ex- Maj, 

Current Discharge and Applicant’s Request

Application Received:  20220117
Characterization of Service Received:   
Narrative Reason for Discharge:   MISCONDUCT (OTHER)
Authority for Discharge:   SECNAVINST 1920.6C 

Applicant’s Request:	Characterization change to:	
Narrative Reason change to:  REQUESTED, BUT NOT SPECIFIED
Reentry Code change to:  NONE REQUESTED

Summary of Service
Prior Service:
Inactive:  USN (ROTC)	19980824 - 20020703  	Active:  

Period of Service Under Review:
Date of Appointment:  20020704	Age:  24
Years Contracted:  Indefinite
Date of Discharge:  20210505	Highest Rank:  MAJ
Length of Service: 18 Year(s)   10 Month(s)   01 Day(s)
Education Level:  	AFQT:  NFIR
Officer’s Fitness reports:  Available

Awards and Decorations (per DD 214):	Rifle  Pistol  (3) BSM PH DMSM MSM NMCCM (2) NMCAM (2) CAR (Iraq) JMUA NUC (4) NMUC NDSM ACM (w/1 Star) ICM (w/3 Stars) GWOTEM (Iraq) GWOTSM SSDR (5) NATO Medal-ISAF Afghanistan  

Periods of UA:  NONE
Periods of CONF:  NONE
Other Time Lost per DD214:  NONE

SCM:    SPCM:    CIVIL ARREST:    CC:   

NJP:  1

- 20200724:	Article 107 (False official statements) 
	Article 133 (Conduct unbecoming officer)
	Article 134 (General article) (3 specifications) Adultery	
	Awarded:  PUNITIVE LETTER OF REPRIMAND  Suspended:  NONE

Administrative Corrections to the Applicant’s DD 214

The NDRB did note administrative error(s) on the original DD Form 214:

	    “SECNAVINST 1920.6C”

The NDRB will recommend to Commandant of the Marine Corps that the DD 214 be corrected as appropriate.

Types of Documents Submitted/reviewed

	DD 214:		Service/Medical Record:		Other Records:	
	Employment:		Finances:		Education/Training:	
	Health/Medical Records:		Rehabilitation/Treatment:		Criminal Records:	
	Personal Documentation:		Community Service:		References:	
	Department of VA letter:		Other Documentation:	

Additional Statements

	From Applicant:		From/To Representation:		From/To Congress member:	
 
Types of Witnesses Who Testified

	Expert:  			Character:    

	Witness E-1:			Witness C-1:	
	Witness E-2:			Witness C-2:

Pertinent Regulation/Law

A.  Secretary of the Navy Instruction 1920.6C (ADMINISTRATIVE SEPARATION OF OFFICERS), effective 15 December 2005 until Present, establishes policies, standards and procedures for the administrative separation of Navy and Marine Corps officers from the naval service in accordance with Title 10, United States Code and DoD Directive 1332.30 of 14 March 1997.

B.  Secretary of the Navy Manual 5420.1 of 29 September 2020 (Standards for the execution of the Naval Discharge Review Board).

DEPARTMENT OF THE NAVY
NAVAL DISCHARGE REVIEW BOARD (NDRB)
DISCHARGE REVIEW DECISIONAL DOCUMENT

Applicant’s Issues

1.	The Applicant requests a discharge upgrade and contends that the overall quality of his 18 years of service was honorable and PTSD/TBI mitigates the misconduct.
Discussion

Date:  20230725		Location:  WASHINGTON D.C.	Representation:  

The Naval Discharge Review Board (NDRB), under its responsibility to examine the propriety and equity of an Applicant’s discharge, is authorized to change the character of service and the reason for discharge if such change is warranted.  In reviewing discharges, the Board presumes regularity in the conduct of governmental affairs unless there is substantial credible evidence to rebut the presumption, to include evidence submitted by the Applicant.  The Board completed a thorough review of the circumstances that led to the discharge and the discharge process to ensure the pertinent standards of equity and propriety were met.

