IN THE CASE OF: BOARD DATE: 27 September 2016 DOCKET NUMBER: AR20150007975 BOARD VOTE: ___x_____ ___x___ ___x____ 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: 27 September 2016 DOCKET NUMBER: AR20150007975 BOARD DETERMINATION/RECOMMENDATION: The Board determined that the evidence presented was 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 re-issuing the applicant's DD Form 214 for the period ending 9 June 2000 to show the characterization of service as "General, Under Honorable Conditions" and his rank/grade as PV2/E-2 with an effective date of 11 February 2000. ____________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. IN THE CASE OF: BOARD DATE: 27 September 2016 DOCKET NUMBER: AR20150007975 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 under other than honorable conditions discharge be upgraded. 2. The applicant states he served one combat tour in Iraq from 15 August 1990 - 8 April 1991 during Operations Desert Shield/Desert Storm and he was awarded the Combat Infantryman Badge. Upon his return the Army did not afford him an opportunity to receive behavioral health treatment even though he had the symptoms of post-traumatic stress disorder (PTSD). He was self-medicating with illegal drugs in an attempt to numb his symptoms when he tested positive during a routine urinalysis. He was sent to Walter Reed Army Medical Center for an evaluation for drug treatment and then he was sent to Andrews Air Force Base for drug treatment, but not for the root cause of his issues. He was insane at the time of his discharge on 1 August 2000 and he was diagnosed with PTSD in 2001 at the St. Cloud Department of Veterans Affairs (VA) Medical Center (VAMC), MN. He is currently rated 100 percent service-connected disabled, "permanent and total." 3. The applicant provides: * DD Form 214 (Certificate of Release or Discharge from Active Duty) with a separation date of 1 August 1992 * DD Form 214 with a separation date of 9 June 2000 * a letter, dated 29 December 2015, from VAMC, NW Metro Outpatient Clinic, Rio Rancho, NM 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 initially enlisted in the Regular Army on 20 April 1989. He completed basic combat and advanced individual training and was awarded military occupation specialty (MOS) 11B (Infantryman). 3. He served in Southwest Asia from 15 August 1990 to 8 April 1991. 4. On 1 August 1992, he was released from active duty. He completed 3 years and 7 days of active service that was characterized as honorable. His DD Form 214 shows he was awarded the Southwest Asia Service Medal with two bronze service stars, the Kuwait Liberation Medal (Saudi Arabia), and the Combat Infantryman Badge. 5. On 20 April 1995, he enlisted in the Regular Army in pay grade E-4. In September 1995, he was awarded MOS 98C (Signals Intelligence Analyst). On 25 September 1995, he was assigned to the 741st Military Intelligence Battalion at Fort Meade, MD. On 12 December 1997, he was promoted to sergeant/pay grade E-5. 6. On 20 February 1998, he was assigned to the 3rd Military Intelligence Battalion in Korea. On 28 May 1998, he immediately reenlisted in pay grade E-5 for 3 years. On 21 February 1999, he was assigned to the 741st Military Intelligence Battalion at Fort Meade. 7. The Fort Meade Family Advocacy Case Review Committee (CRC) sent three memoranda, dated 8, 27, and 28 July 1999. a. On 8 July 1999, a memorandum was sent to the applicant's commander strongly recommending that the applicant be directed to refrain from going to the residence he shared with his wife and daughter. (1) The CRC had received several reports of spouse abuse involving the applicant and his wife. The reports alleged he had damaged property belonging to his wife and damaged the home they shared. (2) The reports alleged that the couple had pushed and hit each other on multiple occasions and that these incidents had taken place in the presence of their 4-year old daughter. (3) CRC strongly recommended that for the safety of all family members the applicant be directed to refrain from going to his residence at the present time. CRC recommended that his command provide assistance and/or supervision to facilitate arrangements for the applicant to spend time with his daughter. (4) His wife had obtained an ex parte order (temporary restraining order) with a court date of 14 July 1999 to determine if the order would be extended. b. On 27 July 1999, a memorandum was addressed to whom it may concern from the CRC and indicated the applicant was referred to the Army Family Advocacy Program following an incident of domestic violence involving him and his spouse. (1) The applicant was scheduled to participate in Men's Group at Fort Meade beginning in September 1999. The group met for eight 1 1/2 hour sessions and addressed a variety of issues including recognizing and controlling anger, dealing with feelings and emotions, stress management, and communication. (2) The applicant was also referred to a parenting class and, if he and his spouse made a decision to reunite, they would be offered a communication workshop and marital counseling. (3) The applicant had self-referred into the Substance Abuse Rehabilitation Center (SARC). He was participating in the SARC partial hospitalization program, consisting of daily, full-day substance abuse treatment for an average of 2 weeks. Following this program he would begin the intensive outpatient treatment program consisting of daily, half-day treatment for