IN THE CASE OF: BOARD DATE: 28 January 2020 DOCKET NUMBER: AR20160017262 APPLICANT REQUESTS: In effect, that his honorable discharge shown on his 2015 DD Form 214 (Certificate of Release or Discharge from Active Duty) be corrected to show he was medically retired. APPLICANT'S SUPPORTING DOCUMENTS CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record) * Standard Form (SF) 600 (Chronological Record of Medical Service) dated 22 April 2015 * SF 600 dated 29 June 2015 * SF 600 dated 9 July 2015 * DD Form 2807-1 (Report of Medical History) dated 13 July 2015 * Department of Veterans Affairs letter dated 12 October 2016 FACTS: 1. The applicant states he did not receive proper treatment for his service-connected conditions prior to his release from active duty. His service-connected conditions have continued to worsen since his release from active duty. 2. The applicant enlisted in the Regular Army on 3 March 2009 for a 6-year period of service. The applicant was trained and qualified in military occupational specialty (MOS) 14G (Air Defense Battle Management System Operator). 3. He completed a foreign service tour in Afghanistan supporting Operation Enduring Freedom from 2 July 2010 to 26 June 2011, a period of 11 months and 25 days. For his service he received the Afghanistan Campaign Ribbon with one bronze service star and the Joint Services Commendation Medal. 4. While deployed to Afghanistan he was promoted to the rank and grade of sergeant/E-5 on 1 June 2011. 5. On 29 March 2012, the applicant signed his DA Form 2166-8 (Noncommissioned Officer (NCO) Evaluation Report (NCOER)) for the period ending 5 April 2012. His principal duty title is shown as Avenger squad leader in addition to personnel management, training, and supervisory duties he also was responsible for the Avenger Weapon Systems and its associated equipment valued in excess of $3,500,000.00. During this rating period he also served as a trainer/advisor for the Afghanistan National Army Infantry NCO Battle Course. a. There are no derogatory annotations under Part IV (Army Values/Attributes/Skills/Action). His rater’s comments were he displayed personal courage by volunteering to serve in the most challenging leadership positions; placed the welfare of his subordinates and other Soldiers above his own personal desires; and demonstrated the utmost loyalty to his seniors, peers and subordinates. b. Under Part IV (Values/NCO Responsibilities) he received all excellence ratings for his competence, physical fitness and military bearing, leadership, training and responsibilities. His rater stated he was among the best sergeants he’d known. A few of the comments noted by his rater include: * commended by a major general for his outstanding performance * displayed vast knowledge of air defense operations logging over 720 hours of air- space management tracking over 800 kilometers of air space in Northern Afghanistan * he scored 286 points on his Army Physical Fitness Test (APFT) with his platoon averaging 285 points * developed an outstanding rapport with senior members of the Afghanistan National Army * qualified expert on two separate weapons systems * trained 15 Afghanistan National Army instructors in NCO leadership impacting the overall performance of 620 Afghanistan soldiers * he enrolled and completed college courses continuing his civilian education * he had no safety violations or Soldiers injured c. Under Part V (Overall Performance and Potential) his senior rater recommended him for promotion to staff sergeant ahead of his peers and he commented the applicant was the top Avenger squad leader in the unit. 6. On 14 May 2014, the applicant signed an NCOER for the rating period from 6 April 2012 to 17 April 2014. During this rating period he had a new rater and senior rater. He served as a section team leader for the Air Defense Airspace Management/Brigade Aviation Element for an infantry brigade combat team. There are no derogatory annotations on this report. a. Under Part IV he received four excellence ratings for his values and NCO responsibilities, leadership, training, responsibility and accountability. He received one success rating in the area of physical fitness and military bearing. His rater stated he was among the best sergeants in the unit. A few of the comments noted by his rater on this NCOER include: * displayed competence within his MOS and outside of his MOS resulting in zero aviation and fires conflicts during 30 live fire combined arms brigade missions * brigade commander commended his performance during a joint readiness training exercise * mentally tough, maintains poise and bearing in the most stressful of situations * ensured 395 brigade vehicles received required upgrades enhancing the combat effectiveness of the brigade * dedicated his personal time off to train, mentor and develop Soldiers * his training expertise contributed to the success of a division combined arms exercise with the South Korea Army * saved the unit over $56,000.00 in equipment ordering costs * displayed outstanding organizational and planning skills by maximizing use of limited resources to achieve and exceed established standards * completed the Special Forces assessment and selection process with a recommendation to proceed to the qualification course b. Under Part V his senior rater stated he should be promoted ahead of his peers because he has unlimited potential. He should be assigned to leadership positions of increasing responsibilities and that he had technically mastered his MOS duties and leadership skills. 