IN THE CASE OF: BOARD DATE: 19 April 2022 DOCKET NUMBER: AR20210015043 APPLICANT REQUESTS: * a change in the narrative reason for separation to reflect a medical discharge * correction of Block 21a. (Member Signature) of her DD Form 214 (Certificate of Release or Discharge from Active Duty) to show her signature * a personal appearance before the Board APPLICANT'S SUPPORTING DOCUMENTS CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record) * Eight Copies of DD Form 214 (Certificate of Release or Discharge from Active Duty) * Sexual Harassment Memorandum dated 29 October 2016 * Tripler Army Medical Center Visit dated 6 October 2019 * Memorandum to Undergo Surgery dated 21 July 2020 * Safety Check Email dated 17 August 2020 * Orders 231-0010 dated 18 August 2020 * Father’s Email dated 24 August 2020 * U.S. Army Installation Management Command (IMCOM) Letter dated 25 August 2020 * Interactive Customer Evaluation (ICE) Report dated 31 August 2020 * Applicant Email dated 1 September 2020 * Surgery Memorandum dated 3 September 2020 * Dr. Email dated 4 September 2020 * DA Form 3349 (Physical Profile Record) dated 8 September 2020 * Applicant Letter to Congress * Investigation Results Email dated 9 September 2020 * Voiding DD Form 214 Memorandum dated 11 September 2020 * Orders 255-0006 dated 11 September 2020 * Father’s Letter dated 13 October 2020 * Chief Warrant Officer Four (CW4) MCC Memorandum dated 26 October 2020 * Letter of Support dated 3 November 2020 * 8th Theater Sustainment Command Administrative Separation Guide (28 pages) * Excerpt of Army Regulation (AR) 635-40 (Physical Evaluation for Retention, Retirement, or Separation), Chapter 4 FACTS: 1. The applicant states she is requesting Block 28 (Narrative Reason for Separation) of her DD Form 214 be corrected to reflect she was discharged due to disability. a. The Medical Evaluation Board (MEB) supersedes administrative separations per AR 635-40, paragraphs 4-3f (2) and 4-9. Her MEB was initiated by Dr. at behavioral health on 2 September 2020. She would also like an opportunity to sign the updated DD Form 214 since she was previously on leave; however, she was still locally available when the transition department signed off on the DD Form 214. b. Colonel (COL) also informed her that she would not be separated until the Army completed the investigation. She was informed on 9 September 2020 that the investigation was completed on 2 September 2020; however the MEB referral occurred 2 days prior to her separation date. Additionally, there was an agreement to retain her pending the outcome of the “administrative (15-6) investigation.” She and the senator’s representative did not receive any feedback concerning the investigation’s outcome until 9 September 2020. 2. The applicant provides: a. The below listed documents to be referenced in the service record: * DD Form 214 (eight copies) * Orders 231-0010 dated 18 August 2020 * Voiding DD Form 214 Memorandum dated 11 September 2020 * Orders 255-0006 dated 11 September 2020 b. A memorandum for record with the subject Notification of Informal Sexual Harassment Complaint, dated 29 October 2016, indicated the applicant filed an informal sexual harassment complaint on 28 October 2016 with the 2nd Infantry Division (2ID) Sexual Harassment and Assault Response Prevention (SHARP) office. The applicant stated she was inappropriately touched by a noncommissioned officer (NCO) and it had created a hostile work environment (the word “touched” is lined through on the memorandum and the word “kissed” is handwritten above). The NCO was counseled and the recommendation was to remove him from his position. c. General instructions for her visit at Tripler Army Medical Center (TAMC), dated 6 October 2019, shows the applicant was treated for adjustment disorder with depressed mood. A series of laboratory tests were completed and the instructions noted that further evaluation was necessary. d. A TAMC memorandum, dated 21 July 2020, which states the applicant was scheduled to undergo surgery on 31 July 2020 and would require 14 days of convalescent leave. e. An email, dated 17 August 2020, wherein the applicant notified her leadership that the showed up at her residence for a safety check and her family was terrified. She requested they not send HPD back to her residence and informed them that she was comfortable receiving safety checks from her NCOs. f. An email from her father, dated 24 August 2020, to the IMCOM commander, COL , expressing concerns for his daughter. He believed she was being discriminated against for being a minority and she was being denied medical care. The applicant’s primary care manager (PCM) had refused to see her on two occasions and told her to make an appointment with gynecology which forced her to make two visits to the Acute Care Center (ACC) at Schofield Barracks. He believed the PCM had been influenced by the commander to proceed with separation under Chapter 5-17. The command had also called her physician and canceled the applicant’s mammogram surgery scheduled for 21 September 2020. g. A letter from COL , IMCOM Commander, dated 25 August 2020, notified Senator that an administrative investigation was going to be conducted regarding the applicant’s allegations. The investigation was expected to be completed no later than 8 September 2020 and an update would be provided following the investigation. h. An ICE report from the applicant, dated 31 August 2020, which states she was discharged from TAMC on 3 August 2020 and on 4 August 2020 she notified her first line supervisor by text that she was having some emotional issues and wanted to speak with the chaplain. He responded by informing her that she could go see the chaplain or he could provide her number to the chaplain. She asked if he could pass her number to the chaplain and she would await the call. She never received the call, but 8.5 hours later two NCOs and five police officers arrived at her house to escort her to the emergency room (ER). She asked the one of the NCOs why he refused to provide the chaplain’s number and the police officer even asked “you work at the church and refused to help her?” She believed her commander had also influenced the chaplain’s assistant which is why he refused to help her. She thanked the IMCOM commander and the chaplain for providing her assistance on 5 August 2020. i. An email from the applicant, dated 1 September 2020, which stated she believed her HIPAA blue patient rights had been violated when she informed the physician and nurses that she did not want any visitors and they still allowed her commander to enter her room without her consent. She was terrified, hopped out of the bed, had a panic attack, and urinated on herself. When she questioned the physician he told her “it had to happen.” During her 6 days in the psychiatric ward she asked to switch doctors and was told to give him another chance. She requested information sheets for two medications he prescribed and had to ask the nurses to provide the sheets since he did not. j. A TAMC memorandum, dated 3 September 2020, indicated the applicant was scheduled for a surgical procedure on 4 September 2020 and would require 14 days of convalescent leave. She was also scheduled for a follow-up appointment 2 weeks following her surgery. k. An email from Dr. dated 4 September 2020, which stated she was recommending approval for the applicant’s profile and the applicant would likely be contacted by the MEB on Tuesday. Dr. also asked if the physician, Dr. would please write “a quick T- con noting” the profile was submitted referencing Dr. note from 2 September 2020. l. A DA Form 3349, dated 8 September 2020, shows the applicant was given a permanent physical profile rating of “3” for psychiatric due