As a result of the Applicant’s claim of a mental health condition, including PTSD, TBI, or Military Sexual Trauma, and in accordance with 10 U.S.C. § 1553, the NDRB included a member who is a physician, clinical psychologist, or psychiatrist.  
Additionally, and pursuant to § 1553, the NDRB reviewed the case with liberal consideration that a mental health condition, including PTSD, TBI, or Military Sexual Trauma potentially contributed to the circumstances resulting in the discharge of a lesser characterization.  The Applicant’s service record documents completion of a deployment from May to December 2013 in support of Operation ENDURING FREEDOM.  Pursuant to § 1553 (d)(2), the service secretary expedited a final decision and accorded the case sufficient priority to achieve an expedited resolution.  

The Applicant's record of service included:

  for  of the Uniform Code of Military Justice (UCMJ): 
Article 107 (False official statements) 
Article 133 (Conduct unbecoming officer)
Article 134 (General article)

:  The Applicant requests a discharge upgrade and contends that the overall quality of his 18 years of service was honorable and PTSD/TBI mitigates the misconduct.

The NDRB reviews the propriety and equity of an Applicant’s discharge individually, on a case-by-case basis.  If such a review reveals an impropriety or inequity, relief is in order.  Regulations permit relief on equitable grounds if the Applicant’s discharge is inconsistent with standards of discipline of the Naval Service.  

Because the Applicant claimed mental health was a factor in their discharge, the Board reviewed the Applicant’s case in accordance with 10 U.S.C. § 1553, and pursuant to the Kurta Memo and other applicable regulations and guidance, including the Wilkie Memo.  Under the Kurta Memo, “[m]ental health conditions, including PTSD; sexual assault; and sexual harassment inherently affect one’s behaviors and choices causing veterans to think and behave differently than might otherwise be expected.”  Although, “[l]iberal consideration does not mandate an upgrade, [r]elief may be appropriate … for minor misconduct commonly associated with mental health conditions … and some significant misconduct sufficiently justified or outweighed by the facts and circumstances.”  Additionally, “substance seeking behavior and efforts to self-medicate symptoms of a mental health condition may warrant consideration.”  However, “[p]remeditated misconduct is not generally excused by mental health conditions, including PTSD; TBI; or by a sexual assault or sexual harassment experience.”  Therefore, “Review Boards will exercise caution in assessing the causal relationship between asserted conditions or experiences and premeditated misconduct.” See USD (P&R) Memo, “Clarifying Guidance to Military Discharge Review Boards and Boards for Correction of Military/Naval Records Considering Requests by Veterans for Modification of their Discharge Due to Mental Health Conditions, Sexual Assault, or Sexual Harassment” 25 August 2017 (“Kurta Memo”).

The review of discharges pursuant to the Kurta Memo and its other applicable regulations/guidance generally involves four questions: a) Did the veteran have a condition or experience that may excuse or mitigate the discharge; b) Did that condition exist/experience occur during military service; c) Does that condition or experience actually excuse or mitigate the discharge; and d) Does that condition or experience outweigh the discharge?  

In this case, the Board found that: a) the Applicant did have a condition/experience that may excuse or mitigate the discharge; b) the condition existed during military service; c) the condition/experience did not mitigate the underlying basis/misconduct for the discharge; and d) the condition/experience did not outweigh the Applicant’s assigned Discharge Characterization.  

MEDICAL BOARD MEMBER OPINION
1.	Does the available record reasonably support a DSM mental/behavioral health condition, PTSD, TBI, or Sexual Trauma/Abuse/IPV existed at the time of the Applicant’s military service?	Yes – ADHD, TBI, PTSD	
2.	A.	Were these conditions present at time of misconduct?	Yes	
	B.	Were these conditions mitigating for the misconduct?	No (see below)	
3.	Were all required mental health and/or medical evaluations conducted in accordance with regulations, prior to the administrative separation of the Applicant?	Yes	
4.	Medical board member comments:	Reviewed the Applicant’s medical treatment records, military service records, and all applicant-provided materials.

The Applicant, a Marine officer with multiple combat deployments, was separated in 2021 for misconduct.  Among the multiple contentions made in the application, the Applicant states that PTSD (combat-related and due to the death of a daughter) negatively affected his judgement and should be grounds for mitigation.  

