IN THE CASE OF:  
BOARD DATE: 24 August 2021 DOCKET NUMBER: AR20210006596 
APPLICANT REQUESTS: The applicant requests correction of her military record/DD Form 214 (Certificate of Release or Discharge from Active Duty) to reflect medical separation or medical disability. 
APPLICANT'S SUPPORTING DOCUMENTS CONSIDERED BY THE BOARD: 
. DD Form 149 (Application for Correction of Military Record) . Department of Veterans Affairs (VA) 21-4138 (Statement in Support of Claim) 1 October 2020 
FACTS: 
1. 
The applicant did not file within the three-year time frame provided in Title 10, United States Code (USC), section 1552 (b); however, the Army Board for Correction of Military Records conducted a substantive review of this case and determined it is in the interest of justice to excuse the applicant's failure to timely file. 

2. 
The applicant states: 


a. In her DD Form 149 –– She is requesting medical separation due to the disabilities of "status post hysterectomy due to complication from cesarean section, post-traumatic stress disorder (PTSD) to include, anxiety disorder with depressive disorder and pyelonephritis with kidney disorder." 
b. In her VA Statement of Support of Claim: 
(1) 
On 20 May 1992, at Darnell Army Medical Center (DAMC), Fort Hood, TX, the decision was made for a cesarean birth. During surgery she expressed feelings of discomfort from cutting, which was said to be only the pressure because she was supposed to be numb. Later she experienced antagonizing pain upon delivery of the head of her baby. Her husband was pulled away and her face was covered and she was put to sleep. While in recovery, still delirious from anesthesia, she told a nurse that her water had broken and she was ready to have her baby. Obviously not aware that she had already delivered. The nurse informed her that her child was already here. She told the nurse that was not possible, then proceeded to explain that her water had 

broken and that she was tired and ready to have the baby. The nurse assured her that her baby was fine and that she needed to just get some rest. Finally, she explained that she was wet and proceeded to show the nurse her soiled bedding. Due to her insistence the nurse checked and saw that it was blood not water that she was feeling. 

(2) 
After just having her baby at DAMC, Fort Hood TX, she was wheeled back in to the surgery room. The ''Pre-operative Diagnosis" was "Uterine with postpartum hemorrhage unresponsive to medical therapy. " Upon reopening her abdomen the doctors discovered about 500 cc (cubic centimeter) of hemolyzed blood in her abdomen and noted that her uterus was boggy and still bleeding briskly from her vagina. After two units of Prostin directly IM and vaginal packing with a large Foley balloon, the bleeding was still quite brisk and according to the doctor there was no response by the uterus. The Foley balloon was inflated to 50 cc to try to work as a balloon pack but there was no stopping of the bleeding which doubled and was another 100 cc in the next two minutes and 30 seconds. According to the doctor's surgical report the estimated blood loss intraoperatively during the actual surgical procedure was 150 cc. 

(3) 
Prior to that the total blood loss between the C -section and the second surgery was estimated to be 2500cc to 2800cc. According to the report, her uterus was removed by a supra-cervical hysterectomy. She was also told during her severe bleeding that a helicopter was standing by, but because of the severe risk of air flight and her not surviving, the surgery was performed there. The aftermath feelings, in the ICU (intensive care unit) recovery room, became that of gross anger, resentment, as well as anxiety and depression with chronic and severe pain; to be awaken with the horrific news that I could no longer bear any more children because her husband consented to her having a hysterectomy. Being a twin and having a mother that had not one but two sets of twins, this to me was betrayal. This ended her marriage and forever changed her life. The residuals from this caused and greatly contributed to the diagnosis that the Veterans Regional Office has given me compensable benefits back to the day after discharge concerning the diagnosis on her DA Form 149. 

(4) 
She believes she was hurriedly discharged as Involuntary Separation Due to Parenthood, rather than having gone before an Army Medical Board to assess her disabilities. As a result of the incidents that followed her giving birth, she feels there should have been other medical alternatives to control or stop her severe bleeding rather than a hysterectomy. She feels she should have been separated from the Army with a medical discharge rather than grossly suffering from the residuals of her surgical hysterectomy as well as the mental disorders it caused and continue to cause. Therefore, she is requesting her DD Form 214 be upgraded to reflect a medical retirement and her military medical records show the same. 