PTSD. She also had two additional active temporary profiles for gynecological conditions and adjustment disorder. Block 5 (Medical Instructions to Unit Commander) further noted the applicant was in the MEB process, should have no access to weapons/ammunition, and should have access to all behavioral health appointments. m. A letter from the applicant to her congressman requesting assistance because she felt she was being bullied, harassed, discriminated against, and had faced retaliation. The applicant provides numerous examples of challenges within her unit with the leadership in the 5 page letter, available for review by the Board. n. An email to the applicant, dated 9 September 2020, notified the applicant that the investigation had been completed on 1 September 2020 with a legal review on 2 September 2020 approved by COL , and the allegations were unfounded. She could request a copy of the investigation through the Freedom of Information Act (FOIA) point of contact. Her orders, dated 18 August 2020, were not adjusted due to the investigation being completed and closed on 2 September 2020. The MEB paperwork and profile had been sent to the command on 8 September 2020, which was after her discharge. The MEB was being reviewed for a final decision and a note would be sent once a decision had been made regarding the MEB proceedings. o. A letter from the applicant’s father, 13 October 2020, expressing his concerns over the toxic environment his daughter was subjected to in. He was dumbfounded to find out she had been diagnosed with PTSD resulting from harassment issues at work. He details significant changes in his daughter’s ability to function. p. A memorandum from CW4 dated 26 October 2020, which indicated he and the applicant were stationed together in South Korea and in Hawaii. He encouraged her to report the sexual harassment in Korea and when she shared she was experiencing trauma at her unit in Hawaii, he encouraged her to contact her congressional representative. He is very aware of the commander’s harassment and discrimination. He hopes she gets the help she desperately needs. q. A letter of support from dated 3 November 2020, which states the applicant shared that she had been re-experiencing trauma for the past six months due to her commander’s inappropriate behavior. She had requested assistance from her congressman, state senator, SHARP, equal opportunity, and the inspector general. In August 2020, she accompanied the applicant to see the Commanding General (CG) and instead they were surprised they had to meet with the Command Sergeant Major. CSM expressed to the applicant that she would be better off being separated from the Army. also assisted the applicant when she self-admitted into the psychiatric ward and served as a witness during the 15-6 investigation. She has been engaged daily with the applicant regarding the ordeal. r. The applicant highlighted and referenced the two documents listed below: * 8th Theater Sustainment Command Administrative Separation Guide * Excerpt of Army Regulation (AR) 635-40 (Physical Evaluation for Retention, Retirement, or Separation), Chapter 4 3. A review of the applicant’s service record shows: a. She enlisted in the Regular Army on 14 September 2015. The service record includes the applicant’s medical evaluations for the purposes of enlistment which indicated she had no significant medical issues and was generally in good health. The applicant was marked “qualified for service.” * DD Form 2807-1 (Report of Medical History) dated 10 July 2014 * DD Form 2807-2 (Medical Prescreen of Medical History Report) dated 30 June 2014 * DD Form 2808 (Report of Medical Examination) dated 10 July 2014 b. Her Enlisted Record Brief shows she served in Korea from approximately 19 February 2016 to 16 January 2018. c. The applicant’s service record contained minimal documents pertaining to her separation processing. The separation packet included: * IMCOM Commander letter to Senator dated 25 August 2020, confirming an investigation would be initiated concerning the applicant’s allegations * DA Form 2627 (Record of Proceedings Under Article 15, UCMJ), dated 6 September 1999, imposed on the applicant for four specifications of dereliction of duty, one specification of maltreatment of subordinates, one specification of false official document, and one specification of disrespect; her punishment included reduction to specialist (SPC)/E-4 * incomplete copy of the initiation for separation without the commander’s signature page * incomplete copy of the separation approval action without the separation authority’s signature page d. The service record was void of the facts and circumstances regarding the investigation referenced by the applicant. e. Orders 231-0010, dated 18 August 2020, discharged the applicant from active duty with an effective date of 4 September 2020. f. A memorandum from the Chief, Transition Center, dated 11 September 2020, which states the applicant’s DD Form 214 issued with an effective date of 4 September 2020 would be voided in accordance with AR 635-8 (Separation Documents). The Garrison Commander determined that the applicant would not be separated prior to 8 September 2020 pending an investigation into her administrative separation. The information was provided to their office on 11 September 2020, after finalizing the DD Form 214 on 10 September 2020. She requested the original DD Form 214 be destroyed by burning or shredding. g. Orders 255-0006, dated 11 September 2020, revoked Orders 231-0010 dated 18 August 2020. h. Orders 262-0012, dated 18 September 2020, discharged the applicant from active duty with an effective date of 4 September 2020. j. She was honorably discharged from active duty on 4 September 2020. Her DD Form 214 shows she was discharged in accordance with paragraph 5-17 of Army Regulation (AR) 635-200 (Active Duty Enlisted Administrative Separations). She was assigned separation code JFV and the narrative reason for separation listed as “Condition, Not a Disability.” She completed 4 years, 11 months, and 21 days of active service with no lost time. 4. The applicant's service record is void of documentation that shows she underwent a medical evaluation board (MEB) or a physical evaluation board (PEB). 5. By regulation (AR 15-185), 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. 6. By regulation (AR 635-200), action will be taken to separate a Soldier for other physical or mental conditions not amounting to disability (AR 635-40) and excluding conditions appropriate for the separation processing under paragraph 5-11 or 5-13 that potentially interfere with assignment to or performance of duty. 7. By regulation (AR 635-8), the DD Form 214 is a summary of the Soldier's most recent period of continuous active duty. It provides a brief, clear-cut record of all current active, prior active, and prior inactive duty service at the time of release from active duty, retirement, or discharge. The information entered thereon reflects the conditions as they existed at the time of separation. Block 28 (Narrative Reason for Separation) is based on regulatory or other authority and can checked against the cross reference in AR 635-5-1 (Separation Program Designator (SPD) Codes). 8. By regulation (AR 635-5-1), Table 2-3 lists for SPD code “JFV” the narrative reason as “Condition, Not a Disability,” by regulatory authority AR 635-200, paragraph 5-17. 9. By regulation (AR 40-501), medical evaluation of certain enlisted military occupational specialties and officer duty assignments in terms of medical conditions and physical defects are causes for rejection or medical unfitness for these specialized duties. If the profile is permanent the profiling officer must assess if the Soldier meets retention standards. Those Soldiers on active duty who do not meet retention standards must be referred to a medical evaluation board. Once a determination of physical unfitness is made, disabilities are rated using the VA schedule of disability rating. 