IN THE CASE OF: BOARD DATE: 11 June 2015 DOCKET NUMBER: AR20150003700 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 his undesirable discharge be upgraded to honorable. 2. The applicant states, in effect, that he completed one full term of honorable service and he only acted out after an accounting error resulted in him not being paid. He contends that he was mistreated by his leadership and they failed to provide him any support. He needs his discharge upgraded because he has been diagnosed with colorectal carcinoma and requires treatment through the Department of Veterans Affairs (VA) Health Care System. 3. The applicant provides: * self-authored statement * numerous in-service and post-service medical records * DD Form 214 (Armed Forces of the United States Report of Transfer or Discharge), effective 4 June 1967 * DD Form 214, effective 9 May 1969 * DD Form 215 (Correction to DD Form 214), dated 4 November 2009 * Purple Heart Certificate COUNSEL'S REQUEST, STATEMENT AND EVIDENCE: 1. Counsel requests the applicant's discharge be upgraded. 2. Counsel states the applicant's military records show his post-traumatic stress disorder (PTSD) caused by his combat service and wounding in Vietnam at age 17 caused the misconduct for which he was discharged from the service under other than honorable circumstances at age 19. He was formally diagnosed with PTSD in 2009 but the lack of recognition of this disorder resulted in an unfavorable discharge. 3. Counsel provides a legal brief and exhibits listed on pages 1-3 of his brief, and included in these exhibits is the applicant's discharge packet. 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 AR20140017312 on 24 February 2015. 2. The documents provided by the applicant are new evidence that requires consideration by the Board. 3. The original Record of Proceedings (ROP) shows the Board made the following determinations: a. His service records were void of any documented incidents of specific traumatic events. Further, his records were void of any and he had not provided any documentary evidence showing he had been diagnosed with PTSD. b. His discharge proceedings for unfitness due to frequent involvement in incidents of a discreditable nature with civil or military authorities were conducted in accordance with laws and regulations in effect at the time. c. The Board acknowledged that 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 warranted careful consideration for the possible re-characterization of their overall service. d. In view of the above, the board denied the applicant's request for an upgrade. 4. His record shows: a. He completed an honorable period of active duty service from 8 February 1966 to 4 June 1967. b. He served two tours in the Republic of Vietnam (RVN) as a rifleman from 22 September 1966 to 30 January 1967 and from 6 October 1967 to 16 February 1968. c. His duty status is shown as patient in a hospital in the RVN and Colorado during the period 14 February to 27 March 1968. d. He was absent without leave (AWOL) from 14-22 July 1968 and again from 8-10 January 1969. e. He was convicted by summary-court martial for breaking restrictions and disorderly conduct in a public place and later convicted by special court-martial for being AWOL and disrespectful to his superior noncommissioned officer. f. On 13 January 1969, he was barred from reenlistment. His commander completed a Certificate of Unsuitability for Enlistment/Reenlistment, dated 17 December 1968, wherein he cited the applicant's habitual misconduct which included four Article 15s, a special court-martial, and a summary court-martial for violations of AWOL and failing to obey orders. He further noted that all rehabilitation attempts had failed. g. He was twice reduced to PFC, item 33 (Appointments and Reductions) of his DA Form 20 shows his last date of rank to PFC was 19 May 1967. h. On 4 November 2009, he was issued a DD Form 215. Among the awards listed are the Purple Heart and Combat Infantryman Badge. 5. The new documentary evidence now provided by the applicant includes: a. A self-authored letter, dated 24 November 2009, in which he describes being injured in Vietnam and spending almost 5 months recovering in different hospitals. Upon his release from the hospital he was transferred to Fort Riley, KS. His new leadership failed to assist him with pay problems and the promotion to specialist four he received while in Vietnam. He states that he was a good Soldier but due to his terrible treatment he developed a bad attitude. His chain of command accused him of lying and being a bad Soldier, even though he was recovering from his wounds. He wanted out of the Army and that is what eventually happened. b. His discharge packet, which shows that on 10 March 1969 his commander recommended the applicant be discharged under the provisions of Army Regulation 635-212 (Personnel Separations-Discharge Unfitness and Unsuitability) for unfitness. The discharge was based on the applicant's repeated commission of petty offenses and habitual shirking and his rank/pay grade is shown as PFC/E-3. A Mental Hygiene Consultation diagnosed the applicant with chronic, moderate, immature personality manifested by poor judgment, resentment of authority, and impulsive, maladaptive behavior. The separation authority approved his discharge and directed the issuance of an Undesirable Discharge Certificate. Special Orders, dated 29 April 1969, reduced the applicant from PFC to PVT, effective 28 April 1969. On 9 May 1969, he was discharged as directed. His DD Form 214 shows he had 12 days of lost time. c. Letters from a civilian psychiatrist and a licensed clinical social worker at the Iowa City VA Health Care Center. Both medical professionals have treated the applicant for PTSD since 2009. His specific symptoms include: avoidance of reminders or associations of his service in Vietnam, extreme irritability and self described inability to manage anger, and rather severe difficulty getting along with others. d. A letter from his spouse wherein she discusses the applicant's continuing struggle to get medical assistance for PTSD. e. A Psychiatric Consult conducted at the Galesburg VA Community Based Outpatient Clinic which shows the applicant was screened as positive for PTSD. f. Documents that list his rank/pay grade as SP4/E-4, to include his Purple Heart citation and pay records. 