an average of an additional 2 weeks. He would then begin follow-up outpatient care which included weekly therapy groups facilitated by professional providers and attendance at Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings. c. On 28 July 1999, a memorandum was sent to the applicant's commander from CRC indicating they had received a report of spouse abuse involving the applicant and his wife. The report alleged they hit each other during an argument. A multidisciplinary assessment and investigation was conducted and, based upon the preponderance of available information, the CRC made a determination of "substantiated." (1) A DD Form 2486 (Child/Spouse Abuse Incident Report) was being forwarded to the U.S. Army Central Registry, Fort Sam Houston, TX. (2) CRC recommended the applicant be directed to comply with the recommended treatment program. The plan recommended that he continue in the Substance Abuse Rehabilitation Program. He should attend the Men's Group and both he and his wife should attend a parenting class. It was recommended that his daughter attend supportive counseling and that his wife continue in Women's Group. If they decide to reunite, they should attend marital counseling and a couple's communication group. 8. On 31 January 2000, the applicant received non-judicial punishment (NJP) for wrongful use of an amphetamine (methylenedioxymethamphetaine (MDMA), commonly known as ecstasy) on or about 16 November 1999 and 16 December 1999. His NJP included reduction to specialist/pay grade E-4. 9. On 11 February 2000, the applicant received NJP for wrongful use of MDMA on or about 26 December 1999 and 4 January 2000. He appealed his NJP. On 14 February 2000, his appeal was reviewed by a judge advocate and on 17 February 2000, his appeal was denied by the 704th Military Intelligence Brigade commander. His NJP included reduction to private/pay grade E-2 (PV2). 10. On 18 April 2000, the applicant's commander notified him that action was being initiated to discharge him prior to the expiration of his term of service for commission of a serious offense. The reason for the commander's proposed action was the applicant's abuse of illegal drugs on two occasions. Such misconduct subjected the applicant to mandatory separation processing under the provisions of Army Regulation (AR) 635-200 (Personnel Separations, Enlisted Personnel, paragraph 9-2 for alcohol or other drug abuse rehabilitation failure, due to his inability or unwillingness to overcome his substance abuse problems despite being offered every opportunity to do so with the help of mental health programs and Alcohol and the Drug Abuse Prevention and Control Program (ADAPCP). 11. His commander recommended separation with a discharge under other than honorable conditions. He was advised of his right to: * consult with counsel * obtain copies of documents that would be sent to the separation authority supporting the proposed separation action * request a hearing before an administrative board * submit statements in his own behalf * be represented by counsel * waive any of these rights * withdraw any waiver of rights at any time prior to the date the discharge authority directed or approved his discharge 12. On 18 April 2000, he acknowledged receipt of the notification of his proposed discharge. 13. The notification letter, dated 18 April 2000, included 15 enclosures. a. A DA Form 4856 (General Counseling Form), dated 19 March 1999, shows he was counseled for failing to repair, failing to obey an order or regulation, and insubordinate conduct toward a noncommissioned officer (NCO). b. A DA Form 4856, dated 19 March 1999, shows he was counseled concerning his contacting senior NCOs or his commander before committing any aggressive action that would bring physical harm to himself or those around him, especially his wife. The commander believed he was suffering immense emotional stress as he adjusted to his reassignment from Korea and the current crisis with his wife. c. A DA Form 4856, dated 6 May 1999, shows he was counseled concerning his failure to report to his place of duty after returning from leave. He was found at his estranged wife's home, which he had been ordered to stay away from because of past domestic problems. d. A DA Form 4856, dated 8 July 1999, shows he was counseled for failing to obey a lawful order not to return his residence unless he notified the chain of command and had a representative present. After having been involved in a violent dispute with his wife on 14 and 18 June 1999, he was ordered not to return without a command representative present. On 6 July 1999, he went back to the residence and he and his spouse had an altercation, which resulted in violence causing both the county police and the military police to be dispatched. e. A DA Form 4856, dated 20 July 1999, indicates he was referred to an out-patient drug and alcohol rehabilitation facility at Andrews Air Force Base based on the request and recommendation of his attending psychiatrist at Walter Reed Army Medical Center. He was also allowed to attend AA meetings. He was not allowed any contact with his wife and only limited contact with his daughter. f. A DA Form 4856, dated 9 November 1999, indicates he was arrested on 8 November 1999 by military police from Fort Meade for driving at 103 miles per hour (mph) in a 55 mph zone. It was determined he had some alcohol on his breath and a subsequent breathalyzer test reported him at .07%. Because he