Brief timeline:
5 Sep 2002 – Commission
09 Feb – 21 Sep 2004 – OIF deployment
~ 16 Aug 2006 – 25 Feb 2006 – OIF deployment
01 Oct 2006 – 23 Sep 2007 – OIF deployment
29 Oct 2006 – WIA (awarded PH)
01 Jan 2007 – 23 Sep 2007 – deployment
25 Mar 2008 – TBI evaluation
2009 – Lower back surgery
2010 – Lower back surgery
04 Mar – 03 Sep 2012 – deployment
26 May - 17 Dec 2013 – OEF deployment
02 Aug 2017 – Arrived for duty – EOTG II MEF
21 Oct 2017 – 13 Nov 2019 – dates of misconduct (including false official statement) 
9 – 10 Jan 2018 – Hospitalization for lower back surgery
14 Dec 2018 – Marriage
27 Mar 2020 – PTA submitted
23 Apr 2020 – Applicant’s letter to ASN
14 May – 13 Aug 2020 – TBI evaluation (ISC Camp Lejeune) – found FFD and worldwide deployable.  Negative PTSD screening.
20 – 22 May 2020 – Hospitalization for lower back surgery
22 May 2020 – PTA accepted
24 Jul 2020 – NJP (Art 107, 133, 134 x 3)
14 Sep 2020 – Surgery on L hand
30 Nov 2020 – 1st LIMDU initiated
22 Apr 2021 – 2nd LIMDU recommended by Neurosurgeon
05 May 2021 – Discharge

The combination of the Applicant's medical treatment files and submitted materials lends to the following conclusions:
1.	PTSD – Neuropsychiatric testing was performed on the Applicant in 2008, indicating the possible presence of PTSD, though a formal diagnosis was not made.  However, this “rule out” diagnosis may have been more tailored to avoid a perceived stigma of PTSD.  However, in 2020, the Applicant underwent a follow-up TBI evaluation, which including a specific evaluation for concomitant PTSD or other confounding mental health issues.  The Applicant screened negative for PTSD at that time.  Though not completely clear, the physician responsible for the final physical may have used this information in his determination not to seek a mental health evaluation specifically for the purposes of the administrative discharge process.
2.	TBI – The Applicant suffered multiple instances of traumatic brain injury, the most severe of which occurred in 2006 (poly traumatic IED blast).  As with the PTSD, the Applicant was screened/treated around the time of the injury and rescreened in 2020.  In 2020, the Intrepid Spirit Center found that the Applicant had recovered all cognitive function and made him FFD and worldwide deployable.
3.	Lower back pain/chronic pain – The Applicant suffered from fairly severe lower back pain complicated by a neuropathic pain down his left leg.  He underwent at least four surgical procedures to reduce the symptoms, each with varying degrees of success and post-operative pain free intervals.  The last operation, performed by neurosurgery in 2020, failed to significantly relieve his symptoms and was under active care at the time of discharge.  In the final clinical visit for back pain (22 Apr 2021), the neurosurgeon requested an additional MRI and pain management consult, thought the Applicant’s separation superseded their completion.
4.	LIMDU for lower back pain –Based on the clinical notes, the Applicant’s primary care provider wrote the first period of LIMDU at the end of November 2020, which would have expired in April 2021.  Neurosurgery requested a second period of LIMDU starting in 2021, though I do not see concrete evidence that this was provided.  A second period of LIMDU, given the competing circumstances of the Applicant’s misconduct, seems unlikely to have been approved.  Despite the email from the neurosurgery clinical nurse, more-likely-than-not, the first period of LIMDU expired without further action.  I agree, however, a more formal disposition (return FFD for the purposes of separation) should have been performed to clarify the situation and to set out reasonable goals for follow-up.
5.	Left hand/wrist pain – the Applicant was also undergoing care for left hand/wrist nerve pain and had surgery in September 2020.  In follow-up, facing a slow and unclear recovery process, the Orthopedic Hand Surgeon laid out three options for the Applicant, who elected a follow-on surgery.  This surgery was not performed because of the Applicant’s separation.  However, based on the surgeon’s notes, I do not see having this surgery as any reason for which the Applicant would have needed to stay on active duty.
6.	In analyzing the information that was submitted to the ASN via endorsements on the Applicant’s request for resignation, I agree that the information in the Commanding General’s second endorsement does not appear accurate, given the history of TBI and the possible previous symptoms of PTSD (both noted in 2008).  However, given the findings of the August 2020 visit at the ISC, I agree with the CMC’s opinion that neither PTSD nor TBI was a contributing factor for this misconduct.  In the end, I find that the ASN (M&RA) was presented with a correct medical picture on which to base his determination.  	

