BOARD DATE: 12 January 2017 DOCKET NUMBER: AR20150017396 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: 12 January 2017 DOCKET NUMBER: AR20150017396 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: 12 January 2017 DOCKET NUMBER: AR20150017396 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 upgrade of his under other than honorable conditions (UOTHC) discharge based on a diagnosis of post-traumatic stress disorder (PTSD). 2. The applicant states, in effect, that he suffers from PTSD and hearing loss due to a gunshot wound to his left frontal lobe that occurred in 2000. In 2007, he sustained a stab wound to the side of his neck. He suffered a heart attack and stroke, he is partially paralyzed, and he is homeless. He states that he cannot obtain medical care from a Department of Veterans Affairs (VA) hospital without an upgrade of his discharge. He requests a personal appearance before the Board. 3. The applicant provides copies of his DD Form 214 (Certificate of Release or Discharge from Active Duty) and medical records. CONSIDERATION OF EVIDENCE: 1. The applicant enlisted in the U.S. Army Reserve on 18 December 1987 for a period of 8 years. He further enlisted in the Regular Army on 5 January 1988 for a period of 3 years and 15 weeks. Upon completion of training he was awarded military occupational specialty 13B (Cannon Crewman). 2. A review of available records shows the applicant was absent without leave (AWOL) on 24 February 1989 and also from 1 May 1989 to 23 October 1993. 3. Headquarters, Fort Dix, NJ, Orders 298-79, dated 25 October 1993, authorized the applicant travel at government expense from the U.S. Army Personnel Control Facility, Fort Dix, NJ, to his home of record (Boston, MA) on 3 November 1993. The orders show he was in an excess leave status awaiting completion of separation processing. 4. A review of the applicant's military personnel records failed to reveal a copy of a DD Form 458 (Charge Sheet) or an administrative separation packet. 5. Headquarters, Fort Dix, NJ, Orders 140-84, dated 20 May 1994, discharged the applicant from the Regular Army effective 8 June 1994. 6. The applicant's DD Form 214 shows he entered active duty this period on 5 January 1988 and he was discharged on 8 June 1994 under the provisions of (UP) Army Regulation (AR) 635-200 (Personnel Separations – Enlisted Personnel), chapter 10, in lieu of trial by court-martial with an UOTHC characterization of service. He had completed 1 year, 11 months, and 12 days of net active service during this period. Item 29 (Dates of Time Lost During This Period) shows time lost under Title 10, U.S. Code, section 972, from 1 May 1989 through 22 October 1993. 7. A review of the applicant's military personnel records failed to reveal evidence that he applied to the Army Discharge Review Board for review of his discharge within that board's 15-year statute of limitations. 8. In support of his application the applicant provides a large volume of his civilian medical records that are summarized below by an Army Review Boards Agency (ARBA) staff medical advisor. 9. In the processing of this case, an advisory opinion was obtained from the medical staff of the ARBA, dated 1 November 2016. a. The ARBA staff psychiatrist stated the applicant is applying for upgrade of his discharge contending that the misconduct which led to his discharge from the Army was due to PTSD. Her review considered the applicant's application, his civilian medical records, and his military personnel records. No military medical records were available for review. b. She noted, "The applicant's civilian healthcare documentation indicates he has been treated for many years for polysubstance abuse and mood disorder. His past history is significant for a stab wound to the side of his neck resulting in subsequent stroke and left hemiparesis [unilateral paralysis]. The injury was incurred during an altercation with his adult stepson. The applicant also incurred a gunshot wound to his head in the past. There is one mention of PTSD in his medical notes. This is in a psychotherapy note written in December 2006 which indicates that the applicant has PTSD from the altercation with his stepson. There is no other mention of PTSD among his multiple psychiatric notes." c. The staff psychiatrist's review of the applicant's military record indicates no symptoms of PTSD or other behavioral health condition. She noted there is no evidence that the applicant failed to meet medical retention standards that were applicable to the applicant's era of service. d. The advisory official concluded, "Based on the documentation available for review at this time, there is insufficient evidence to support the applicant's contention that he developed PTSD while in the military and that PTSD was the cause of the misconduct which led to his [UOTHC] discharge from the Army." 10. On 4 November 2016, the applicant was provided a copy of the ARBA advisory opinion to allow him the opportunity (30 days) to submit comments or a rebuttal. A response was not received from the applicant. REFERENCES: 1. 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." 2. 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. 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, along with 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 UOTHC may have had an undiagnosed condition of PTSD at the time of their discharge. It is also acknowledged that in some cases this undiagnosed condition of PTSD may have been a mitigating factor in the 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 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. 6. 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? 7. Although DoD acknowledges that some Soldiers who were administratively discharged UOTHC may have had an undiagnosed condition of PTSD at the time of their discharge, it is presumed that they were properly discharged based upon the evidence that was available at the time. Conditions documented in the 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. 8. AR 635-200, in effect at the time, sets forth the basic authority for the separation of enlisted personnel. a. Chapter 10 provides that a member who has committed an offense or offenses for which the authorized punishment includes a punitive discharge may submit a request for discharge for the good of the service in lieu of trial by court-martial. The request may be submitted at any time after charges have been preferred and must include the individual's admission of guilt. Although an honorable or general discharge is authorized, a discharge UOTHC is normally considered appropriate. b. Chapter 3, 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. c. Chapter 3, 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. 9. AR 15-185 (Army Board for Correction of Military Records (ABCMR)) prescribes the policies and procedures for correction of military records by the Secretary of the Army acting through the ABCMR. a. The regulation provides that the ABCMR begins its consideration of each case with the presumption of administrative regularity. The applicant has the burden of proving an error or injustice by a preponderance of the evidence. b. Paragraph 2-11 states that applicants do not have a right to a hearing before the ABCMR. The Director of the ABCMR or the chair of an ABCMR panel may grant a formal hearing whenever justice requires. DISCUSSION: 1. The applicant contends that his UOTHC discharge should be upgraded based on a diagnosis of PTSD. 2. The applicant's request for a personal appearance hearing was carefully considered. However, by regulation, an applicant is not entitled to a hearing before the ABCMR. Hearings may be authorized by a panel of the ABCMR or by the Director of the ABCMR. In this case, the evidence of record and independent evidence provided by the applicant is sufficient to render a fair and equitable decision at this time. 3. There is no evidence of record to show the applicant had a medical condition that was found to be medically unfitting during the period of service under review. The ARBA staff psychiatrist found no evidence that the applicant failed to meet medical retention standards that were applicable to the applicant's era of service. She concluded that the documentation submitted by the applicant does not support his contention that he developed PTSD during his service and that PTSD was the cause of the misconduct that led to his discharge. 4. The regulations governing the Board's operation require that the discharge process be presumed to have been in accordance with applicable law and regulations unless the applicant can provide evidence to overcome that presumption. In the absence of evidence to the contrary, the discharge process, the type of discharge, and the characterization of service directed are presumed to have been correct. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20150017396 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20150017396 7 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2