10. By regulation (AR 635-40), 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. Soldiers who sustain or aggravate physically-unfitting disabilities must meet the following line-of-duty criteria to be eligible to receive retirement and severance pay benefits: a. The disability must have been incurred or aggravated while the Soldier was entitled to basic pay or as the proximate cause of performing active duty or inactive duty training. b. The disability must not have resulted from the Soldier's intentional misconduct or willful neglect and must not have been incurred during a period of unauthorized absence. 11. The Army rates only conditions determined to be physically unfitting at the time of discharge, which disqualify the Soldier from further military service. The Army disability rating is to compensate the individual for the loss of a military career. The VA does not have authority or responsibility for determining physical fitness for military service. The VA may compensate the individual for loss of civilian employability. 12. Title 38, United States Code, Sections 1110 and 1131, permit the VA to award compensation for disabilities which were incurred in or aggravated by active military service. However, an award of a VA rating does not establish an error or injustice on the part of the Army. 13. Title 38, Code of Federal Regulations, Part IV is the VA’s schedule for rating disabilities. The VA awards disability ratings to Veterans for service-connected conditions, including those conditions detected after discharge. As a result, the VA, operating under different policies, may award a disability rating where the Army did not find the member to be unfit to perform his/her duties. 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. 14. MEDICAL REVIEW: The Army Review Board Agency (ARBA) Medical Advisor reviewed the supporting documents and the applicant’s military service records. a. A review of the Armed Forces Health Longitudinal Technology Application (AHLTA) & Health Artifacts Image Solutions (HAIMS) the applicant was seen in primary care on 31 May 2017. She reported having trouble sleeping for the past month. She reported that work issues (alerts and loadex) made her uneasy and anxious. She was diagnosed with Anxiety Disorder, unspecified and recommended to see behavioral health. On 7 Jul 2017, she missed her initial BH appointment and declined to reschedule. On 2 Aug 2017, she reported feelings of depression, loneliness, and stress from work. She stated she disliked her MOS and it felt like a chore to go to work. She reported that her leadership puts out information at the last minute and often soldiers sit around motor pool with no tasks. She felt she was not working to her full potential in her MOS. She reported difficulty building a local support network/relationships in the military due to rank differences and most individuals she could have relationships with were significantly younger than her. She wanted to reclass for a different MOS. She was diagnosed with Insomnia, unspecified and Adjustment Disorder with Anxiety. She declined follow-up behavioral health services. On 17 Aug 2017, she returned to the clinic requesting assistance with insomnia but had no follow-up appointments. b. On 10 May 2018, she returned to behavioral health reported work related and family stress. She expressed her dislike for her MOS and feels unable to form meaningful relationships with peers given the age difference. She has asked for another duty position because she is exhausted from work every day and unable to be attentive to her two children. One child is autistic and while her elderly parents live with her they don’t understand autism and it’s a constant struggle at home. She attended sleep group and anger management group for several sessions in May and June 2018. On 14 Aug 2018, she reported continued difficulty at home due to parents being judgmental and trying to control her actions. She reported strong cultural and religious beliefs of her parents that create conflict. She reported most of her anxiety and low mood stems from negative interactions with both parents. She has considered asking them to return to NYC to have more peace in her life but acknowledged she would have to build support services on the island to maintain her family care plan if they leave. Her diagnosis was Other Specified Problems related to psychosocial circumstances. She did not return for follow-up treatment. c. She returned to the clinic on 1 Mar 2019 and reported difficulty with her civilian supervisor while working at her dream job as the installation BOSS President. She reports her main stressor is his lack of respect/trust and he creates a “threatening” environment. She stated she would like a “fresh start” working somewhere else but acknowledged that may not be a realistic option. She did not return for follow-up treatment. On 3 Jun 2019, the applicant returned to BH and reported current stressor being under IG investigation due to a civilian complaint. This resulted in her being removed from the BOSS job and being flagged. She reported wanting out of the Army as life was much better when she was a civilian. She asked about ways to get out sooner than her DEROS date in November 2021. She and her provider “explored what would prohibit or make difficult for her to continue serving her remaining 28 months.” She “admits that for the most part her physical health is in good order.” She noted a diagnosis of fibroids and a need to decide between hormonal medication route or a surgical route. She reports that the military has made it “impossible” for her to have time for herself, have a meaningful relationship or be her “true self.” She just doesn’t have a desire to get up early in the morning and be treated the way she is. She admits concerns about being able to pass the new ACFT. d. She was diagnosed with Adjustment Disorder with mixed anxiety and depressed mood. The provider discussed the need to make a commitment to therapy rather than just coming in when stressors arrive. The applicant agreed to schedule a follow-up appointment. On 5 Jun 2019, she reported decrease in stress since her intake appointment. She stated that it would be better if she could get a “fresh start” (new job or unit). The applicant agreed to discuss medication for her anxiety with her PCM. She was transferred to a new EBH team due to no longer falling under 25th STB and asked for a female provider be assigned. On 2 Jul 2019, she met with her new provider. She reported stress from the ongoing CID investigation and being flagged. The applicant noted her youngest son was going to live with his father in Boston. She reported she had requested surgery to remove fibroids versus medication treatment route. She was working to complete her bachelor’s degree. She reported a significant increase in alcohol use and agreed to a medication consult to address mood symptoms. e. On 15 Jul 2019, she was seen for a medication evaluation. She reported history of anxiety and sleep problems since enlisting in the Army. She stated the racism and discrimination in basic and AIT started her symptoms. She reported stress from her responsibilities as a sergeant, single mother of autistic adolescent in addition to working on her bachelor’s degree. She had 2 associate degrees. She wanted medication to address anxiety and insomnia. She was prescribed Celexa and Ambien as needed for sleep. On 2 Aug 2019, she reported she hated what she was doing. She can’t stand being on-call and getting