BOARD DATE: 9 May 2017 DOCKET NUMBER: AR20160008430 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 BOARD DATE: 9 May 2017 DOCKET NUMBER: AR20160008430 BOARD DETERMINATION/RECOMMENDATION: The Board determined the evidence presented is sufficient to warrant amendment of the ABCMR's decision in Docket Number AR20150001770, dated 24 September 2015. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected to show the upgraded discharge received under the Department of Defense Special Discharge Review Program was affirmed. ___________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: 9 May 2017 DOCKET NUMBER: AR20160008430 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 reconsideration of his earlier request to affirm the upgraded discharge received under the Department of Defense (DOD) Special Discharge Review Program (SDRP). His previous petition also included a request for a personal hearing. 2. The applicant states, in effect, he received a diagnosis for post-traumatic stress disorder (PTSD), and submits medical records from the Department of Veterans Affairs (VA) for consideration by the Board. 3. The applicant provides the following new evidence not previously considered: * VA Form 10-5345 (Request For and Authorization to Release Records or Health Information, dated 5 April 2016 with attached note * 28 pages of VA medical records 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 AR20150001770 on 24 September 2015. 2. The applicant submitted an initial application on 23 January 2015, which was denied. With his current request for reconsideration, he provides new evidence, in the form of VA medical records showing a PTSD diagnosis. In view of the circumstances, this application for reconsideration warrants consideration by the Board. 3. The applicant's service records are not available for review with this case. However, he provides sufficient documents for the Board to conduct a fair and impartial evaluation of his case. 4. His first DD Form 214 shows he was inducted into the Army of the United States on 21 November 1963. He was honorably discharged on 26 November 1964 for the purpose of immediate reenlistment. This form also shows at the time of his discharge: * he held military occupational specialty 111.00 (Light Weapons Infantryman) and he was assigned to 1st Battalion, 19th Infantry Regiment, Germany * he was awarded or authorized the Sharpshooter Marksmanship Qualification Badge with Rifle Bar * he held the rank/grade of private first class/E-3 and completed 1 year and 6 days of net active creditable service 5. His second DD Form 214, which was reissued, shows he enlisted in the Regular Army on 27 November 1964. He was discharged on 25 September 1968 with an under other than honorable conditions characterization of service. This form shows: * he held military occupational specialty 11D (Armor Intelligence Specialist) and he was assigned to the U.S. Army Special Processing Detachment at Fort Knox, KY * he was discharged in the rank/grade of private/E-1 * he had 2 years, 3 months, and 19 days of foreign service * he completed 3 years, 3 months, and 3 days of active service with 206 days of lost time * his lost time was 2 March 1965, 5 July to 2 August 1966, 15 January to 6 February 1968, 20 March to 6 May 1968, 10 to 11 June 1968, and 14 June to 24 September 1968 * his characterization of service was upgraded under the DOD SDRP on 27 May 1977 to under honorable conditions (general) 6. The applicant provides VA medical records that confirm a PTSD diagnosis. 7. On 30 November 2016, a clinical psychologist with the Army Review Boards Agency (ARBA) provided a medical advisory opinion. a. Medical records from a VA Medical Center, dated 16 November 2015, indicated the applicant was diagnosed with PTSD and major depressive disorder (MDD). Symptoms of PTSD, anxiety, and depression were attributed to traumatic combat events experienced in Vietnam between August 1966 and July 1967. These events included running convoys, engaging in several firefights, doing headcounts of deceased Soldiers, and losing friends. Since separating from the Army, he has experienced significant interpersonal and occupational difficulties to include financial and health hardships, sleep problems, nightmares of Vietnam, social isolation, hypervigilance, and survivor's guilt, due to the loss of 13 friends with whom he had served. b. Based on the ARBA clinical psychologist's review of available medical records, it was determined there was a nexus between the applicant's behavioral health condition and the misconduct which led to his adverse discharge. Given that PTSD was not recognized as a diagnosis during his era of service, it is unlikely he, or anyone else, was able to attribute his excessive periods of absence without leave (AWOL) as being combat-related. Prior to separation, the applicant endorsed he had difficulty coping with the effects of war, particularly the loss of his friends. Despite the lack of military medical records, there is sufficient supporting medical documentation from the VA that shows diagnoses for PTSD and MDD. These conditions can cause avoidant behavior such as going AWOL. c. Although he received a characterization upgrade, under the DOD SDRP, he has not been able to receive long-term VA medical care. Given his impairment, and the need for long-term medical and behavioral healthcare, it is likely that PTSD mitigated the misconduct that led to his active duty separation. 8. On 2 December 2016, the Case Management Division, ARBA, provided the applicant a copy of the ARBA medical advisory opinion for review and comment. The applicant stated, in effect, he concurred with the advisory. REFERENCES: 1. Army Regulation 635-212 (Personnel Separations – Discharge – Unfitness and Unsuitability), then in effect, set forth the policy for administrative separation for unfitness. It stated, in pertinent part, individuals would be discharged by reason of unfitness when their records were characterized by one or more of the following: frequent incidents of a discreditable nature with civil or military authorities; sexual perversion; drug addiction; an established pattern of shirking; and/or an established pattern showing dishonorable failure to pay just debts. This regulation prescribed that an undesirable discharge was normally issued unless the particular circumstances warranted a general or honorable discharge. 2. Army Regulation 635-200 sets forth the basic authority for the separation of enlisted personnel. a. 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. b. 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. 