3. 
On 28 March 1990, she enlisted in the Regular Army for a term of 3 years. In connection with her enlistment, she underwent a medical examination, which found her 

clinical evaluation was normal, with the exception of mild pes planus. She was accepted for enlistment. 

4. 
After completing her initial entry training, she was assigned overseas in Germany, in the military occupational specialty 94B (Food Service Specialist) and on 20 September 1991, she was further assigned to Fort Hood, TX. 

5. 
On 20 May 1992, she gave birth to a child at Darnell Army Community Hospital, Fort Hood, TX. 

6. 
On 29 May 1992, the applicant underwent a medical examination; however, it shows it was initiated under AR 635-200 (Personnel Separations –– Enlisted Personnel), Chapter 6. Her medical examiner determined she had a low transverse surgical scar; her neurologic, psychiatric, and pelvic were grossly intact, and that her conditions were acceptable. He noted she had a miscarriage in 1991, and a partial hysterectomy in 1992, which related to her anxiety in surgery in May. He diagnosed her with elevated cholesterol and [?] anxiety S/P (status post) partial hysterectomy. He recommended that she followed-up regarding her cholesterol and qualified her separation. The results of the medical examination were annotated in her medical record. 

7. 
On 29 July 1992, in connection with her examination she completed an SF 93 (Report of Medical History). 


(1) 
She indicated that her health was fair but she had a lot of stress and discomfort, and she was taking medication for pain. She listed various medical conditions she had in the past or currently had: 

. coughed up blood . swollen and painful joints . dizziness or fainting spells . shortness of breath . pain or pressure in chest . high or low blood pressure . cramps in her legs . stomach, liver, or intestinal trouble . frequent or painful urination . kidney stone or blood in urine . recent gain or loss of weight . recurrent back pain . foot trouble . frequent trouble sleeping . depression or excessive worry . nervous trouble of any sort 

(2) 
She further detailed her medical history, noting she had been a patient for a PID (pelvic inflammatory disease) miscarriage at Berman Hospital, at Ansbach, Germany; she was hospitalized for a kidney infection in 1991 at DACH; and at age 21, she had a hysterectomy, C-section, and DNC (dilatation and curettage) in 1992 at DACH. 


8. 
On 16 August 1992, she underwent a mental status evaluation. The examiner determined: her behavior was normal; she was fully alert; she was fully oriented; she was anxious; her thinking process was clear; her thought content was normal; and her member was good. There was no indication made regarding the reason for the mental evaluation and whether she had the mental capacity to understand and participate in the proceedings; if she was mentally responsible; if she met retention requirements of AR 40-501 (Standards of Medical Fitness), or if she needed further examination. However, he recommended self-referral to ventilate possible feelings of anxiety. 

9. 
On 24 August 1992, she was counseled by her immediate commander regarding her responsibility to provide a family care plan for the care of her dependent child, using DA Form 5304-R (Family Care Plan [FCP] Counseling Checklist). Her spouse, who was also in the military, certified the form indicating that he had also been counseled regarding the same responsibilities. The form appeared to be initialed by the spouse's commander, but is void of a commander's signature. On the same date, the applicant informed her First Sergeant (1SG), she would not be able to submit a plan for long term care of her dependent. The 1SG counseled her and informed her she had 45 days from the birth of her child to submit guardianship documents and failure to submit a FCP could result in her discharge under AR 635-200, paragraph 5-8, and the characterization of service she may receive. She stated she had exhausted all means in attempting to identify a long term guardian and none existed; therefore, she informed the command she would not be able to comply with Army policy and she understood she would be eliminated from the service. 