was attending ADAPCP meetings for alcohol and drug abuse, as well as being restricted to post, he had failed to obey a lawful order, broke restriction, recklessly operated a vehicle, and had driven under the influence. g. A memorandum, dated 7 July 1999, from the applicant's unit commander to the Battalion Commander described her actions with the applicant during the period from 11 June 1999 and 7 July 1999. h. On 22 March 1999, the applicant's unit commander requested a follow-up psychiatric examination for psychiatric treatment the applicant received in Korea. On 21 April 1999, the applicant was evaluated by a captain, the Psychology Resident, and a major, the Supervising Psychologist, U.S. Army Medical Department Activity, Fort Meade, MD. After discussing the results of the clinical interview and psychological testing they determined: (1) The applicant was within the high average range of intelligence with a history of attention deficit/hyperactivity disorder, predominantly inattentive type for which he was receiving pharmacological intervention. His personality testing results showed that he answered questions in a consistent and forthright manner. These results suggest that he may be likely to place his own concerns and needs before those of others. (2) There were indications that he may experience constraints placed upon him as particularly onerous and may be likely to act impulsively in efforts to escape from perceived limitations on his freedom. (3) It was not possible to determine with any certainty whether this pattern of understanding and interacting with the world reflected a more chronic and long-standing characterological tendency or, rather, suggests a reaction to current life stressors. (4) The applicant appeared to have a psychiatric condition which impaired his judgment, reliability, and stability. He had pursed treatment for these problems in an inconsistent manner. While it was possible that his current difficulties would resolve without further psychiatric intervention, the applicant appeared to be subject to bouts of impulsive and poorly considered behavior that constituted a security risk. (5) Access to secured information should be curtailed until the applicant was able to demonstrate a more stable pattern of behavior and judgment. (6) If efforts were to be made to restore his security clearance, it was recommended that he participate in weekly individual psychotherapy to address his impulsive behavior and poor judgment. i. A memorandum, dated 22 November 1999, from SARC Activity, Fort Meade, MD declared the applicant an ADAPCP rehabilitation failure. (1) The applicant was referred to the ADAPCP SARC after becoming despondent after a court decision resulted in an ex parte order limiting his visitation rights to his daughter. He had been sent to Walter Reed Army Medical Center for 5 days receiving treatment for depression and detoxification. He was then transferred to Malcolm Grow Medical Center where he received intensive substance abuse rehabilitation for polysubstance dependence and alcohol dependence from 19 July 1999 - 13 August 1999. (2) A rehabilitation meeting was held at SARC on 23 August 1999 and the applicant was enrolled in the outpatient program for follow-up treatment. It was recommended and agreed upon by the team and the applicant that he abstain from alcohol and drugs while enrolled. He was to attend group counseling once a week, submit to random urinalysis, attend three AA or NA meetings per week and obtain a sponsor, and address personal issues as needed. The applicant was being followed by psychiatry for an attention deficit disorder, and for depression. He was also attending an anger management course to comply with a court order. (3) On 22 October 1999, a second rehabilitation meeting was held to review progress. His progress was assessed as being good as he had complied with treatment guidelines. He had been complaining of problems with attention and maintaining focus, and had been requesting consideration for being placed on an amphetamine regimen, which was approved of by psychiatry. He was counseled regarding the importance of strict compliance with treatment and medication guidelines and understood the consequences of noncompliance. (4) On 8 November 1999, the applicant was apprehended for driving under the influence of alcohol while speeding and reckless endangerment. (5) On 17 November 1999, a third rehabilitation team meeting was held. Based on the applicant's relapse and the alcohol related incident, his noncompliance with treatment guidelines, and having received all available treatment options, the rehabilitation team declare the applicant an ADAPCP rehabilitation failure. The applicant had been offered every opportunity to rehabilitate himself, but had been unwilling or unable to overcome his substance abuse problems. It was not believed that continued rehabilitation would have been successful, and the team recommended the applicant be processed for separation. j. On 23 March 2000, the applicant was given a mental status evaluation. The examiner found he met the physical retention standards prescribed in Army Regulation 40-501 (Standards of Medical Fitness). The examiner further determined he was mentally responsible, able to distinguish right from wrong, able to adhere to the right, and had the mental capacity to understand and participate in proceedings. The applicant presented with no psychiatric diagnosis that would warrant any action through medical channels. He was psychiatrically cleared for any administrative action deemed necessary by her command. 