7. He attended the advanced leadership course for Air Defense Artillery during the period from 14 April to 22 May 2014. He achieved course standards receiving satisfactory ratings for his written communication, oral communication, leadership skills, working in a group and for his ability to conduct research. His evaluation is recorded on DA Form 1059 (Service School Academic Evaluation Report). His rater’s comments include: * his ability to effectively communicate was demonstrated during an informational briefing showing he could disseminate pertinent information to his peers * he used an indirect leadership style to accomplish assigned tasks * he effectively works with others * his research abilities were satisfactory * he achieved an academic average of 87.5 percent 8. Upon returning to his unit, he resumed his duties as a squad leader for an Air Defense Airspace Management/Brigade Aviation Element for an infantry brigade combat team. He received an NCOER for the rating period from 18 April 2014 through 17 April 2015. His rater did not change from his previous NCOER though his senior rater did change. Again, there are no derogatory comments or annotations noted on this NCOER. a. Under Part IV he received three excellence ratings for his competence, training, responsibility and accountability. He received two success ratings for physical fitness and military bearing, and his leadership. His rater stated he was among the best sergeants he knew. Comments noted by his rater include: * distinguished himself during multiple exercises while attending the complex Ground Air Integration Course * de-conflicted 14 sling load missions to include four howitzer gun raids during a brigade size training field exercise * he scored 263 points on his APFT * trained 15 Soldiers who successfully completed air assault school * showed genuine concern for his Soldiers by ensuring he was counseled and issues were handled in a timely manner * demonstrated sound leadership during development of an airspace management tactical standard operating procedures guide * developed small unmanned aerial systems flight execution procedures enabling the brigade to conduct over 216 hours of flight time * responsible for the operational readiness of over $6,000,00.00 of mission critical equipment increasing the brigade’s ability to rapidly deploy b. Under Part V his new senior rater stated he should be promoted ahead of his peers because of his superb performance in finding a balance when confronted with multiple tasks producing successful results under stressful conditions. He should be assigned to leadership positions of increasing responsibilities and he was clearly capable of serving with distinction in the most demanding and critical assignments. 9. A review of his Enlisted Record Brief (ERB), Section IV (Personal and Family Data) shows he underwent a physical examination on 18 February 2015 and his physical profile ratings were all "1s" meaning he had no physical or psychological limitations or duty restrictions. 10. On 24 June 2015, Orders 175-0172 were issued by personnel at Joint Base Elemendorf-Richardson, Alaska. This order reassigned the applicant to the U.S. Army transition point for transition processing and concurrently ordered his release from active duty, not by reason of physical disability, effective 24 July 2015. He was assigned to the U.S. Army Reserve (USAR) (Control Group) the day after his release from active duty. 11. Accordingly on 24 July 2015 the applicant was honorably released from active duty. He was issued a DD Form 214 documenting his service. He served on active duty for 6 years, 4 months and 22 days. His rank at the time of separation was sergeant/pay grade E-5. Among his awards and decorations were the Joint Service Commendation Medal, Army Commendation Medal, Army Achievement Medal and two Army Good Conduct Medals in addition to authorized service ribbons and a campaign medal. Among the most pertinent entries, this DD Form 214 shows in: * Block 23 (Type of Separation) – release from active duty * Block 24 (Characterization of Service) – honorable * Block 25 (Separation Authority) – Army Regulation 635-200 (Active Duty Enlisted Administrative Separations), paragraph 16-7 * Block 28 (Narrative Reason for Separation) – reduction in force 12. As a member of the USAR, he extended his enlistment for 8 months establishing his new expiration of term of service to 29 September 2017. 13. On 31 October 2017, he was discharged from the USAR by Orders 17-297-00002, dated 24 October 2017, issued by Headquarters, 81st Regional Support Command. 14. The applicant provided the following evidence in support of his application. a. An SF 600 dated 27 April 2015, shows he was treated at the post behavioral health clinic by a medical provider. The diagnoses shown were: * Axis I – major depressive disorder, recurrent; post-traumatic stress disorder (PTSD); and alcohol abuse * Axis II – Cluster B personality disorder * Axis III – chronic knee pain, headaches * Axis IV – employment, primary social support * Axis V – Global Assessment of Functioning (GAF) Score of 65 [mild symptoms] [The GAF score is used to rate how serious a mental illness may be. It measures how much a person’s symptoms affect his day-to-day life on a scale of 1 (severely impaired) to 100 (extremely high functioning). The GAF rating is determined by an interview, a questionnaire, medical records, care givers information and police records.] b. The medical provider stated, in effect, the applicant has a history of nonadherence to his medical treatment plan. After discussion, he agreed to a treatment plan wherein he would