10. 
On 15 September 1992, the applicant's immediate commander notified her of his intent to separate her from the service under AR 635-200, paragaraph 5-8, involuntary separation due to parenthood. 


a. The applicant acknowledged receipt of the notification of a proposed separation action under AR 635-200, paragraph 5-8; she was advised by her consulting counsel regarding the contemplated action against her; and she elected not to submit a statement in her own behalf. 
11. 
The intermediate commander recommended approval of the separation and on 24 September 1992, the appropriate separation authority approved the discharge and directed she be issued an Honorable Discharge Certificate. 

12. 
On 7 October 1992, the applicant was discharged accordingly. Her service was characterized as honorable. She completed 2 years, 6 months, and 10 days of her 3­year contractual obligation. Her DD Form 214 shows she served in Southwest Asia from 20 December 1990 to 10 March 1991 and: 


. Separation Authority:  Army Regulation 635-200 (Personnel Separations – 
Enlisted Personnel), paragraph 5-8 
. Separation Code: "LDG" 
. Reentry Code:  3 
. Narrative Reason for Separation: Involuntary Separation Due to Parenthood 
13. The applicant requests a medical discharge or medical retirement. She states she believes she was hurriedly discharged as Involuntary Separation Due to Parenthood, rather than having gone before an Army Medical Board to assess her disabilities. As a result of the incidents that followed her giving birth, she feels there should have been other medical alternatives to control or stop her severe bleeding rather than a hysterectomy. She feels she should have been separated from the Army with a medical discharge rather than grossly suffering from the residuals of her surgical hysterectomy as well as the mental disorders it caused and continue to cause. Therefore, she is requesting her DD Form 214 be upgraded to reflect a medical retirement and her military medical records show the same. 
a. 
Her record shows she enlisted in the Regular Army for a term of 3 years. After the birth of her child, she and her military spouse were counseled by their commanders, respectively, in regards to providing a family care plan as a result of being dual military parents. Her record contains her FCP counseling by the commander and a counseling statement from the 1SG. The applicant informed her commander and 1SG, she was unable to provide a long term care provider. Based on her statement, the commander initiated separation under AR 635-200, paragraph 5-8. She completed 2 years, 6 months, and 10 days of her 3-year contractual obligation. 

b. 
In regards to her contention she should receive a medical separation or medical retirement due to status post hysterectomy due to complication from cesarean section, PTSD, to include anxiety disorder with depressive disorder and pyelonephritis with kidney disorder: 


(1) 
The applicant received a medical examination and a mental status evaluation, prior to the separation proceedings. During the medical examination applicant indicated various medical conditions she either had in the past or at the time of her examination. The medical examination indicated the purpose for the examination was for AR 635-200, Chapter 6. The examiner determined she had a low transverse surgical scar and her neurologic, psychiatric, and pelvic were grossly intact. She was 

diagnosed with elevated cholesterol and [?] anxiety status post partial hysterectomy and the examiner qualified her for separation. The mental status evaluation did not indicate the reason for the evaluation nor did it indicate whether or not she met medical retention standards. The examiner recommended the applicant seek assistance for her possible anxiety through self-referral. 

(2) 
Her available record does not show any evidence she was diagnosed with PTSD, to include anxiety disorder with depressive disorder and pyelonephritis with kidney disorder. She was diagnosed with elevated cholesterol and [?] anxiety status post-partial hysterectomy by the examiner during her separation medical examination. The applicant did not provide any in-service medical records and or VA medical documents to support her contentions. 


c. AR 635-200, states in: 
(1) Paragraph 1-18, when a Soldier’s conduct or performance becomes unacceptable, the commander will ensure that a responsible official formally notifies the Soldier of his/her deficiencies. At least one formal counseling session is required before separation proceedings may be initiated and there must be evidence that the Soldier’s deficiencies continued after initial formal counseling. 
(2) 
Paragraph 5-8 (Involuntary Separation Due to Parenthood), Soldiers will be considered for involuntary separation when parental obligations interfere with fulfillment of military responsibilities. AR 600-20 (Personnel General – Army Command Policy), chapter 5 provides Soldier's responsibilities for care of family members as related to military responsibilities. An honorable or general, under honorable conditions discharge is appropriate under this paragraph. 