14. On 20 April 2000, after having been advised by his consulting counsel of the basis for the contemplated action to separate him for commission of a serious offense and for alcohol or other drug abuse rehabilitation failure, the applicant waived consideration of his case by an administrative separation board and appearance before such board. He acknowledged he could expect to encounter substantial prejudice in civilian life if a general discharge under honorable conditions was issued to him. He also acknowledged that as a result of a discharge under other than honorable conditions he might be ineligible for many or all benefits as a veteran under both Federal and State laws and he could expect to encounter substantial prejudice in civilian life. He indicated he was submitting a statement in his own behalf; however, such statement was not available for review. 15. On 26 and 27 April 2000, the applicant's intermediate commanders recommended he be separated from the Army prior to the expiration of his current term of service under the provision of chapters 9 and 14 of AR 635-200. 16. On 26 May 2000, the Office of the Staff Judge Advocate, Fort Meade, MD, submitted a memorandum to the Commander, U.S. Army Garrison, Fort Meade, subject: Separation under AR 635-200, Chapter 14-12c and Chapter 9-2 Pertaining to (Applicant). a. The applicant had more than 10 years of military service and was entitled to request that his case be heard by and administrative separation board. The applicant had unconditionally waived his right to a separation board. b. On 23 August 1999, the applicant (then a sergeant) was enrolled in the ADAPCP for alcohol abuse. On 8 November 1999, he was apprehended by the military police for driving 103 mph to a 55 mph zone. He was also cited for driving under the influence of alcohol and his breath alcohol content was measured at .07. ADAPCP determined him to be a rehabilitation failure and the unit initiated separation proceedings in accordance with chapter 9 of AR 635-200. c. On 16 December 1999, the applicant participated in a unit urinalysis. His urine tested positive for the presence of a designer drug, ecstasy, a methamphetamine. On 4 January 2000, his urine again tested positive for the presence of methamphetamines. The unit initiated separation proceedings for commission of a serious offense. The company, battalion, and brigade commanders all recommend that the applicant be separated with an other than honorable conditions discharge. d. When more than one basis exists to separate a Soldier, the immediate commander may initiate under all applicable bases and notify the Solder of the same. Where the unit initiates separation under more than one basis, the separation authority may approve separation for only one basis. e. The Staff Judge Advocate recommended the separation action under chapter 9 be disapproved, that the chapter 14 separation action be approved, and that the applicant be separated with an other than honorable conditions characterization of service. 17. On 26 May 2000, the separation authority disapproved the request for separation of the applicant under the provisions of chapter 9 of AR 635-200. The separation authority approved the request for separation of the applicant under the provisions of paragraph 14-12c of AR 635-200 for the commission of a serious offense. The separation directed the characterization of service to be other than honorable conditions, that he not be transferred to the Individual Ready Reserve, and that he be reduced to private/pay grade E-1. 18. U.S. Army Garrison, Fort Meade, MD, Orders 154-102, dated 2 June 2000, reduced the applicant from PV2 to private/pay grade E-1 (PV1) effective 26 May 2000. 19. On 9 June 2000, the applicant was discharged by reason of misconduct with a characterization of service of under other than honorable conditions in the grade/pay grade of PV1/E-1. The DD Form 214 issued at that time shows the authority for the discharge was AR 635-200, paragraph 14-12c. The DD Form 214 shows he completed 5 years, 1 month, and 20 days of net active service this period, with continuous honorable active service from 20 April 1995 - 27 May 1998. The DD Form 214 shows he was awarded two Army Achievement Medals and his third award of the Army Good Conduct Medal. 20. The applicant provided a letter, dated 29 December 2015, from the attending psychiatrist at the VA Medical Center, VA NW Metro Outpatient Clinic, Rio Rancho, NM. a. A review of the applicant's medical record from the St. Cloud, MN, VA revealed he was initially diagnosed with combat-related PTSD in August 2000 and the examiner specifically noted combat stress during Desert Storm as the precipitating cause of his chronic and severe PTSD. b. The applicant experienced active symptoms of PTSD on a continuous basis from the time of his service in Kuwait and Iraq in 1990-1991 to the present, including throughout the period of his second Army enlistment between 1995 and 2000, despite the fact that he did not receive treatment until after his discharge from military service. c. It is overwhelmingly likely that the applicant's PTSD was the cause of mental health, behavioral, and disciplinary problems that ultimately led to his separation and "other than honorable" discharge in June 2000. Given his achievements early in his service, it seems highly likely that had he been diagnosed earlier and received appropriate treatment he would have continued to perform well. d. The applicant continues to engage in regular treatment for his PTSD at the clinic. 