last minute orders. Her relationship ended and she has “given up on love.” She stated “I don’t want to be treated like a nobody because of rant.” She reported the sleep medication was helpful but the Celexa wasn’t helping. She reported looking forward to start Soldier for Life in 6 months. f. On 19 Aug 2019, she was transferred to a new psychiatrist at her request. She reported she was awaiting a decision from her brigade commander regarding the results of the CID investigation recommending an Article 15. On 9 Sept 2019, she met with her new psychologist for therapy. The applicant reported that she received and Article 15 for creating a hostile work environment, forgery, disrespectful behavior and 3 other charges. She was demoted to E4. On 17 Sept 2019, she reported filing an appeal for her Article 15. She reported significant increase in depression and anxiety subsequent to the Article 15. She has stopped going to the gym, doesn’t go to PT and has gained 10 lbs. over the last 4 months. She denied any stressors from her current work environment. She was considering going to NYC to visit her parents. On 19 Sept 2019, she met with her new prescriber with no change in diagnosis. g. On 24 Sept 2019, she was seen as a walk-in. She reported increased stress due to Article 15, loss of rank, loss of pay (suspended). Her appeal is submitted and she is hoping to get a response in the next week. She would also like to take some time off due the stress she has been under. A safety check was completed and she was released. She already had an appointment with her regular provider later in the week. On 27 Sept 2019, she reported a reduction in depression and anxiety. On 3 Oct 2019, she was seen for a medication management appointment. The psychiatrist noted the applicant had a “chronic history of adjusting to military life with family, occupational and interpersonal work stress developing recurrently.” “The possibility of cluster B personality traits should be considered as interpersonal struggles along with m early impressions of affect lability, splitting behavior, dramatic interpersonal style, and externalizing behavior suggest the possibility of such.” He discussed treatment options based on diagnostic conclusions. He noted “psychotropic intervention is not strongly recommended in her case but maybe helpful in relieving overall burden of anxious symptoms.” The applicant requested another antidepressant trial. He continued Ambien but recommended alternate sleep augmentation if problem persisted. h. On 6 Oct 2019, the applicant was seen for a command directed behavioral health evaluation (CDBHE). She was reported increased depression and stress due to recent UCMJ charges. She appealed but the appeal was rejected the day before. The unit chaplain had reported concerns due to passive suicidal texts send to the chaplain assistant. She was cleared and returned to duty. On 7 Oct 2019, she was seen for a safety check. She denied suicidal ideation and stated she just needed to vent yesterday and process her feelings. She was irritated about having to be seen in the ER which was a waste of time. On 21 Oct 2019, she reported sleeping better and feeling calmer. She was on leave the past week and completed her school work for the semester and got 2 A’s. She reported she has not been given any work to do lately and will move to a new unit in December. On 24 Oct 2019, her Ambien was discontinued and she was started on Trazadone. On 12 Nov 2019, she was seen by her psychiatrist. No medication changes. She reported stress navigating the Red Cross system so she can attend a family member’s funeral. She reported her commander makes her feel isolated by not giving her any responsibilities. She confronted her leadership and they told her to “focus on her medical appointments.” Her provider continued diagnosis of Adjustment Disorder and noted cluster B personality traits. i. On 3 Dec 2019, she was seen for a CDBHE. Her commander noted that she is emotionally unstable and had difficulty maintain her military bearing. He can’t count on her to accomplish tasks to standards. He wanted to know if she was capable of performing her MOS. The unit wants to move her to unit that can utilize 88M MOS as the current unit does not have available 88M positions. She frequently requests to go to sick call during morning PT. She was found to meet retention standards and needed no duty limitations recommended psychological assessment. On 5 Dec 2019, she was seen for a follow-up medication management appointment. She reported feeling better and had boost in her mood secondary to finding purpose at work. She has been working in the chapel and feels she has a good relationship with the other people who work there. She reported being optimistic about her unit move and that it would be a fresh start for her. She reported not needing to take Ambien for the past 5 days. Diagnoses of Adjustment Disorder and cluster B traits was continued. j. On 6 Dec 2019, she met with her therapist. She reported reconnecting with her family after 12 years while home for her brother’s funeral. She met a high school friend while in Jamaica and they continue to talk daily. She reported sleeping 9-9.5 hours per night and that her anxiety and depressive symptoms were reduced significantly on her medication. She was doing PT with the chaplain office co-workers daily. On 9 Dec 2019, she was seen for psychological assessment. The psychologist noted she took 8 hours to complete one measure that normally takes 90 minutes. She was scheduled to return to complete the remaining tests. On 13 Dec 2019, she took 5 hours to complete ½ of the MMPI-2-RF (typically 90 minutes to complete entirely). The test was discarded as unscorable. On 18 Dec 2019, she was seen to review the findings from the completed psychological testing to clarify diagnosis. The provider noted the applicant “admitted she was doing everything she could to avoid being released by the Army.” The psychologist noted the “lack of forthrightness and resistance to unguarded cooperation combined with a documented patter of emotional and behavioral problems” suggests “the presence of character pathology most like of the passive aggressive type.” The provider stated the applicant “would be unsuitable for military service if she cannot demonstrate sufficient rehabilitation and meet the standards of military bearing and performance.” He recommended administrative separation if she failed to meet performance/behavior standards. k. On 8 Jan 2020, she met with her therapist. A review of her BHDP (multiple symptoms checklists) results indicated subclinical to low general distress. She discussed being found fit for duty and getting a counseling statement that her command would monitor her performances for a month. She stated she wanted to leave her garrison unit and return to a transportation unit and work in her MOS to advance her career. However, she reported that she likes working in the Chaplain’s office. She reported upcoming tooth surgery in February and fibroid surgery in June 2020. However, she reported being “interested in getting a diagnosis before she gets out” of the Army. There was no change in diagnosis. l. On 21 Jan 2020, she reported that she was in a “great mood” and had no anxiety since her last therapy appointment. She reported no issues at work and was conducting herself with professionalism. She reported only using Ambien once in the past 3 weeks. On 5 Mar 2020, she was seen for a Chapter 5-17 evaluation. The psychologist noted the command had not seen an improvement over the 30-day assessment period. The psychologist noted the applicant was stable and had been off her psychotropic medication since November 2019. She reported being symptom free over the past 90 days. She