(3) 
Paragraph 6-3, Soldiers may be discharged or released because of genuine dependency or hardship. Dependency exists when death or disability of a member of a Soldier's (or spouse's) immediate family causes that member to rely upon the Soldier for principal care or support. Hardship exists when, in circumstances not involving death or disability of a member of a Soldier’s (or spouse’s) immediate family, separation from the Service will materially affect the care or support of the family by alleviating undue and genuine hardship. 

d. 
AR 600-20, paragraph 5-5 (Family care plans) provided plans must be made to ensure family members are properly and adequately cared for when a Soldier is deployed on temporary duty or otherwise not available due to military requirements. Commanders were to conduct or arrange by a representative for Family Care Plan counseling and require a Family Care Plan be completed for, among other reasons, a pregnant soldier who has no spouse; is divorced, widowed, or separated; or is residing without her spouse or is married to another service member. 

e. 
AR 40-501 provides a listing of all medical conditions and specific causes for referral to an MEB, medical conditions and physical defects which may render a Soldier unfit for further military service. The medical conditions and physical defects, individually or in combination, are those, that significantly limit or interfere with the Soldier's performance of their duties; may compromise or aggravate the Soldier's health or well­being if they were to remain in the military Service; may compromise the health or well­being of other Soldiers; and/or may prejudice the best interests of the Government if the individual were to remain in the military Service. Conditions listed in Chapter 3, who do not meet the required medical standards will be evaluated by an MEB. 

f. 
AR 635-40 (Physical Evaluation for Retention, Retirement, or Separation), states the mere presence of an impairment does not, 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 the with the requirements of the duties the Soldier reasonably may be expected to perform because of their office, grade, rank or rating. To ensure all solders are physically qualified to perform their duties in a reasonable manner, medical retention qualification standards have been established in Army Regulation 40-501. 

g. 
AR 635-5-1 (Personnel Separations – Separation Program Designators [SPD]), provides the following Authorities, Reasons, and SPD Codes: 

• 
AR 635-200, para 5-8; Inability to Perform Prescribed Duties Due to Parenthood; LDG 

• 
AR 635-40, para 4-24b(1); Disability, Permanent; SFJ 

• 
AR 635-40, para 4-24b(2); Disability, Temporary; SFK 

• 
AR 635-40, para 4-24b(3); Disability, Severance Pay; JFL 

• 
AR 635-40, para4-24e(4); Disability, Other; JFR 



h. 
Title 10, U.S. Code, chapter 61, provides for the retirement and discharge of members of the Armed Forces who incur a physical disability in the line of duty while serving on active or inactive duty. However, the disability must have been the proximate result of performing military duty. It further provides for disability retirement or separation for a member who is physically unfit to perform the duties of his office, rank, grade, or rating because of disability incurred while entitled to basic pay. 

i. 
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 Department of Veterans Affairs (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. 

j. 
Title 38, USC, 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. 

k. 
Title 38, CFR, 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 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. 


l. The Office of the Undersecretary of Defense for Personnel and Readiness provides guidance that 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 mental health conditions, Traumatic Brain Injury (TBI), post-traumatic stress disorder (PTSD), sexual harassment and sexual assault. The veteran’s testimony alone, oral or written, may establish the existence of a condition or experience, that the condition or experience existed during or was aggravated by military service, and that the condition or experience excuses or mitigates the discharge. 
14. 
In reaching its determination, the Board can consider the applicant's petition, her service record, and her statements in light of the published guidance on equity, injustice, or clemency. 