3. On 4 April 1977, DOD directed the Services to review all less than fully honorable administrative discharges issued between 4 August 1964 and 28 March 1973. In the absence of compelling reasons to the contrary, this program, known as the DOD-SDRP, required that a discharge upgrade, to either honorable or general, be issued in the case of any individual who: * had completed a normal tour of duty in Southeast Asia * been wounded in action * been awarded a military decoration other than a service medal * had received an honorable discharge from a previous period of service, or had a record of satisfactory military service of 24 months prior to discharge * consideration of other factors, including possible personal problems, which may have contributed to the acts which led to the discharge and a record of good citizenship since the time of discharge would also be considered 4. Public Law 95-126, enacted in October 1978, required the Service Departments to establish historically-consistent uniform standards for discharge reviews. Reconsideration using these uniform standards was required for all discharges previously upgraded under the SDRP and certain other programs were required. Individuals whose SDRP upgrades were not affirmed upon review under these historically-consistent uniform standards were not entitled to VA benefits unless they had been entitled to such benefits before their SDRP review. 5. The Board has been advised in similar cases that the VA often requires validation of affirmation of SDRP upgrades by the military service corrections boards in order to authorize the service member VA benefits. 6. PTSD can occur after someone goes through a traumatic event like combat, assault, or disaster. a. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA), and 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 (DSM-III) nosologic classification scheme. Although controversial when first introduced, the PTSD diagnosis has filled an important gap in psychiatric theory and practice. b. From a 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." 7. 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 he or she has been exposed to an event that is considered traumatic. a. Clinical experience with the PTSD diagnosis has shown 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. b. 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. 8. In May 2013, the APA released the Fifth Revision of the DSM (DSM-5). This updated edition included 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. 9. 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. a. This acknowledgement is the result of the extensive research conducted by the medical community, along with the relatively recent issuance of revised criteria regarding the causes, diagnosis, and treatment of PTSD. b. It is also recognized that, in some cases, this undiagnosed condition of PTSD may have been a mitigating factor in the misconduct that served as a catalyst for the Soldier's discharge. c. Of note, research has demonstrated 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 extended periods. 10. In view of the foregoing, on 3 September 2014, the Secretary of Defense gave written guidance to Service Discharge Review Boards (DRBs) and Service Boards for Correction of Military/Naval Records (BCM/NRs). The memorandum directed them to consider the revised PTSD criteria, detailed medical considerations, and mitigating factors when taking action on requests for upgrades in the character of service for former service members who had a valid diagnosis of PTSD. 11. BCM/NRs are not courts, nor are they investigative agencies. Therefore, the determinations are 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? 12. Although 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. a. 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. b. BCM/NRs 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. c. PTSD is not a likely a 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. 13. Army Regulation 15-185 (ABCMR) states ABCMR members will review all applications that are properly before them to determine the existence of an error or injustice; direct or recommend changes in military records to correct the error or injustice, if persuaded that material error or injustice exists and that sufficient evidence exists on the record. The ABCMR will decide cases on the evidence of record. It is not an investigative body. The ABCMR may, in its discretion, hold a hearing. Applicants do not have a right to a hearing before the ABCMR. The Director or the ABCMR may grant a formal hearing whenever justice requires. DISCUSSION: 1. By regulation, an applicant is not entitled to a hearing before the Board. Hearings may be authorized by a panel of the Board or by the Director of the ABCMR. In this case, the evidence of record, including independent evidence he provided, is sufficient to render a fair and equitable decision at this time. 2. While the applicant's military service records are not available for review, his 1968 DD Form 214 indicates, after initially receiving an under other than honorable conditions character of service, it was upgraded to general under honorable conditions following a review under the DOD SDRP. This upgrade, however, did not result in an entitlement to VA benefits unless affirmed by, in this case, the Army. Given the applicant's apparent inability to gain access to VA benefits, it appears the Army never gave such affirmation. 3. During the applicant's era of service, PTSD was largely unrecognized by the medical community and DOD. Both now have a more thorough understanding of PTSD, as well as its potential to be a causative factor in a Soldier's misconduct. This is particularly true when the condition goes undiagnosed, and there has not been timely treatment. Soldiers who suffer from PTSD warrant careful consideration for the possible recharacterization of their overall service when they were separated solely for misconduct that was subsequent to a traumatic event. 4. The applicant's VA records provide evidence that he has been diagnosed with PTSD and MDD. The records further indicate his symptoms are the result of his combat experiences. a. While his military service records are not available for review, his 1968 DD Form 214 confirms he had extended periods of AWOL, and it is reasonable to presume his AWOLs contributed to his adverse separation. b. Based on a review of both his available service record and the medical documentation available from VA, the ARBA clinical psychologist concluded there was a nexus between his PTSD and his periods of AWOL. As such, the clinical psychologist found his PTSD was mitigating. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20160008430 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20160008430 9 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2