was cleared for administrative separation. She reported that she was pending administrative separation and would be completing her bachelor’s degree in Human Resources the following week. She stated she was still recovering from her GYN surgery and was wondering if she would be eligible for a MEB for her physical medical problems. She reported that her physical problems limit her ability to perform her duties as a soldier. The applicant stated she was overwhelmed with her pain and so many things to address. Her BHDP scores were in the subclinical to low level of distress. She reported liking her job in the chaplain’s office and was sleeping 9 hours per night. She planned to ETS in October 2020. The applicant did not have any BH treatment appointments from 21 Jan 2020 to 9 Jul 2020. m. On 9 Jul 2020, she reported that she may be receiving a 5-17 chapter. She stated she would be receiving her BS degree in Human Resources the next week. She stated she has multiple physical problems to include complication from a gynecology surgery. She has convalescent leave through the end of July. She wonders if she is eligible for a medical board due to her physical medical problems. She stated her energy level is low and she is in physical pain and has limitations to perform her duties due to her physical medical problems. On 17 Jul 2020, she reported continued pain from her recent surgery. She was seeing a second opinion about her condition. On 20 Jul 2020, The provider noted her convalescent leave had ended and her unit wanted her to return to work. she reported she was to have surgery on her right breast on the 30th. General surgery note from 21 Jul 2020 indicates the applicant denied pain, skin changes nor discharge in her right breast due to benign mass. A tentative surgery date of 31 Jul 2020 was set. On 23 Jul 2020, she reported continued shoulder pain and felt she needed a profile for her shoulder. On 24 Jul 2020, she was seen in the orthopedic clinic for shoulder pain. The provider noted minimal physical therapy due to applicant’s gynecology surgery. MRI shoed tendinopathy and bursitis of right shoulder. She received an injection to address symptoms. n. On 28 Jul 2020, she was seen as a behavioral health walk-in and reported distress because her unit wanted her to sign her chapter packet and Soldier for Life paperwork the next day. Her realization that her military career was over triggered her distress. She did not want to be discharged from the Army until she completes additional surgeries and wants a medical board for her medical problems. She reported suicidal ideation and was psychiatrically admitted for 3 days. Diagnoses on discharge from the hospital was Borderline Personality Disorder and Adjustment Disorder. On 3 Aug 2020, her provider noted the diagnosis of personality disorder was supported by “personality structure including abandonment fears, unstable and intense interpersonal relationships, recurrent suicidal gestures, affect instability and stress related paranoia.” He further stated “although she has a supportive environment in the Army and home, she struggles to cope with stress and adapt in a meaningful way. Her mood and suicidality is transient. She would ultimately benefit from separation from the Army which she sees as the current cause of her distress.” o. On 4 Aug 2020, she reengaged with outpatient behavioral health services with her previous psychiatrist. The provider noted applicant had “prior intermittent adjustment disorder with cluster B traits returning for re-consultation after pervious termination of treatment in January 2020 in the wake of resolved adjustment disorder.” She reported that she returned to treatment because of “abuse of power and harassment by her command.” When asked for specific evidence of such abuse she cited “making creepy faces”, “calling me incessantly during my convalescent leave”… always being in my business” and “asking about my medical issues.” The psychiatrist noted that he “reviewed our past discussions concerning observations of tendencies of extreme over- inflation or devaluation of interpersonal relations, especially during time of conflict. Attempted to confront her on whether her current perceptions of hostility on the part of her commander may not be influenced by similar processes.” She stated she wanted to leave the Army on “my terms and not his way.” Continued to state she could not meet with her commander under any circumstances without becoming extremely distressed and returning to TAMC. The psychiatrist noted in his conversation with the commander that the commander was aware of the stress caused by his interactions with her and was limiting his interactions to the extent necessary. He reported the chapter process should be completed within 2-3 weeks. p. On 11 Aug 2020, she completed a new intake to re-engage in behavioral health therapy. Her diagnosis was Adjustment Disorder. She was also seen for a CDBHE that day after disclosing to her chaplain that she intended to crush her home medications and “you know what that means.” She informed trial defense services that she wanted to drive her car into oncoming traffic.” The Honolulu police department (HPD) went to the home and found 25 bottles of previously prescribed medications in the home. She reported that she refused to participate in progressing toward her separation from the military. She feels she is not getting the support she needs from her command. Her NCO and 1SG accompanying her expressed concern that the applicant was altering their attempts to help her and complete her out-processing the military as targeting her. A safety check was completed and she was released with guidance to return to the clinic the next day. q. On 12 Aug 2020, her treating psychiatrist noted her affect was euthymic to bright and inconsistent with her stated mood. He noted she appeared pleasant and at ease. She reported being offended that HPD used handcuffs which were not removed until she got to the TAMC ER. She believed that was ordered by commander. The psychiatrist noted when he indicated this was likely police policy she received the information poorly and that any attempts by the provider at such defense of her commander felt like an attack on her and complete negation of everything she is experiencing. She stated she would cooperate with the administrative separation but refused t interact with her commander or do anything until she is provided an opportunity to do Soldier for Life Transition Assistance Program. r. On 14 Aug 2020, she contacted her psychiatrist to complain that her chain of command did not return all of the medication confiscated by HPD. The provider explained that given her past suicidal threat to crush her medications, he was prescribing a week’s worth of medication at a time with automatic refills. On 18 Aug 2020, she presented as a walk-in to see her psychiatrist. She reported frustration because no one would stop her commander from completing her administrative separation. She had engaged with EO, IG, and TDS but did not feel she was being supported. The psychiatrist documented: “Recommended avoidance of psychotropic interventions and focus on long term therapy as treatment for her present complaints. The patient states she wants to continue all medications started by inpatient team, despite noting minimal clinical benefit and minimal prospects for success in the face of obvious stressor. Lexapro is not an unreasonable or uncommon off label treatment attempting to lower anxiety/irritability for borderline patients in acute distress.” “Brexpiprazole appears to have been added as an augmenting treatment in an attempt to control agitation associated with command contact. This patient does have transient distress around her