6. His counsel contends the applicant's medical records support a diagnosis of PTSD and he points to the applicant's service medical records which show he was recommended for a psychiatric consult in August 1968 and later diagnosed with anxiety. 7. 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 it 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." 8. 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. 9. The DSM fifth revision (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. 10. 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 under other than honorable conditions 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. 11. 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. 12. 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? 13. Although the DoD acknowledges that some Soldiers who were administratively discharged under other than honorable conditions 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. 14. Army Regulation 635-212, in effect at the time, set forth the basic authority for the separation of enlisted personnel. The regulation provided, in pertinent part, that members involved in frequent incidents of a discreditable nature with civil or military authorities, sexual perversion, drug addiction or the unauthorized use or possession of habit-forming drugs or marijuana, an established pattern for shirking, an established pattern showing dishonorable failure to pay just debts or failure to contribute adequate support to dependents, were subject to separation for unfitness. Such action would be taken when it was clearly established that despite attempts to rehabilitate or develop him as a satisfactory Soldier further effort was unlikely to succeed. An undesirable discharge was normally considered appropriate. 15. Paragraph 3-7a of Army Regulation 635-200 (Active Duty Enlisted Administrative Separations) 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 (emphasis added), or is otherwise so meritorious that any other characterization would be clearly inappropriate. 15. Paragraph 3-7b 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. DISCUSSION AND CONCLUSIONS: 1. His discharge proceedings for unfitness were conducted in accordance with law and regulations in effect at the time. As such, the characterization of the applicant's 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. At the time of his 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. 3. Soldiers who suffered from PTSD and were separated solely for misconduct subsequent to a traumatic event warrant careful consideration for the possible recharacterization of their overall service. 4. A review of his record and the evidence that he provided shows that he was subjected to the ordeals of war while serving in the RVN. His record shows that he served two tours of duty in Vietnam while performing the duties of an infantryman. He suffered a combat jury during his second tour and he was awarded the Purple Heart. 5. Subsequent to these experiences, medical evidence shows the applicant was diagnosed with PTSD/PTSD-related symptoms by a competent mental health professional. Therefore, it is reasonable to believe the applicant's PTSD condition existed at the time of discharge. 6. His record does contain evidence of misconduct to include four Article 15's and two court-martial convictions for what his commander considered habitual petty offenses, and the misconduct of going AWOL appears to have been an isolated event that occurred after his second tour of duty in Vietnam. 7. It is concluded that the PTSD conditions were a causative factor in the misconduct that led to the discharge. After carefully weighing that fact against the severity of the applicant's misconduct, there is sufficient mitigating evidence to warrant upgrading the characterization of the applicant's service to a general discharge under honorable conditions and restoring his rank/grade to PFC/E-3 with an effective date of 19 May 1967. 8. An honorable character of service is appropriate when the quality of the Soldier's service generally has met the standards of acceptable conduct and performance of duty for Army personnel and an under honorable conditions character of service is appropriate for those Soldiers whose military record is satisfactory but not sufficiently meritorious to warrant an honorable discharge. The applicant's military service was marred with misconduct more than once. Therefore, he is not entitled to an honorable discharge. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ____X____ ____X____ ___X_____ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ________ ________ ________ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: 1. The Board determined that the evidence presented was sufficient to warrant amendment of the ABCMR’s decision in Docket Number AR20140017312, dated 24 February 2015. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by re-issuing the applicant's DD Form 214 for the period ending 9 May 1969 to show the characterization of service as "General Under Honorable Conditions" and restoring his rank/grade to PFC/E-3 with an effective date of 19 May 1967. 2. The Board further determined that the evidence presented is insufficient to warrant a portion of the requested relief. As a result, the Board recommends denial of so much of the application that pertains to upgrading the characterization of his discharge to honorable. _______ _ __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) AR20150003700 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20150003700 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1