15. 
MEDICAL REVIEW: 


The Army Review Boards Agency (ARBA) Medical Advisor was asked to review this case. Documentation reviewed included the applicant’s ABCMR application and accompanying documentation, the military electronic medical record (AHLTA), the VA electronic medical record (JLV), the electronic Physical Evaluation Board (ePEB), the Medical Electronic Data Care History and Readiness Tracking (MEDCHART) application, and the Interactive Personnel Electronic Records Management System (iPERMS).  The ARBA Medical Advisor made the following findings and recommendations: 
a. The applicant is applying to the ABCMR requesting in essence, a referral to the Disability Evaluation system (DES). 
“I am requesting a correction/Upgrade or to change my military records/DD-214 discharge to reflect a Medical separation or Medical Disability Retirement due the disabilities of ‘status post hysterectomy due to complication from cesarean section, post-traumatic stress disorder (PTSD) to include, anxiety disorder with depressive disorder and pyelonephritis with kidney disorder.’” 
b. 
The Record of Proceedings details the applicant’s military service and the circumstances of the case. The applicant signed DD 214 for the period of service under consideration shows she entered the regular Army on 28 March 1990 and was discharged on 7 October 1992 under authority provided in paragraph 5-8 of AR 635­200, Personnel Separations – Enlisted Personnel (7 September 1990): Involuntary separation due to parenthood. 

c. 
The applicant’s pre-entrance Report of Medical History and Report of Medical examination show she was in good health, without significant medical history or conditions. 

d. 
Her pre-separation Report of Medical History shows she was treated for a kidney infection in October 1991 and underwent a C-section and partial hysterectomy on 20 May 1992. The two diagnoses on the accompanying Report of Medical History were 


“Elevated cholesterol” and “anxiety s/p partial hysterectomy.” 
e. Her pre-separation mental status evaluation was completed on 6 August 1992. The provider documented a normal exam and recommended the applicant self-refer for 
“feelings of anxiety.” 
f. The applicant was counseled by her first sergeant on 24 August 1992 on the possibility of an administrative separation for failure to provide a family care plan. 
“SPC {Applicant} indicated on 24 August 1992 that she would be unable to submit a plan for Long Term Care of her dependent. I have informed SPC {Applicant} that per AR 600-200, she has 45 days from the birth of her child to submit guardianship documents. She was informed that failure to submit a Family Care Plan would result in her elimination under the provisions of AR 635­200, Chapter 5-8.” 
g. 
On 15 September 1992, her company commander notified her or his intent to initiate separation action under paragraph 5-8 of AR 635-200 for not having a family care plan.  His subsequent request was approved by the brigade commander on 24 September 1992. 

h. 
There was no medical documentation submitted with the application. Because of the period of service under consideration, there are no encounters in AHLTA. 

i. 
There is no evidence the applicant had a mental health or other medical condition which would have failed the medical retention standards of chapter 3, AR 40-501 prior to her administrative discharge. Thus, there was no cause for referral to the Disability 


Evaluation System.  Furthermore, there is no evidence that any medical condition prevented the applicant from being able to reasonably perform the duties of her office, grade, rank, or rating prior to her discharge. 
j. 
Review of the applicant’s records in JLV shows she has been awarded multiple VA service connected disability ratings.  However, the DES compensates an individual only for condition(s) which have been determined to disqualify him or her from further military service. The DES has neither the role nor the authority to compensate service members for anticipated future severity or potential complications of conditions which were incurred or permanently aggravated during their military service; or which did not cause or contribute to the termination of their military career.  That role and authority is granted by Congress to the Department of Veterans Affairs and executed under a different set of laws. 

k. 
It is the opinion of the Agency Medical Advisor that a referral of this case to the Disability Evaluation System is not warranted. 


BOARD DISCUSSION: 
The Board carefully considered the applicants request, supporting documents, evidence in the records, and regulatory guidance. The Board considered the applicant's statement, the medical records, and the review and conclusions of the advising official.  Based upon a preponderance of the evidence, the Board concurred with the medical advisory opinion finding insufficient evidence the contested medical conditions failed to meet retention standards during her period of service. Therefore, the Board determined referral to DES for consideration of a medical separation is not warranted. 
BOARD VOTE: 
Mbr 1 Mbr 2 Mbr 3 
: : : GRANT FULL RELIEF 
: : : GRANT PARTIAL RELIEF 
: : : GRANT FORMAL HEARING 
:XX :XX :XX 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. 
X 
CHAIRPERSON 
I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. 
REFERENCES: 
1. 
Title 10, USC, section 1552(b), provides that applications for correction of military records must be filed within three years after discovery of the alleged error or injustice. This provision of law also allows the Army Board for Correction of Military Records (ABCMR) to excuse an applicant's failure to timely file within the three-year statute of limitations if the ABCMR determines it would be in the interest of justice to do so. 