commander, bordering on paranoid ideation, but this manifestation is known to occur in BPD patients under stress and is limited to such interactions.” “I have counseled her on the potential medical risks of said medication and recommended discontinuation but she desires to continue it.” The psychiatrist noted the applicant was already on low dose metformin and he would check fasting blood glucose in 4-8 weeks and would insist on discontinuation of medication if it is elevated. She had a telephonic session with her psychologist the same day. She reported her growing concern about the fact there is no medical board pending for her physical medical conditions. She reported receiving her orders for separation on 2 Sept 2020. She is requesting the Commanding General stop her separation orders until her commander and his staff can be investigated. She stated she wanted to be allowed to attend the behavioral health intensive outpatient program before she is discharged. Her BHDP scores showed a score of 0 for PTSD screener indicating PTSD not likely. Her provider continued her diagnosis of Adjustment Disorder. s. On 20 Aug 2020, she was seen by a health psychologist in conjunction with evaluation for Misophonia (strong reaction to specific sounds). On 20 Aug 2020, she was seen by general surgery to reschedule cancelled surgery to remove small benign masses (1 and 1.5cm) in her right breast. The surgeon counseled her regarding the masses being benign and continued observation versus surgery. The applicant stated she desired surgery. The surgeon noted her pending military separation on 4 Sept 2020 and her medical eligibility for 180 days post separation. On 20 Aug 2020, she contacted her psychiatrist and informed him she was going to discontinued medication management treatment due to separation. She noted she would continue seeing her therapist during her post-separation period while eligible for medical care. He encouraged her to coordinate with the VA if she planned to continue taking currently prescribed psychotropic medication. On 21 Aug 2020, she was evaluated in the audiology clinic. A diagnosis of misophonia was ruled out and that annoyance hyperacusis (dislike of common annoyance sounds and a general preference for a quiet environment) was an accurate diagnosis. The provider recommended consideration of hearing aid or some other sound masking device might be beneficial. t. On 26 Aug 2020, she called her psychiatrist due to stress from her unit. She received a counseling that morning for missing a CIF turn in appointment to turn in her military gear. She requested the psychiatrist give her quarters so she doesn’t have to be around her unit. The psychiatrist contacted the commander and was informed that she is only required to report for necessary tasks in support of administrative proceedings and has been pulled from any and all other tasks. NCOs check on her daily for accountability and safety. The psychiatrist did not place her on quarters. On 28 Aug 2020, she presented as a walk-in to the pain clinic and asked about a possible MEB referral. She was informed that she does not meet the criteria for a MEB due to pain. She was cleared for medical separation without need for extension for any condition she was treated for in the pain clinic. u. On 31 Aug 2020, she was seen in the ENT clinic for possible hearing aids. The provider determined that hearing aides were not recommended for her condition. The provider noted she should continue behavioral health treatment and her PCM could consider referral to neurology for possible migraine or other headache disorders. On 1 Sept 2020, she met with her psychologist via phone. The psychologist noted that they “discussed her medical board preparation which included a decision on what diagnosis to use.” He noted that given her childhood sexual violence history the Clinician- Administered PTSD Scale (CAPS) would be used. She also spoke by phone with her psychiatrist. The psychiatrist noted that “contrary to previous statement she would like to continue in treatment relationship with myself and requests refills of her medication.” He noted that he would maintain weekly refill allotments of prescribed medications. He continued diagnosis of Borderline Personality Disorder (BPD) and ordered refill of 3 medications. On 2 Sept 2020, the psychologist administered the CAPS (a structured questionnaire of PTSD symptoms). He noted that she disclosed her sexual assault history for the first time and her PTSD symptoms. The applicant reported that her commander canceled her breast surgery. Her medical record indicates surgery was cancelled when she requested psychiatric admission due to increased occupational stress and pending administrative separation. The provider diagnosed her with PTSD, submitted a permanent profile for PTSD and referred her for a MEB. v. On 8 Sept 2020, she was seen by a previous provider due to a request for a female therapist. The provider diagnosed her with BPD and a need to rule out PTSD. She documented that the applicant was no longer in the military but would continue to receive services for 6 months. Administrative note from 9 Sept 2020 indicates a MEB will not be processed because the applicant has been discharged from the Army. On 11 Sept 2020, she had a telephonic session with her treating provider. She stated she wanted to see the female therapist for 10-12 sessions to work on her sexual assault history. On 15 Sept 2020, she had a medication management appointment. He reported her stress level and anxiety have decreased as a result of being out of the Army. The psychiatrist encouraged her to begin coordinating with the VA for transition of treatment. Diagnosis BPD. On 22 Sept 2020, she met with female therapist. The applicant stated she was feeling much better. She stated she avoided hearing stories of other people’s sexual assault but denied nightmares. She continued to feel nervous around male Army NCOs in authority positions. Treatment diagnosis was BPD. On 6 Oct 2020, she reported she was returning to in November. On 7 Oct 2020, she was seen for medication management. On 26 Oct 2020, she contacted her provider to cancel appointment later that day. On 6 Nov 2020, she was seen in general surgery for 2- month post op appointment following mass excision on right breast on 4 Sept 2020. No further follow-ups were recommended. On 12 Nov 2020, she was seen for post op appointment 1 month after tonsillectomy. She completed a second post op appointment on 25 Nov 2020. On 11 Dec 2020, she contacted her provider and informed her she had transitioned her care to the VA. A review of JLV indicates the applicant was seen on 2 Nov 2020. The provider noted a service connected rating of 10% for tinnitus. She reported an increase in anxiety and depression since her discharge. She stated she lived with her parents and children but stays in her room most of the time. She stated being in Hawaii was a trigger for her and she was moving to NYC in December 2020. She was diagnosed with Adjustment Disorder with Depressed Mood and Unspecified Trauma and Stressor-Related Disorder. On 9 Dec 2020, she was diagnosed with PTSD due to MST (sexual assault in Korea- NCO kissed her on her neck). On 18 Dec 2020, she was started on Prozac. On 28 Jan 2021, she reported primary stressor is finding housing before housing voucher expires in March 2021. On 18 Mar 2021, she was seen for follow-up medication management. She reported no benefit from current dosage and continued stress regarding housing. On 29 Apr 2021, she reported being upset that her caregiver request was denied as she needs assistance from her mother due to PTSD and depressive symptoms. w. On 24 Jun 2021, she reported her depressive and anxiety symptoms are overwhelming but doesn’t