When reviewing discharges, the Board considers the standards for determining characterization of service where an Honorable characterization of service is warranted when the quality of a member’s service generally meets the standard of acceptable conduct and performance for Naval personnel.  Further, an honorable discharge characterization does not require flawless military service; many veterans are separated with an honorable characterization despite some relatively minor or infrequent misconduct.  A General (Under Honorable Conditions) discharge is warranted when the quality of the member’s service has been honest and faithful but significant negative aspects of the member’s conduct or performance of duty outweighed the positive aspects of the member’s service record.  An Under Other Than Honorable Conditions discharge is warranted when a member engages in conduct involving one or more acts or omissions that constitute a significant departure from the conduct expected of members of the Naval Service. 

In this case, the Applicant’s service was honest and faithful but significant negative aspects of his conduct or performance of duty outweighed the positive aspects of his service record.  In making its determination, the Board considered the totality of the Applicant’s service inclusive of his misconduct and overall active duty career of nearly 19 years that included five combat deployments as a Logistics Officer and Operational Advisor.  The Applicant was the subject of a command investigation involving adultery with a subordinate Marine.  Following the investigation, the Applicant agreed to Non-Judicial Punishment and submitted a Request for Resignation In Lieu of Further Administrative Processing.  The Board considered the Applicant’s contention that the Under Other Than Honorable Conditions discharge characterization received was unjust given that the Applicant’s misconduct spanned only a few months in an otherwise honorable career and service connected PTSD/TBI mitigates the misconduct.  A review of the Applicant’s military medical records provides diagnoses of TBI, PTSD, and ADHD while on active duty.  However, the Board agreed with the medical opinion made at the time of the Applicant’s discharge that his mental health condition was not a contributing factor in his misconduct and therefore the Applicant’s mental health condition was not a mitigating factor for the misconduct.  

The Board also considered the overall quality of the Applicant’s service, to include service as a high performing Logistics Officer and Advisor who earned a Bronze Star Medal, a Purple Heart, and a Combat Action Ribbon during his multiple deployments.  In addition the Board accounted for the Applicant’s post-service conduct with due consideration towards his effective management of his mental health condition, and continued gainful employment.  These efforts deserve recognition in otherwise notable career notwithstanding the Applicant’s singular period/act of misconduct.  In consideration for all these factors, and the misconduct, the Board determined that the misconduct was a significant negative aspect within his military career but did not find that it constituted a significant departure of military conduct.  Consequently, the Board found a change in characterization of service to Under Honorable Conditions (General) is appropriate.  Relief Granted.

Decision

After a thorough review of the available evidence, to include the Applicant’s issues, summary of service,  record entries, and discharge process, the Board found .  Therefore, the awarded characterization of service shall  UNDER HONORABLE CONDITIONS (GENERAL), the narrative reason for separation shall  MISCONDUCT (OTHER) with a corresponding separation code of JKM1, and the reentry code shall  N/A.  The Applicant remains eligible for a personal appearance hearing for a period of fifteen years from the date of the discharge.  The Applicant is directed to the Addendum for additional information.

ADDENDUM:  Information for the Applicant

Additional NDRB Reviews: After receiving a NDRB Document Review, an Applicant remains eligible for a Personal Appearance/Telephonic Hearing if the application is received by the NDRB within 15 years of the Applicant’s date of discharge.  The Applicant can provide documentation to support any claim(s) related to their discharge as well as evidence of post-service accomplishments.  Representation at a personal appearance hearing by an Attorney (or Advocate) is recommended but not required.  There are veterans organizations such as the American Legion and the Disabled American Veterans that are willing to provide guidance to former service members in their efforts to obtain a discharge upgrade.  However, if you have been discharged for more than 15 years, already had a personal appearance hearing, or otherwise exhausted your opportunity to be heard by the NDRB, the Applicant may petition the Board for Correction of Naval Records (BCNR), 701 South Courthouse Road, Suite 1001, Arlington, VA 22204-2490, or http://www.secnav.navy.mil/mra/bcnr/Pages/default.aspx for further review.