continue titration of Venlafaxine for mood and anxiety symptoms; to decrease Wellbutrin extended release medication to 300 milligrams per day from 450 milligrams because he noticed no improvement to his depressive symptoms on the higher dose; and to continue Quetiapine at 25 to 50 milligrams for insomnia. He was pending an evaluation for attention deficit hyperactive disorder (ADHD) by a psychologist and he should continue engagement with the Army Substance Abuse Program (ASAP). He was released without duty limitations. c. An SF 600 dated 29 June 2015, shows he was seen at the traumatic brain injury clinic for headaches. On 12 June 2015 he received an occipital nerve block and the applicant noted a decrease in the severity of his headaches; however, the frequency of headaches remained unchanged. A review of a magnetic resonance imagining (MRI) of his cervical spine was normal. An MRI of his brain was consistent with his complaints of chronic headaches and chronic migraine headaches. The provider noted there were no abnormalities in the applicant’s medical systems including his neurological and psychological systems. There was no evidence of a head injury. His general appearance was normal, he was well developed, well-nourished and in no acute distress. His neurological thought content was normal as he was oriented to time, space and person. He described the applicant’s mood as good and his affect was normal. The provider further noted the applicant stated he was getting out of the Regular Army and that he had a civilian job post-service. d. An SF 600 dated 9 July 2015, showing he was treated as an outpatient at the post behavioral health clinic by the same provider noted on his 27 April 2015 SF 600. This was a follow-up appointment wherein the medical provider reviewed the applicant’s diagnoses, medications and provided therapy. The provided noted the applicant’s behavioral health treatment started on 2 October 2013. At that time he was diagnosed with major depressive disorder, single episode, with an appearance of PTSD symptoms. He further showed symptoms of obsessive compulsive disorder personality traits. He was diagnosed with Cluster B personality disorder and alcohol abuse. He was not compliant with his prescribed medication regime. He was also diagnosed with ADHD after an assessment. He was started on a trail medication but discontinued it because of the side effects. The provider stated, "[Service Member] SM says he is doing well, says he is looking forward to his [expiration of term of service] ETS." The medical provider adjusted the applicant’s Axis V GAF score to 70 [mild symptoms]. He was released without duty limitations. [There are four personality disorders which fall under the classification of "Cluster B." The personality disorders are antisocial, borderline, histrionic, and narcissistic. These personality disorders are grouped together due to the overall nature of these disorders being dramatic, erratic or otherwise involving high intensities of emotional outbursts and occurrences.] e. A DD Form 2807-1 shows the applicant completed it on 13 July 2015. He listed numerous medical and psychological deficiencies. A medical doctor reviewed this form and made an annotation to see the applicant’s electronic medical record for details and explanations. f. A letter from the VA, dated 12 October 2016, shows he receives service- connected disability compensation. His combined evaluation was 80 percent disabling with an effective date of 1 August 2015. 15. On 19 December 2019, the Army Review Boards Agency medical advisor rendered a medical advisory after reviewing the applicant’s electronic military personnel and medical treatment records. The medical provider also reviewed the applicant’s VA medical records through the Joint Legacy Viewer. After taking into consideration the Secretary of Defense and Secretary of the Army written guidance, the medical provider determined at the time of the applicant’s release from active duty he met psychiatric medical retention standards of Army Regulation 40-501 (Standards of Medical Fitness), chapter 3, paragraphs 31 to 37. The medical provider stated, "[The applicant’s] NCOERs, awards, service school evaluation reports, promotions, and medical reports all support at the time of separation he was psychiatrically fit for duty." a. Currently, he is rated a combined 100 percent for service-connected disabilities. His disabilities include chronic adjustment disorder with anxious and depressed mood (70 percent), migraine headaches (50 percent), hernia (30 percent), flat foot (30 percent), cervical strain (20 percent), limited flexion of knees, thumb and ankle (each rated 10 percent), traumatic brain disease (10 percent) and tinnitus (10 percent). b. His military medical record shows he was seen by a behavioral health provider on 8 July 2015 for a review prior to his separation date. The provider noted in the applicant’s record he had no significant behavioral health concerns. On 20 July 2015, he met with a provider to renew his Adderall prescription which was effectively managing his symptoms prior to his discharge. There were no annotations showing his duty was limited due to his multiple behavioral or physical health conditions/diagnoses. His treatment was transferred to the VA on 5 September 2015. c. On 26 May 2016, he was evaluated by a VA psychiatric nurse practitioner due to his increased behavioral health symptoms. He had stopped taking his prescribed psychotropic medications because of their various side effects. His diagnoses were: * PTSD, by history * alcohol dependence * alcohol use disorder * headaches, severe and chronic * major depressive disorder, by history d. He was employed by the State Department serving in Afghanistan from September 2015 to April 2016. He then completed training and was employed by a civilian defense contractor with duty overseas. He also continued with his education. His employment and continuing education indicate he had a level of functioning consistent with his functioning at the time of his discharge. e. A copy of the complete medical advisory was provided to the Board for their review and consideration. 