feel able to pursue therapy and doesn’t want to make any medication changes. The psychiatrist recommended increasing her dosage. On 26 Aug 2021, she reports recently getting married but denied any improvement in symptoms. She stated she was seeking a doctor that can provide medical marijuana for PTSD. She declined referral for therapy and was not open to increasing dosage or trying different medication. On 2 Dec 2021, she reported discontinuing medication after finding out she was pregnant. On 2 Feb 2022, she reported increased anxiety due to realities of pregnancy sinking in, having recently had Covid, and not enough time to rest. She reported improvement in her depression which she creates with having a sense of purpose (substitute teaching). Her most recent psychiatry appointment was 30 Mar 2022. She reported continuing to work as a substitute teacher and is pursuing a master’s degree. She reported her anxiety was manageable and her depression is 5 out of 10 but it can vary a lot. She continued to benefit from having a sense of purpose. She continued to decline referral for therapy. x. The applicant has a service connected disability rating of 70% for PTSD. In accordance with the 3 Sep 2014 Secretary of Defense Liberal Guidance Memorandum and the 25 Aug 2017, Clarifying Guidance there is documentation to support a behavioral health diagnosis at the time of her discharge. While the applicant was referred for a MEB, she was not a MRDP. The applicant had recurring episodes of Adjustment Disorder that aligned with her transition to new jobs and new units. When she initially sought behavioral health treatment it was due to her not being challenged by her work, difficulty building a support network, and not liking her MOS. When she started at the BOSS office her stress went down and she reported things were much better. Her stress went up when she reported difficulty with her civilian supervisor and increased interpersonal difficulty. Each new unit or new job was followed by resolution or significant decrease in stress until she would have new interpersonal difficulties or become dissatisfied with the new job. If she was working in her MOS she would report being unhappy/unfulfilled and if wasn’t she reported stress due to not being allowed to work in her MOS. y. She was consistently in treatment from Jun 2019 to her discharge and did not report any PTSD symptoms until 2 Sept 2020. Treating diagnoses during this period was BPD and Adjustment Disorder. Her mood symptoms would remit for periods of time but interpersonal difficulties persisted throughout and a indicative of BPD. There was no period of treatment for PSTD symptoms prior to submission for a MEB. Her diagnosis of Borderline Personality Disorder significantly contributed to her interpersonal difficulties and occupational impairment. BPD is not a medically boardable diagnosis. MEB was not warranted as she had not reach MRDP for PTSD. It is acknowledged for PTSD. This determination alone, however, does not automatically mean that military medical disability/retirement is warranted. It is important to understand that the VA operates under different rules, laws, and regulations when assigning disability percentages than the Department of Defense (DoD). In essence, the VA will compensate for all disabilities felt to be unsuiting. The DoD does not compensate for unsuiting conditions but rather for conditions that are determined to be unfitting. The applicant asserts she was denied medical care. This is not consistent with her medical record. Her surgery was postponed because of a psychiatric hospitalization due to the applicant’s report of suicidal ideation and harassment from her unit. Her commander confirmed the NCO the applicant had difficulties with was not long in the unit. The unit had contacted her to sign her chapter paperwork and Soldier for Life paperwork the following day resulting in her going to the ER. She could not contract for safety and was hospitalized from 28 July 2020 to 3 August 2020 requiring her surgery to be rescheduled. The applicant continued to receive medical care including surgery subsequent to her discharge until December 2020 when the applicant transferred her care to the VA. z. Medical disability/retirement is not warranted. BOARD DISCUSSION: 1. The applicant's request for a personal appearance hearing was carefully considered. In this case, the evidence of record was sufficient to render a fair and equitable decision. As a result, a personal appearance hearing is not necessary to serve the interest of equity and justice in this case. 2. Board members considered her request to sign the DD Form 214. Regulatory guidance provides that when a Soldier is not available, enter “SOLDIER NOT AVAILABLE TO SIGN.” This is a valid entry that is neither erroneous nor unjust. 3. As far as the medical discharge, after reviewing the application, all supporting documents, and the evidence found within the military record, the Board found that relief was not warranted. The applicant’s contentions, the military record, and regulatory guidance were carefully considered. Board members agreed with the medical reviewer's assessment that her diagnosis of Borderline Personality Disorder significantly contributed to her interpersonal difficulties and occupational impairment. However, Borderline Personality Disorder is not a medically boardable diagnosis, and she had not reached Medical Retention Determination Point for PTSD. Furthermore, VA service- connected disability compensation has no bearing on her military fitness. The VA will compensate for all disabilities felt to be unsuiting. The military does not compensate for unsuiting conditions but rather for conditions that are determined to be unfitting. The applicant asserts she was denied medical care. This is not consistent with her medical record. The applicant continued to receive medical care including surgery subsequent to her discharge until December 2020 when the applicant transferred her care to the VA. Based on a preponderance of evidence, the Board determined the reason for her separation was not in error or unjust. 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. Army Regulation 15-185 (ABCMR) prescribes the policies and procedures for correction of military records by the Secretary of the Army, acting through the ABCMR. The ABCMR begins its consideration of each case with the presumption of administrative regularity, which is that what the Army did was correct. a. The ABCMR is not an investigative body and decides cases based on the evidence that is presented in the military records provided and the independent evidence submitted with the application. The applicant has the burden of proving an error or injustice by a preponderance of the evidence. b. The ABCMR may, in its discretion, hold a hearing or request additional evidence or opinions. Additionally, it states in paragraph 2-11 that 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. 2. Army Regulation 635-200 (Active Duty Enlisted Administrative Separations), sets forth the basic authority for the separation of enlisted personnel. Chapter 5-17 of the regulation states a Soldier may be separated for other physical or mental conditions not amounting to disability (AR 635-40) and excluding conditions appropriate for the separation processing under paragraph 5-11 or 5-13 that potentially interfere with assignment to or performance of duty. Unless the reason for separation requires a specific characterization, a Soldier being separated for the convenience of the Government will be awarded a character of service of honorable, under honorable conditions, or an uncharacterized description of service if in entry-level status. 