2017, and by a 5-0 vote, the Board determined the discharge is now inequitable. The Board found the circumstances surrounding her discharge (i.e. OBH bi-polar mitigates the condition) mitigated the discrediting entry in her service record. Accordingly, the Board voted to grant full relief in the form of an upgrade of the characterization of service to honorable and a change to the narrative reason for separation to Secretarial Authority. (Board member names available upon request) 3. DISCHARGE DETAILS: a. Reason / Authority / Codes / Characterization: Physical Condition, Not A Disability / AR 635-200, Chapter 5, Paragraph 5-17 / JFV / RE-3 / General (Under Honorable Conditions) b. Date of Discharge: 19 August 2004 c. Separation Facts: (1) Date of Notification of Intent to Separate: 17 August 2004 (2) Basis for Separation: "Other Medical Conditions," for emotional control and behavioral problems incompatible with military service. (3) Recommended Characterization: General (Under Honorable Conditions) (4) Legal Consultation Date: Waived, 17 August 2004 (5) Administrative Separation Board: NA (6) Separation Decision Date / Characterization: 17 August 2004 / General (Under Honorable Conditions) 4. SERVICE DETAILS: a. Date / Period of Enlistment: 8 October 2003 / 6 years b. Age at Enlistment / Education / GT Score: 23 / HS Graduate / 128 c. Highest Grade Achieved / MOS / Total Service: E-2 / None / 10 months, 12 days d. Prior Service / Characterizations: None e. Overseas Service / Combat Service: None f. Awards and Decorations: None g. Performance Ratings: NA h. Disciplinary Action(s) / Evidentiary Record: Two counseling statements reference the applicant being notified of consideration of separation under chapter 5-17, AR 635-200 as a result of a disorder manifesting disturbances or perception, thinking, emotional control or behavior sufficiently sever that her ability to effectively perform military duties was significantly impaired. i. Lost Time / Mode of Return: None j. Diagnosed PTSD / TBI / Behavioral Health: Report of Mental Status Evaluation, dated 24 July 2004, reflects the applicant was evaluated pursuant to AR 635-200, para 5-17, for a disorder manifesting disturbances or perception, thinking, emotional control or behavior sufficiently severe that the applicant's ability to effectively perform military duties was significantly impaired. The commander was advised that this would potentially interfere with assignment or performance of duty, including military training. There was no indication that the disorder had be aggravated by the applicant's relatively short period of Active Duty. The condition was not amendable to rehabilitation while in initial entry training and did not amount to disability. The finding did not meet the criterial for chapter 5-13, however, it did support administrative separation under AR 635-200, paragraph 5-17. Narrative Summary submitted by the applicant, dated 12 August 2004, reflects the applicant was diagnosed with (Axis I) Adjustment Disorder with Depressed Mood, evaluated, treated, and substantially improved; (Axis II) Personality disorder, not otherwise specified, with Borderline features; and (Axis III) for Lexapro overdose, evaluated without sequelae; Letter from the Commission Veteran Affairs Linn County, Iowa, dated 15 December 2015, reflects the applicant had been diagnosed with Bi-Polar Condition and was taking medication. 5. APPLICANT-PROVIDED EVIDENCE: DD Form 149; self-authored letter; letter from the Commission of Veteran Affairs Linn County, Iowa; instruction on what you should know about how to upgrade your military discharge; extract pages of AR 635-200, 6 June 2005 pages 45-48 and AR 635-200, 6 June 2005/RAR 17 December 2009; and DD Form 214. 6. POST SERVICE ACCOMPLISHMENTS: None submitted with the application. 7. REGULATORY CITATION(S): Army Regulation (AR) 635-200 provides the basic authority for the separation of enlisted personnel. Paragraph 5-17 specifically provides that a Soldier may be separated for other physical or mental conditions not amounting to a disability, which interferes with assignment to or performance of duty and requires that the diagnosis be so severe that the Soldier's ability to function in the military environment is significantly impaired. AR 635-200, paragraph 5-1, states that a Soldier being separated under this paragraph will be awarded a characterization of service of honorable, under honorable conditions, or an uncharacterized description of service if in entry-level status. A general (under honorable conditions) discharge is normally inappropriate for individuals separated under the provisions of Chapter 5-17 unless properly notified of the specific factors in the service that warrant such characterization. Secretary of Defense Memorandum for Secretaries of the Military Departments (Subject: Supplemental Guidance to Military Boards for Correction of Military/Naval Records Considering Discharge Upgrade Requests by Veterans Claiming Post Traumatic Stress Disorder, dated September 3, 2014), provided guidance to help ensure consistency across the military services in consideration of PTSD relevant to Service Members' discharges. "Liberal consideration will be given in petitions for changes in characterization of service to service