2. 
Army Regulation (AR) 635-200 (Personnel Separations –– Enlisted Personnel) sets forth the basic authority for the separation of enlisted personnel from the Army. 


a. Paragraph 1-18 provides: 
(1) When a Soldier’s conduct or performance becomes unacceptable, the commander will ensure that a responsible official formally notifies the Soldier of his/her deficiencies. At least one formal counseling session is required before separation proceedings may be initiated and there must be evidence that the Soldier’s deficiencies continued after initial formal counseling. 
(2) 
For Soldiers not in training status will be locally reassigned at least once, with a minimum of three months of duty in each unit. Reassignment should be between battalion-sized units or higher when considered necessary by the local commander. Permanent Change of Station funds normally will not be used for rehabilitative transfers. However, in meritorious cases where it is determined that a Soldier with potential to be 

a distinct asset to the Army would benefit from a change in commanders, associates, and living conditions, the commander exercising general court-martial jurisdiction may authorize PCS transfer within the same command. As an alternative, a request for reassignment to another command may be submitted to Headquarters, Department of the Army. 

(3)  
Waiver of counseling requirement is not authorized. The separation authority may waive the transfer requirements in circumstances where common sense and sound judgement indicate that such transfer will serve no useful purpose or produce a quality Soldier. 

b. 
 Paragraph 5-8 (Involuntary Separation Due to Parenthood) provides Soldiers will be considered for involuntary separation when parental obligations interfere with fulfillment of military responsibilities. AR 600-20 (Personnel General – Army Command Policy), chapter 5 provides Soldier's responsibilities for care of family members as related to military responsibilities.) 

(1)  Specific reasons for separation because of parenthood include: 
• 
Inability to perform prescribed duties satisfactorily 

• 
Repeated absenteeism 

• 
Repeated tardiness 

• 
Inability to participate in field training exercises or perform special duties such as charge of quarters and staff duty noncommissioned officer 

• 
Non-availability for worldwide assignment or deployment according to the needs of the Army 



(2)  
Separation processing may not be initiated under this paragraph until the Soldier has been adequately counseled concerning deficiencies and has been afforded the opportunity to overcome them in accordance AR 635-200 paragraph 1-18 and AR 600-20 (Personnel General – Army Command Policy). Soldiers may be separated with an honorable or general, under honorable conditions under this paragraph. 

c. 
 Chapter 6 (Separation because of dependency or hardship), paragraph 6-3, states separation under this chapter is for the convenience of the Government. It provides Soldiers of the Active Army and the Reserve Components may be discharged or released because of genuine dependency or hardship. 

(1)
 Paragraph 6-3a states dependency exists when death or disability of a member of a Soldier's (or spouse's) immediate family causes that member to rely upon the Soldier for principal care or support. 

(2)  
Paragraph 6-3b states hardship exists when, in circumstances not involving death or disability of a member of a Soldier's (or spouse's) immediate family, separation from the Service will materially affect the care or support of the family by alleviating undue and genuine hardship. Under this provision for hardship discharge, parenthood of married Soldiers (paragraph 6-3(1)) and sole parenthood (paragraph 6-3(2)) are conditions under which separation may be granted. A married Soldier who becomes a parent by birth, adoption, or marriage (stepparent) and whose child (or children) is less than 18 years of age and resides within the household, may apply for separation under hardship. The Soldier must submit evidence that the roles of parent and Soldier are incompatible and that the Soldier cannot fulfill his or her military obligation without neglecting the child or children. There must be unexpected circumstances beyond the Soldier's control. An example of unexpected circumstances beyond the soldier's control is the birth of a child with a serious birth defect requiring constant care. Inability to obtain an approved dependent care plan does not qualify the Soldier for separation under this provision. 