21. On 3 August 2016, an advisory opinion was received from the Office of the Surgeon General (OTSG). OTSG stated it is plausible that a nexus exists between PTSD and the misconduct that resulted in the applicant's discharge. a. OTSG was asked to determine if there was a nexus between the information/diagnoses contained in the documentation and the misconduct that resulted in the applicant's discharge. The opinion was based solely on the information provided by the Board as the Department of Defense (DOD) electronic medical record (AHLTA) was not in use at the time of his service. b. Records document the applicant's long history of misconduct including drug and alcohol use, driving while intoxicated, failure to obey a lawful order, failure to report, and disrespect toward a superior noncommissioned officer (NCO). There was also evidence of his involvement with the Family Advocacy Program to address domestic violence and anger management associated with marital conflict. He participated in the SARC, but was deemed a treatment failure in November 1999. c. In June 1999, he was command-directed for psychological testing and evaluation where he was diagnosed with adjustment disorder with mixed disturbance of emotions and conduct. The evaluator noted security concerns related to poor judgment and impulsivity, but concluded the applicant met retention standards. d. The applicant asserts he was self-medicating symptoms of PTSD with illegal drug use, and notes he is currently rated 100 percent service connected by the VA for PTSD. 22. On 4 August 2016, the applicant was provided a copy of the advisory opinion. He did not provide any comments or a rebuttal. REFERENCES: 1. AR 600-8-19 (Enlisted Promotions and Reductions), paragraph 6-1e, in effect at the time, stated when the separation authority determines that a Soldier is to be discharged from the Service under other than honorable conditions, they will be reduced to the lowest enlisted grade. Board action is not required for this reduction. 2. AR 635-200 sets forth the basic authority for the separation of enlisted personnel. a. Paragraph 9-2c states that initiation of separation proceedings is required for Soldiers designated as alcohol/drug rehabilitation failures. b. Chapter 14 establishes policy and prescribes procedures for separating personnel for misconduct because of minor disciplinary infractions, a pattern of misconduct, commission of a serious offense, conviction by civil authorities, desertion, and AWOL. Paragraph 14-12c provides for the separation of a Soldier by reason of commission of a serious offense. Abuse of illegal drugs is serious misconduct. The issuance of a discharge under other than honorable conditions is normally considered appropriate for separations under the provisions of chapter 14. c. 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. d. 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. 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." 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 DSM fifth revision (DSM-V) 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; or (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; or (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; or (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); or (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; or (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. 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 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. 7. 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 under other than honorable conditions 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. 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 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 under other than honorable conditions 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 under other than honorable conditions. 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 discharge proceedings for misconduct were conducted in accordance with law and regulations in effect at the time. The characterization of the applicant's service 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. 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. 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. PTSD is not a likely cause for either premeditated misconduct or misconduct that continues for an extended period of time. 4. The attending psychiatrist at the VA Medical Center stated the applicant was diagnosed with PTSD in August 2000, within 2 months of his discharge, and the examiner specifically noted combat stress during Desert Storm as the precipitating cause of the applicant's chronic and severe PTSD. He also stated the applicant's PTSD was overwhelmingly likely the cause of his mental health, behavioral and disciplinary problems that led to his separation, and it is likely that if he had been diagnosed earlier and received appropriate treatment, he would have continued to perform well. 5. OTSG stated it is plausible that a nexus exists between the applicant's PTSD and the misconduct that resulted in his discharge. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20150007975 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20150007975 17 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2