16. On 5 January 2019, the applicant was mailed a copy of the medical advisory recommendation in compliance with Title 10, U.S. Code, section 1556 and to provide him an opportunity to respond. He did not respond or provide a rebuttal statement within the time prescribed in his notification letter. BOARD DISCUSSION: 1. The Board carefully considered the applicant’s request, supporting documents, evidence in the records, and regulatory requirements. The Board noted the facts presented above. The Board noted that his military medical record shows he was seen by a behavioral health provider on 8 July 2015 for a review prior to his separation date. The provider noted in the applicant’s record he had no significant behavioral health concerns. On 20 July 2015, he met with a provider to renew his Adderall prescription which was effectively managing his symptoms prior to his discharge. There were no annotations showing that his duty was limited due to his multiple behavioral or physical health conditions/diagnoses. The medical provider determined at the time of the applicant’s release from active duty he met psychiatric medical retention standards of Army Regulation 40-501 (Standards of Medical Fitness), chapter 3, paragraphs 31 to 37. The medical provider stated, "[The applicant’s] NCOERs, awards, service school evaluation reports, promotions, and medical reports all support at the time of separation he was psychiatrically fit for duty." Accordingly, the evidence that the applicant provided (SF 600s dated 27 April 2015, 29 June 2015, and 9 July 2015) does not demonstrate that he had an psychiatric or physically unfitting condition at the time of separation that required evaluation by the disability system or consideration of a disability or medical retirement. The applicant was honorably released from active duty 24 July 2015 the applicant by reason of reduction in force. After discharge, his treatment was transferred to the VA on 5 September 2015. 2. Based on a preponderance of evidence, the Board determined that there was no error or injustice in the applicant’s honorable release from active duty due to reduction in force, and found that relief is not warranted. 1. After reviewing the application and all supporting documents, the Board found that relief was / was not warranted. BOARD VOTE: Mbr 1 Mbr 2 Mbr 3 : : : GRANT FULL RELIEF : : : GRANT PARTIAL RELIEF : : : GRANT FORMAL HEARING :X :X :X DENY APPLICATION 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. 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. REFERENCES: 1. Title 10, U.S. Code (USC), chapter 61, provides the Secretaries of the Military Departments with authority to retire or discharge a member if they find the member unfit to perform military duties because of physical disability. The U.S. Army Physical Disability Agency is responsible for administering the Physical Disability Evaluation System (PDES) and executes Secretary of the Army decision-making authority as directed by Congress in chapter 61 and in accordance with Department of Defense Directive 1332.18 (Disability Evaluation System (DES)) and Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation). a. The objectives of the system are to maintain an effective and fit military organization with maximum use of available manpower, provide benefits for eligible Soldiers whose military service is terminated because of service-connected disability, and provide prompt disability processing while ensuring the rights and interests of the government and the Soldier are protected. b. Soldiers are referred to the DES when they no longer meet medical retention standards in accordance with Army Regulation 40-501, chapter 3, as evidenced in an medical evaluation board (MEB), when a Soldier receives a permanent medical profile, P3 or P4, and is referred by an MOS Medical Retention Board, when they are command-referred for a fitness-for-duty medical examination, and or they are referred by the U.S. Army, Human Resources Command (HRC). c. The DES assessment process involves two distinct stages: the MEB and the physical evaluation board (PEB). The purpose of the MEB is to determine whether the service member's injury or illness is severe enough to compromise his/her ability to return to full duty based on the job specialty designation of the branch of service. A PEB is an administrative body possessing the authority to determine whether a service member is fit for duty. A designation of "unfit for duty" is required before an individual can be separated from the military because of an injury or medical condition. Service members who are determined to be unfit for duty due to disability are either separated from the military or are permanently retired, depending on the severity of the disability and length of military service. d. The mere presence of a medical impairment does not in and of itself justify a finding of unfitness. In each case, it is necessary to compare the nature and degree of physical disability present with the requirements of the duties the Soldier may reasonably be expected to perform because of his or her office, grade, rank, or rating. Reasonable performance of the preponderance of duties will invariably result in a finding of fitness for continued duty. A Soldier is physically unfit when a medical impairment prevents reasonable performance of the duties required of the Soldier's office, grade, rank, or rating. 