BOARD DATE: 16 August 2016 DOCKET NUMBER: AR20150004773 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: 16 August 2016 DOCKET NUMBER: AR20150004773 BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. ___________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: 16 August 2016 DOCKET NUMBER: AR20150004773 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 general, under honorable conditions discharge to honorable, based on a diagnosis of post-traumatic stress disorder (PTSD). 2. The applicant states: a. He did not drink before going to Vietnam. He started drinking in Vietnam and the drinking progressed. He did not think he would make it back alive and then he received a 42-day drop. When he returned from Vietnam, he was very aggressive and drank a lot. He thought he would be okay once he returned, but his drinking got worse. He tried self-hypnosis which helped for a while, but a doctor told him to stop it. He would not talk about Vietnam. He was diagnosed with PTSD in 1983. He took the test 29 times to be sure of the diagnosis. He went to the Opportunity Center for treatment, but was only treated for his chronic alcohol, nothing else. b. An active duty a social worker was involved in changing his orders for Germany. A colonel could not figure out why he (the applicant) was screwing up because he had been a top notch Soldier before. He turned his Vietnam experience inside. He became very agitated when things did not go right. His parents and a deceased brother knew him best. They are no longer alive. His parents were living in Carlisle, PA, when he returned. His father had him admitted to the Department of Veterans Affairs (VA) Hospital in Lebanon, PA, because he felt the applicant was really screwed up since his return from Vietnam. c. The doctor working at the Lebanon VA found that PTSD was the reason he was having heart problems. He initially responded to treatment and was doing all right. Ten days later, he was a mess. The doctor stated his problems were aggravated by his heart attack, which restarted his PTSD. He also stated that even though he was screwed up there was nothing he could do to help because the government did not have the money and/or the Philadelphia District to do the research on it. He knew he was sick though. He told his parents it would probably pass (illnesses) when he went to work. He had 56 jobs the first two years he was out of the Army. He was eventually admitted to a mental ward where he was treated for alcoholism and not PTSD. At one point, he was told his diet was wrong. In reality, it was a reaction to Agent Orange and a food combination. He also received treatment for PTSD from a psychologist in Bath, NY. He requests his discharge be upgraded to honorable due to the lack of treatment and late diagnosis of PTSD, which was a contributing factor to his discharge from the military. 3. The applicant provides his DD Form 214 (Armed Forces of the United States Report of Transfer or Discharge) and some VA progress notes. 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 (RA) on 27 November 1968 and he held military occupational specialty 62K (Grader Operator). He was honorably discharged on 28 July 1969 for the purpose of immediate reenlistment. His DD Form 214 shows he completed 8 months and 1 day of creditable service. 3. He reenlisted in the RA on 29 July 1969. He served in Germany from on or about 2 November 1969 to on or about 27 April 1970. He also served in Vietnam from 13 June 1970 to 28 April 1971 in an engineer construction battalion. He was promoted to specialist five/E-5 in November 1970. 4. Following his Vietnam tour, he was reassigned to Fort Carson, CO. While there, he accepted nonjudicial punishment (NJP) under the provisions of Article 15 of the Uniform Code of Military Justice on: * 13 September 1973, for being absent without leave (AWOL) from 7 to 10 September 1973, on two occasions for willfully disobeying a lawful command * 27 November 1973, for leaving his appointed place of duty without authority, being disrespectful in language toward a commissioned officer, and willfully disobeying a lawful order; he was reduced to pay grade E-4 5. On 1 October 1973, the Officer in Charge, Opportunity Center advised the applicant's commander of the applicant's progress in relation to his chronic alcoholism. He stated the applicant was admitted to the Opportunity Center Halfway House due to depression caused by his wife and children leaving him. He completed his residency at the Halfway House, but his prognosis was fair to poor. a. On 7 September 1973, he returned from leave but failed to return to the center. A counselor contacted him and reminded him of group therapy but he failed to keep his appointment. The counselor also had a conversation with his doctor at the psychiatric ward. The applicant was depressed but not suicidal and he was released from the ward on 25 September 1973 and again placed in the Halfway House. b. He had feelings of depression due to loss of his family and feelings of worthlessness due to alcohol. He suffered from social isolation due to his refusal to take part in group or individual counseling. He was treated with medication for depression and was a high suicidal risk. 6. On 7 November 1973, the applicant’s immediate commander notified him of his intent to initiate action to eliminate him from the Army under the provisions of chapter 13 of Army Regulation (AR) 635-200 (Personnel Separations – Enlisted Personnel) because of unsuitability. Specifically, the immediate commander cited the applicant's chronic alcoholism. His supervisors wrote statements describing the applicant's excessive alcohol dependence and its negative effect on his performance. They described their multiple failed efforts in counseling, coaching, and rehabilitating him. 7. On 12 November 1973, the applicant acknowledged receipt of the notification of his pending separation action. He was advised by counsel of the basis for the contemplated action to separate him for unsuitability under the provisions of AR 635-200. He waived consideration of his case by a board of officers, personal appearance before a board of officers, and representation by counsel. He elected not to submit a statement on his own behalf. He further indicated that he understood that he might expect to encounter substantial prejudice in civilian life if he received a general, under honorable conditions discharge. He also understood that in the event of the issuance of an undesirable discharge, he might be ineligible for many or all benefits as a veteran under both Federal and State laws, and may encounter substantial prejudice in civilian life. 8. Subsequent to this acknowledgement, the applicant’s immediate commander initiated elimination action against him under the provisions of chapter 13 of AR 635-200 because of unsuitability. The commander stated that the applicant had received extensive counselling but failed to respond positively. He requested a waiver of any further rehabilitative efforts as he did not see any positive response. 