Appeal Procedures on NDRB Decision: If you contest the NDRB’s decision in your case AND you already contested the NDRB’s previous decision at a Personal Appearance Hearing or otherwise exhausted your opportunity before the NDRB (or it has been more than 15 years since your discharge), the Applicant may petition the Board for Correction of Naval Records (BCNR), 701 South Courthouse Road, Suite 1001, Arlington, VA 22204-2490, or http://www.secnav.navy.mil/mra/bcnr/Pages/default.aspx for further review.  The BCNR is the highest level of administrative review within the Department of the Navy/Marine Corps to correct errors or injustices to member’s records.

Complaint Procedures on Format: If you believe the decision in your case is ambiguous, not responsive to the issues you raised, or does not otherwise comport with the decisional document requirements of DoD Instruction 1332.28, you may submit a complaint in accordance with Enclosure (5) of that Instruction to the Joint Service Review Activity (JSRA), OUSD (P&R) PI-LP, The Pentagon, Washington, DC  20301-4000.  You should read Enclosure (5) of the DoD Instruction 1332.28 before submitting such a complaint.  This complaint procedure does not permit a challenge on the merits of the NDRB’s decision; the JSRA is designed solely to ensure that the NDRB decisional documents meet applicable requirements for clarity and responsiveness.  Therefore, if you are contesting the merits of the NDRB’s decision and already had a NDRB personal appearance hearing or otherwise exhausted your opportunities before the NDRB, the Applicant may appeal/petition the Board for Correction of Naval Records (BCNR), 701 South Courthouse Road, Suite 1001, Arlington, VA 22204-2490, or http://www.secnav.navy.mil/mra/bcnr/Pages/default.aspx for further review.

Service [VA] Benefits: The U.S. Department of Veterans Affairs (VA) determines eligibility for post-service benefits, not the NDRB.  The NDRB has no authority to upgrade a discharge for the sole purpose of facilitating access to VA benefits.  Regulations limit the NDRB’s review solely to a determination of the propriety, equity, and clemency of a discharge.  Consequently, the Applicant should petition the VA, which determines eligibility for post-service benefits.  The VA conducts its own determination of eligibility based on service records and input from an Applicant upon their request.  (See www.va.gov/discharge-upgrade-instructions).  Therefore, if the NDRB grants a change to a discharge, the NDRB will notify the Commander, Navy Personnel Command or Commandant of the Marine Corps that the DD 214 be corrected as appropriate; however, it is the Applicant’s responsibility to ensure these changes are incorporated into the record by the respective Service Headquarters.  Further, it is the Applicant’s sole responsibility to submit these changes to the VA for a determination of eligibility for VA Benefits.  Finally, the Applicant should refer to the Veterans Administration website (https://www.va.gov/) for information regarding VA benefits and healthcare.  Additionally, Veterans in acute suicidal crisis can go to any VA or non-VA health care facility for emergency health care at no cost – including inpatient or crisis residential care for up to 30 days and outpatient care for up to 90 days.  Veterans do not need to be enrolled in the VA system to use this benefit.  In order to find the nearest VA office to receive assistance with determining VA eligibility/access, the Applicant should refer to https://www.va.gov/find-locations. 

Employment/Educational Opportunities: The NDRB has no authority to upgrade a discharge for the sole purpose of enhancing employment or educational opportunities.  Regulations limit the NDRB’s review to a determination of the propriety and equity of the discharge.

Reenlistment/RE-code: The NDRB has no authority to upgrade a discharge for the sole purpose of enhancing reenlistment opportunities.  An unfavorable “RE-CODE” is, in itself, not a bar to reenlistment.  A request for a waiver can be submitted during the processing of a formal application for reenlistment through a recruiter.

Medical Conditions and Misconduct: DoD disability regulations do not preclude a disciplinary separation.  Appropriate regulations stipulate that separations for misconduct take precedence over potential separations for other reasons.  Whenever a member is being processed through the Physical Evaluation Board, and is processed subsequently for an administrative involuntary separation or is referred to a court martial for misconduct, the disability evaluation is suspended pending the outcome of the non-disability proceedings.  If the action includes either a punitive or administrative discharge for misconduct or for any basis wherein an Other Than Honorable discharge is authorized, the medical board report is filed in the member’s terminated health record.  Additionally, the NDRB does not have the authority to change a narrative reason for separation to one indicating a medical disability or other medical related reasons.  Only the BCNR can grant this type of narrative reason change.

Automatic Upgrades: There is no law or regulation that provides for an unfavorable discharge to be upgraded based solely on the passage of time or good conduct subsequent to leaving naval service.