3.  AR 600-20 (Personnel General – Army Command Policy), in effect at the time, prescribed the policies and responsibilities of command, which included military discipline and conduct, and the Army Equal Opportunity Program. Paragraph 5-5 (Family care plans) provided plans must be made to ensure family members are properly and adequately cared for when a Soldier is deployed on temporary duty or otherwise not available due to military requirements. 
a.  Commanders were to conduct or arrange by a representative for Family Care Plan counseling and require a Family Care Plan be completed for: 
(1)  
A pregnant soldier who has no spouse; is divorced, widowed, or separated; or is residing without her spouse or is married to another service member. 

(2)  
A soldier who has no spouse; is divorced, widowed or separated, or is residing apart from his or her spouse; who has joint or full legal and physical custody of one or more family members under the age of 19 or who has adult family member(s) incapable of self-care regardless of age. 


(3).  A soldier who is divorced (not remarried) and who has liberal or extended visitation rights by court decree which would allow family members to be solely in the soldier's care in excess of 30 consecutive days. 
(4).  A soldier whose spouse is incapable of self-care or is otherwise physically, mentally, or emotionally disabled so as to require special care or assistance. 
(5)  A soldier categorized as half of a dual-military couple of the Active Army or Reserve Component of any service who has joint or full legal custody of one or more family members under age 19 or who has adult family member(s) incapable of self-care regardless of age. 
b. 
 DA Form 5305-R (Family Care Plan) is the means by which Soldiers provide for the care of their family members when military duties prevent the Soldier from doing so. Soldiers are responsible for implementing the Family Care Plan and thus ensuring the care of their family members. DA Form 5305-R will be completed and approved within 30 days for active duty Soldiers from the date of counseling. 

c. 
The unit commander may designate an authorized representative to conduct Family Care Plan counseling using DA Form 5304-R and to initial and sign the counseling form in the commander's behalf. The unit commander is the sole approving authority for DA Form 5305-R. This responsibility will not be delegated. The commander will give the soldier 30 days from date of the first disapproval to submit additional documentation or evidence to support the Family Care Plan. He or she may consider extenuating circumstances in approving DA Form 5305-R, but must understand that the soldier is considered non-deployable until a Family Care Plan is validated and approved. The commander should consider initiating a bar to reenlistment and/or involuntary separation proceedings against soldiers who fail to properly manage personal, marital, or family affairs, or who fail to provide or maintain adequate Family Care Plans. 

d. 
 Enlisted soldiers will be counseled on voluntary and involuntary separation whenever parenthood interferes with military responsibilities under provision of AR 635­200 for active duty Soldiers. 


4.  AR 40-501 (Standards of Medical Fitness) provides information on medical fitness standards for induction, enlistment, appointment, retention, and related policies and procedures. Chapter 3 (Medical Fitness Standards for Retention and Separation, Including Retirement), provides a listing of all medical conditions and specific causes for referral to an MEB.  It states: 
a. The various medical conditions and physical defects which may render a Soldier unfit for further military service and which fall below the standards required for all enlisted Soldiers of the Active Army, Army Reserve National Guard, and U.S. Army Reserve.  The medical conditions and physical defects, individually or in combination, are those, that: 
(1)  Significantly limit or interfere with the Soldier's performance of their duties. 
(2)  May compromise or aggravate the Soldier's health or well-being if they were to remain in the military Service.  This may involve dependence on certain medications, appliances, severe dietary restrictions, or frequent special treatments, or a requirement for frequent clinical monitoring. 
(3)  May compromise the health or well-being of other Soldiers. 
(4)  
May prejudice the best interests of the Government if the individual were to remain in the military Service. 

b. 
Soldiers with conditions listed in Chapter 3, who do not meet the required medical standards will be evaluated by an MEB. Possession of one or more of the conditions listed in this chapter does not mean automatic retirement or separation from service. Physicians are responsible for referring Soldiers with conditions listed in Chapter 3 to an MEB. 


5. Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) establishes the PDES according to the provisions of Title 10, U.S. Code, chapter 61, Retirement or Separation for Physical Disability, and Department of Defense Directive 1332.18. It states: 
a. 
The mere presence of an impairment does not, 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 the requirements of the duties the Soldier reasonably may be expected to perform because of tier office, grade, rank or rating. To ensure all solders are physically qualified to perform their duties in a reasonable manner, medical retention qualification standards have been established in Army Regulation 40-501. These guidelines are used to refer Soldier to an MEB. 

b. 
 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 they can no longer continue to reasonably perform because of a physical disability incurred or aggravated in service. 

c. 
When a Soldier is being processed for separation or retirement for reasons other than physical disability, continued performance of assigned duty commensurate with his or her rank or grade until the Soldier is scheduled for separation or retirement, creates a presumption that the Soldier is fit. An enlisted Soldier who reenlistment has not been approved before the end of his or her current enlistment, is not processing for separation; therefore, this rule does not apply. The presumption of fitness may be overcome if the evidence establishes that: 


(1)  
The Soldier was, in fact, physically unable to perform adequately the duties of his or her office, grade, rank or rating for a period of time because of disability. There must be a causative relationship between the less than adequate duty performance and the unfitting medical condition or conditions. 

(2)  
An acute, grave illness or injury or other significant deterioration of the Soldier's physical conditions occurred immediately prior to, or coincident with processing for separation or retirement for reasons other than physical disability and which rendered the Soldier unfit for further duty. 

d. 
The fact that a Soldier has a condition listed in the Department of Veterans Affairs schedule for Rating Disabilities (VASRD) does not equate to finding of physical unfitness. An unfitting, or ratable condition, is one which renders the Solder unable to perform the duties of their office, grade, rank, or rating, in such a way as to reasonably fulfill the purpose of their employment on active duty. 

e. 
The medical treatment facility commander with the primary care responsibility will evaluate those referred to him/her and will, if it appears as though the member is not medically qualified to perform duty or fails to meet retention criteria, refer the member to a MEB. Those members who do not meet medical retention standards will be referred to a physical evaluation board (PEB) for a determination of whether they are able to perform the duties of their grade and MOS with the medically-disqualifying condition. The PEB evaluates all cases of physical disability equitably for the Soldier and the Army. The PEB investigates the nature, cause, degree of severity, and probable permanency of the disability of Soldiers whose cases are referred to the board. Finally, it makes findings and recommendations required by law to establish the eligibility of a Soldier to be separated or retired because of physical disability. 


6. AR 635-5-1 (Personnel Separations – Separation Program Designators [SPD]), in effect at the time, prescribed the specific authorities (regulatory, statutory, or other directives) and reasons for separating Soldiers from active duty, and the SPD codes to be entered on the DD Form 214. It provides the following Authorities, Reasons, and SPD Codes: 
• 
AR 635-200, para 5-8; Inability to Perform Prescribed Duties Due to Parenthood; LDG 

• 
AR 635-40, para 4-24b(1); Disability, Permanent; SFJ 

• 
AR 635-40, para 4-24b(2); Disability, Temporary; SFK 

• 
AR 635-40, para 4-24b(3); Disability, Severance Pay; JFL 

• 
AR 635-40, para4-24e(4); Disability, Other; JFR 


7. 
Title 10, U.S. Code, chapter 61, provides for the retirement and discharge of members of the Armed Forces who incur a physical disability in the line of duty while serving on active or inactive duty. However, the disability must have been the proximate result of performing military duty. It further provides for disability retirement or separation for a member who is physically unfit to perform the duties of his office, rank, grade, or rating because of disability incurred while entitled to basic pay. 

8. 
 38 USC 1110 (General -Basic Entitlement): 

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. 

9. 
 38 USC 1131 (Peacetime Disability Compensation -Basic Entitlement): 

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. 

10. 
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 (TBI); sexual assault; or sexual harassment. Standards for review should rightly consider the unique nature of these cases and afford each veteran a reasonable opportunity for relief even if the sexual assault or sexual harassment was unreported, or the mental health condition was not diagnosed until years later. 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. 

11. 
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. 


a. 
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 on the basis of 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. 

b. 
 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. 


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