treatment record entries which document one of more symptoms which meet the diagnostic criteria of Post-Traumatic Stress Disorder (PTSD) or related conditions. Special consideration will be given to Department of Veterans Affairs (VA) determinations which document PTSD or PTSD-related conditions connected to military services. In cases where Service Records or any document from the period of service substantiated the existence of one or more symptoms of what is now recognized as PTSD or PTSD-related condition during the time of service, liberal consideration will be given to finding that PTSD existed at the time of service. Liberal consideration will also be given in cases where civilian providers confer diagnoses of PTSD or PTSD-related conditions, when case records contain narratives that support symptomatology at the time of service, or when any other evidence which may reasonably indicate that PTSD or a PTSD-related disorder existed at the time of discharge which might have mitigated the misconduct that caused the under other than honorable conditions characterization of service. This guidance in not applicable to cases involving pre- existing conditions which are determined not to have been incurred or aggravated while in military service." 8. DISCUSSION OF FACT(S): The applicant requests an upgrade of her general (under honorable conditions) discharge to honorable. The applicant's record of service, the issues and documents submitted with his application were carefully reviewed. The applicant contends, in effect, that her characterization of service is improper and inequitable. The evidence of record shows the applicant, was diagnosed by competent medical authority for "other medical conditions," for emotional control and behavioral problems incompatible with military service. The unit commander did not inform the applicant as to the specific factors in the service record that warranted a general, (under honorable conditions discharge). AR 635-200, Paragraph 2-2a states "The commander would cite specific allegations on which the proposed action is based and will also include the specific provision of this regulation authorizing separation." Figure 2-1, which is a sample notification memorandum, also requires the commander to "state specific, factual details that constitute the basis for the proposed action." It appears the commander's notification memorandum is lacking factual detailed information in the section which call for specific, factual reasons for the proposed action. A general (under honorable conditions) discharge is normally inappropriate for individuals separated under the provisions of Chapter 5-17 unless properly notified of the specific factors in the service that warrant such characterization. The independent documents submitted by the applicant showing she was diagnosed with bi- polar condition were noted. However, there is a presumption of regularity in the conduct of governmental affairs that shall be applied in any review unless there is substantial credible evidence to rebut the presumption. The applicant bears the burden of overcoming this presumption through the presentation of substantial and credible evidence to support this issue. There is no evidence in the record, nor has the applicant produced any evidence to support the contention that she was misdiagnosed or mistreated at the time of discharge. The discharge was consistent with the procedural and substantive requirements of the regulation, was within the discretion of the separation authority, and the applicant was provided full administrative due process. 9. BOARD DETERMINATION: In a records review conducted at Arlington, VA on 3 May 2017, and by a 5-0 vote, the Board determined the discharge is now inequitable. The Board found the circumstances surrounding her discharge (i.e. OBH bi-polar mitigates the condition) mitigated the discrediting entry in her service record. Accordingly, the Board voted to grant full relief in the form of an upgrade of the characterization of service to honorable and a change to the narrative reason for separation to Secretarial Authority. 10. BOARD ACTION DIRECTED: a. Issue a New DD-214: Yes b. Change Characterization to: Honorable c. Change Reason to: Secretarial Authority d. Change Authority to: AR 635-200, Chapter 5-3 e. Change SPD/RE Code to: Change SPD to JFF / No Change to RE code f. Restore Grade to: No Change Authenticating Official: Legend: AWOL - Absent Without Leave GD - General Discharge NCO - Noncommissioned Officer SCM - Summary Court Martial BCD - Bad Conduct Discharge HS - High School NIF - Not in File SPCM - Special Court Martial BH - Behavioral Health HD - Honorable Discharge NOS - Not Otherwise Specified SPD - Separation Program Designator CG - Company Grade Article 15 IADT - Initial Active Duty Training OAD - Ordered to Active Duty TBI - Traumatic Brain Injury CID - Criminal Investigation Division MP - Military Police OMPF - Official Military Personnel File UNC - Uncharacterized Discharge ELS - Entry Level Status MST - Military Sexual Trauma PTSD - Post-Traumatic Stress Disorder UOTHC - Under Other Than Honorable Conditions FG - Field Grade Article 15 NA - Not applicable RE - Reentry VA - Veterans Affairs ARMY DISCHARGE REVIEW BOARD CASE REPORT AND DIRECTIVE AR20160005240 5