Post-Traumatic Stress Disorder and/or Traumatic Brain Injury: For all claims involving PTSD and/or TBI, the NDRB’s review implemented the guidance set forth in the SECDEF Memorandum of 3 September 2014 (Supplemental guidance to Military Boards for Correction of Military/Naval Records Considering Discharge Upgrade Requests by Veterans Claiming Post Traumatic Stress Disorder).  In accordance with U.S. Code, Title X, Section 1553 (d)(1) & (d)(2), the NDRB included a member who is a physician, clinical psychologist, or psychiatrist and accorded the case sufficient priority to achieve an expedited resolution and a final decision.  If the Applicant’s claim of PTSD/TBI was based in whole or in part on sexual trauma, intimate partner violence, or spousal abuse, the NDRB obtained a review by a psychiatrist, psychologist, or social worker with training on mental health issues associated with PTSD/TBI or other trauma.  

Post-Service Conduct: The NDRB is authorized to consider post-service factors in the recharacterization of a discharge.  Outstanding post-service conduct, to the extent such matters provide a basis for a more thorough understanding of the Applicant’s performance and conduct during the period of service under review, is considered during Board reviews.  Documentation to support a post-service conduct upgrade includes, but is not limited to: a verifiable continuous employment record; marriage and children’s birth certificates (if applicable); character witness statements; documentation of community or church service; certification of non-involvement with civil authorities; evidence of financial stability or letters of good standing from banks, credit card companies, or other financial institutions; attendance at or completion of higher education (official transcripts); and documentation of a drug-free lifestyle.   The Applicant is advised that completion of these items alone does not guarantee the upgrade of an unfavorable discharge, as each discharge is reviewed by the Board on a case-by-case basis to determine if post-service accomplishments help demonstrate that in-service misconduct was an aberration and not indicative of the member’s overall character.

Issues Concerning Bad-Conduct Discharges (BCD): Because relevant and material facts stated in a court-martial specification are presumed by the NDRB to be established facts, issues relating to the Applicant’s innocence of charges for which he was found guilty cannot form a basis for relief.  With respect to a discharge adjudged by a special court-martial, the action of the NDRB is restricted to upgrades based on clemency.  Clemency is an act of leniency that reduces the severity of the punishment imposed.  The NDRB does not have the jurisdictional authority to review a discharge or dismissal resulting from a general court-martial.

Board Membership: The names and votes of the members of the NDRB Board are recorded on the original of this document and may be obtained from the service records by writing to: Secretary of the Navy Council of Review Boards, Attn: Naval Discharge Review Board, 720 Kennon Street SE Rm 309, Washington Navy Yard DC  20374-5023.

Military Sexual Trauma: The Department of Veterans Affairs (VA) uses the term "military sexual trauma" (MST) to refer to experiences of sexual assault or repeated, threatening sexual harassment experienced while on federal active duty, active duty for training, or inactive duty training.  To get confidential one-on-one help please contact the MST Coordinator at your nearest VA Medical Center or Call Safe Helpline at 1-877-995-5247 or visit www.mentalhealth.va.gov/msthome.asp.

Reporting Military Sexual Trauma: To report a military sexual trauma, you can make an anonymous report to the Naval Criminal Investigative Service (NCIS) by Text or Online.  The NCIS Tip Line provides service members, veterans and civilians a safe, discreet and ANONYMOUS option to report criminal and force protection threats within the USN and USMC without concerns of retaliation.  To report a crime by Text: Text 274637 (CRIMES); Type “NCIS” at the top of the message; and include as much detail as possible to ensure your tip can effectively be investigated.  To send your ANONYMOUS Tip via the online, go to https://www.tipsubmit.com/webtipsNAV.aspx?AgencyID=840.

Suicide Prevention: Veterans in emotional crisis or their loved ones can call the free and confidential Veterans Crisis Line at 1-800-273-8255 (then press 1); or chat online at http://www.veteranscrisisline.net, or send a text message to 838255 to connect with a caring, qualified Veteran Affairs Responder who can deal with any immediate crisis.  Additionally, Veterans in acute suicidal crisis can go to any VA or non-VA health care facility for emergency health care at no cost; you can use this benefit regardless of your discharge status, or enrollment in VA health care.  In order to find the nearest VA office to receive assistance, see Find your nearest VA medical center.