2. Army Regulation 40-501 (Standards of Medical Fitness) Chapter 3 (Medical Fitness Standards for Retention and Separation, including Retirement) provides the various medical conditions and physical defects which may render a Soldier unfit for further military service and which fall below acceptable physical standards. The regulation in effect at the time stated: a. Paragraph 3-31 states the causes for referral to an MEB for disorders with psychotic features includes diagnosed psychiatric condition(s) that fail to respond to treatment or restore the Soldier to full function with 1 year of onset of treatment. A second cause is mental disorders not secondary to intoxication, infections, toxic, or other organic causes, with gross impairment in reality testing, resulting in interference with social adjustment or with duty performance. b. Paragraph 3-32 states the causes for referral to an MEB for mood disorders includes persistence or recurrence of symptoms sufficient to require extended or recurrent hospitalization, symptoms necessitating limitation of duty or duty in a protected environment or symptoms resulting in interference with effective military performance. c. Paragraph 3-33 states for anxiety, somatoform, dissociative disorders and mood disorders (depression) a Soldier can be referred to an MEB if the medical condition(s) require extended or recurrent hospitalization, limitation of duty or duty in a protected environment or interfere with effective military performance. d. Paragraph 3-35 concerns personality disorders and it states these conditions will be dealt with through administrative channels including Army Regulation 635-200. f. Paragraph 3-36 states situational maladjustments due to acute or chronic situational stress do no render an individual unfit because of physical disability, but may be a basis for administrative separation if recurrent and interfere with military duty. 3. Army Regulation 635-40 establishes the Army Physical Disability Evaluation System and sets forth policies, responsibilities, and procedures that govern the evaluation for physical fitness of Soldiers who may be unfit to perform their military duties because of physical disability. a. Chapter 3 states the mere presence of impairment does not, of itself, justify a finding of unfitness because of physical disability. In each case, it is necessary to compare the nature and degree of physical disability present with the requirements of the duties the member reasonably may be expected to perform because of his or her office, rank, grade or rating. b. Chapter 4 provides guidance on referring Soldiers for evaluation by a MEB when a question arises as to the Soldier's ability to perform the duties of his or her office because of physical disability. 4. Title 10, U.S. Code, section 1201, provides for the physical disability retirement of a member who has at least 20 years of service or a disability rating of at least 30 percent. Title 10, U.S. Code, section 1203, provides for the physical disability separation of a member who has less than 20 years of service and a disability rating less than 30 percent. 5. Title 38, U.S. Code, sections 1110 and 1131, permits the VA to award compensation for disabilities which were incurred in or aggravated by active military service. However, an award of VA rating does not establish error or injustice on the part of the Army. The Army rates only conditions determined to be physically unfitting at the time of discharge which disqualify the Soldier from further military service. The VA awards disability ratings to veterans for service-connected conditions, including those conditions detected after discharge, to compensate the individual for loss of civilian employability. These two government agencies operate under different policies. Unlike the Army, the VA can evaluate a veteran throughout his or her lifetime, adjusting the percentage of disability based upon that agency's examinations and findings 6. Army Regulation 635-200 (Active Duty Enlisted Administrative Separations), in effect at the time, set policies, standards, and procedures to ensure the readiness and competency of the force while providing for the orderly administrative separation of Soldiers for a variety of reasons. Readiness is promoted by maintaining high standards of conduct and performance. Chapter 16 (Selected Changes in Service Obligations), paragraph 16-7 pertains to early separation due to reduction in force, strength limitations or budgetary constraints. When authorization limitations, strength restrictions, or budgetary constraints require the Regular Army or Reserve Component enlisted active duty force reduction, the Secretary of the Army or his designee may authorize voluntary or involuntary early release from active duty. There are statutory authorities for Secretariat separations. The U.S. Army Human Resources Command will implement the Secretarial decision by issuing separation instructions. For the purposes of post-service benefits, early separation under this paragraph is considered to be for the convenience of the Government. //NOTHING FOLLOWS// ABCMR Record of Proceedings (cont) AR20160017262 11 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1