9. His intermediate commander personally interviewed him and recommended approval of the discharge action. He opined: * the applicant displayed an immaturity as evidenced by his constant sobbing throughout the interview * his sobbing was deeper than self-pity to self-rejection and remorse; he then would suddenly express a desire to be rehabilitated * he could not guarantee any success of rehabilitation and expressed hostility and bitterness towards his company commander * his rehabilitation would be so difficult and time consuming and he, himself could not produce any plan of action or some proof that rehabilitation would be successful * he expressed a desire to leave the Army and would be happy with a chapter 13, his retention was clearly detrimental to the Army 10. On 3 December 1973, the separation authority waived the rehabilitative efforts and approved the applicant’s discharge under the provisions of chapter 13 of AR 635-200. He directed the issuance of a General Discharge Certificate. Accordingly, the applicant was discharged on 10 December 1973. 11. The DD Form 214 he was issued shows he was discharged under the provisions of chapter 13 of AR 635-200 with a character of service as under honorable conditions (general). This form further shows he completed 4 years, 4 months, and 10 days of active military service and he had 12 days of lost time. He was awarded or authorized the: * Vietnam Campaign Medal with Device (1960) * Vietnam Service Medal with one bronze service star * one overseas service bar 12. 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. 13. The applicant provided three pages of VA progress notes written between December 1998 and August 1999. He was admitted to the hospital on 3 August 1999. He had a history of PTSD, major depression, and bi-polar disorder. He self-reported 29 suicide attempts by overdosing on his own medications. He and his family agreed to participate in a PTSD Family Education Group. He also was enrolled in an outpatient bi-polar disorder research program. 14. The Board requested and the Office of The Surgeon General (OTSG) provided an advisory opinion on 13 July 2016. An OTSG official referenced the Diagnostic and Statistical Manual (DSM) 5, AR 40-501 (Standards of Medical Fitness), with rapid revision, dated 4 August 2011, and AR 635-200, dated 6 September 2011. a. The applicant entered active duty on 29 July 1969 and received a general, under honorable conditions discharge on 10 December 1973 under the provisions of chapter 13 of AR 635-200. The OTSG was asked to determine if the applicant's mental health conditions (PTSD) contributed to the misconduct leading to his general discharge. This opinion is based solely on the information provided by the Board as the Department of Defense electronic medical record (AHLTA) was not in use at the time. b. Records confirm that he received six counseling statements, two UCMJ actions, and an NJP. There is also evidence that during his time in service he struggled with alcohol dependence, failed multiple efforts at rehabilitation and spent time in a halfway house for his alcohol dependence. c. The only record of a PTSD diagnosis by the VA is an August 1999 inpatient admission note containing the diagnoses of PTSD and major depression. Given the absence of documentation regarding the nature or severity of his symptoms, we are unable to assess how PTSD or any other mental health condition may have contributed to the misconduct that led to his general discharge. 15. The applicant was provided with a copy of this advisory opinion to give him an opportunity to submit a rebuttal or general comments. He did not respond. REFERENCES: 1. AR 635-200 provides for the separation of enlisted personnel: a. Chapter 13, in effect at the time, set forth the policy and prescribed procedures for discharging enlisted personnel for unsuitability. Action was to be taken to discharge an individual for unsuitability when, in the commander's opinion, it was clearly established that: the individual was unlikely to develop sufficiently to participate in further military training and/or become a satisfactory Soldier or the individual's psychiatric or physical condition was such as to not warrant discharge for disability. Unsuitability included inaptitude, character and behavior disorders, disorders of intelligence and transient personality disorders due to acute or special stress, apathy, defective attitude, and inability to expend effort constructively, enuresis, chronic alcoholism, and homosexuality. Evaluation by a medical officer was required and when psychiatric indications were involved, the medical officer must be a psychiatrist, if one was available. A general under honorable conditions or an honorable discharge was considered appropriate. b. Paragraph 3-7a, 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. 2. PTSD can occur after someone goes through a traumatic event like combat, assault, or disaster. The 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." 3. 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. 4. 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. 5. 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 individuals 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. 6. Corrections Boards will exercise caution in weighing evidence of mitigation in cases in which serious misconduct precipitated a discharge. 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: 1. The applicant's records reveal a history of misconduct with extensive counseling for various infractions, failed rehabilitation efforts, poor prognosis in a halfway house for alcohol abuse, AWOL, and two instances of NJP. He appears to have been provided with multiple counseling and/or opportunities for rehabilitation by various members of his chain of command but failed to respond constructively. His chronic alcoholism led his chain of command to initiate separation action for unsuitability. 2. His separation was accomplished in compliance with applicable regulations and there is no indication of procedural errors that would tend to jeopardize his rights. The discharge proceedings were conducted in accordance with law and regulations applicable at the time and the character of the discharge is commensurate with the applicant's overall record of military service. The reason for discharge and the characterization of service were both proper and equitable. 3. There are no service medical records available to support his PTSD contention. The only record of him receiving treatment for PTSD by the VA is an August 1999 inpatient admission note. Due to the absence of conclusive documentation regarding the nature and severity of his behavioral health diagnoses such as a VA Rating Decision, there is insufficient evidence to determine if and how PTSD or any other mental health condition may have contributed to his repetitive acts of misconduct that led to his discharge. 4. Based on the available evidence, the quality of his service did not meet 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. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20150004773 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20150004773 8 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2