3. Army Regulation 635-8 (Separation Processing and Documents), states the DD Form 214 is a summary of the Soldier's most recent period of continuous active duty. It provides a brief, clear-cut record of all current active, prior active, and prior inactive duty service at the time of release from active duty, retirement, or discharge. The information entered thereon reflects the conditions as they existed at the time of separation. Block 28 (Narrative Reason for Separation) is based on regulatory or other authority and can checked against the cross reference in AR 635-5-1 (Separation Program Designator (SPD) Codes). 4. Army Regulation 635-5-1 (Separation Program Designator Codes), provides separation program designator (SPD) codes are three-character alphabetic combinations that identify reasons for, and types of, separation from active duty. The narrative reason for the separation will be entered in block 28 of the DD Form 214 exactly as listed in Tables 2-2 and 2-3. Table 2-3 lists for SPD code “JFV” the narrative reason as “Condition, Not a Disability,” by regulatory authority AR 635-200, paragraph 5-17. 5. Title 10, U.S. Code, 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 Army physical disability evaluation system and executes Secretary of the Army decision-making authority as directed by Congress in chapter 61 and in accordance with DOD Directive 1332.18 and Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation). a. Soldiers are referred to the disability system when they no longer meet medical retention standards in accordance with Army Regulation 40-501 (Standards of Medical Fitness), chapter 3, as evidenced in an MEB; when they receive a permanent medical profile rating of 3 or 4 in any factor and are referred by an MOS Medical Retention Board; and/or they are command-referred for a fitness-for-duty medical examination. b. The disability evaluation assessment process involves two distinct stages: the MEB and 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 or not 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 either are separated from the military or are permanently retired, depending on the severity of the disability and length of military service. Individuals who are "separated" receive a one-time severance payment, while veterans who retire based upon disability receive monthly military retired pay and have access to all other benefits afforded to military retirees. c. 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. 6. Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) establishes the Army Disability Evaluation System and sets forth policies, responsibilities, and procedures that apply in determining whether a Soldier is unfit because of physical disability to reasonably perform the duties of his office, grade, rank, or rating. Only the unfitting conditions or defects and those which contribute to unfitness will be considered in arriving at the rated degree of incapacity warranting retirement or separation for disability. a. Disability compensation is not an entitlement acquired by reason of service- incurred illness or injury; rather, it is provided to Soldiers whose service is interrupted and who can no longer continue to reasonably perform because of a physical disability incurred or aggravated in military service. b. Soldiers who sustain or aggravate physically-unfitting disabilities must meet the following line-of-duty criteria to be eligible to receive retirement and severance pay benefits: (1) The disability must have been incurred or aggravated while the Soldier was entitled to basic pay or as the proximate cause of performing active duty or inactive duty training. (2) The disability must not have resulted from the Soldier's intentional misconduct or willful neglect and must not have been incurred during a period of unauthorized absence. 7. Army Regulation 40-501 (Standards of Medical Fitness) governs medical fitness standards for enlistment, induction, appointment (including officer procurement programs), retention, and separation (including retirement). The Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) is used by the Army and the VA as part of the process of adjudicating disability claims. It is a guide for evaluating the severity of disabilities resulting from all types of diseases and injuries encountered as a result of or incident to military service. This degree of severity is expressed as a percentage rating which determines the amount of monthly compensation. 8. 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 of less than 30 percent. 9. Title 38 U.S. Code, section 1110 (General - Basic Entitlement), states for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service, during a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation as provided in this subchapter, but no compensation shall be paid if the disability is a result of the veteran's own willful misconduct or abuse of alcohol or drugs. 10. Title 38 U.S. Code, section 1131 (Peacetime Disability Compensation - Basic Entitlement) states for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service, during other than a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation as provided in this subchapter, but no compensation shall be paid if the disability is a result of the veteran's own willful misconduct or abuse of alcohol or drugs. 11. On 25 August 2017, the Office of the Undersecretary of Defense for Personnel and Readiness issued clarifying guidance for the Secretary of Defense Directive to DRBs and BCM/NRs when considering requests by Veterans for modification of their discharges due in whole or in part to: mental health conditions, including PTSD, traumatic brain injury, sexual assault, or sexual harassment. Boards are to give liberal consideration to Veterans petitioning for discharge relief when the application for relief is based, in whole or in part, on those conditions or experiences. The guidance further describes evidence sources and criteria and requires boards to consider the conditions or experiences presented in evidence as potential mitigation for misconduct that led to the discharge. 12. On 25 July 2018, the Under Secretary of Defense for Personnel and Readiness issued guidance to Military Discharge Review Boards and Boards for Correction of Military/Naval Records (BCM/NRs) regarding equity, injustice, or clemency determinations. Clemency generally refers to relief specifically granted from a criminal sentence. BCM/NRs may grant clemency regardless of the type of court-martial. However, the guidance applies to more than clemency from a sentencing in a court- martial; it also applies to other corrections, including changes in a discharge, which may be warranted based on equity or relief from injustice. This guidance does not mandate relief, but rather provides standards and principles to guide Boards in application of their equitable relief authority. In determining whether to grant relief based on equity, injustice, or clemency grounds, BCM/NRs shall consider the prospect for rehabilitation, external evidence, sworn testimony, policy changes, relative severity of misconduct, mental and behavioral health conditions, official governmental acknowledgement that a relevant error or injustice was committed, and uniformity of punishment. Changes to the narrative reason for discharge and/or an upgraded character of service granted solely on equity, injustice, or clemency grounds normally should not result in separation pay, retroactive promotions, and payment of past medical expenses or similar benefits that might have been received if the original discharge had been for the revised reason or had the upgraded service characterization. //NOTHING FOLLOWS// ABCMR Record of Proceedings (cont) AR20210015043 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1