Current Discharge and Applicant’s Request

Application Received: 20230410
Characterization of Service Received:   
Narrative Reason for Discharge:   PATTERN OF MISCONDUCT
Authority for Discharge:   MILPERSMAN 1910-140 [PATTERN OF MISCONDUCT] 

Applicant’s Request:	Characterization change to:	
Narrative Reason change to: SECRETARIAL AUTHORITY
Reentry Code change to: REQUESTED, BUT NOT SPECIFIED

Summary of Service

Prior Creditable Service:
Inactive:	 	           	Active:	 

Period of Service Under Review:
Date of Enlistment:  20090708	Age at Enlistment:  
Period of Enlistment:   Years   Extension
Date of Discharge:  20130628	Highest Rank/Rate:  GSMFN
Length of Service:  03  Year(s)  11  Month(s)  21  Day(s)	
Education Level:  12	AFQT:  80
Deployment/Operation: 

Evaluation Marks (# of occasions):  Performance/Proficiency: 3.0 (3)   Behavior/Conduct: 2.33 (3)   OTA: 2.95 
Fitness Reports: 

Awards and Decorations (per DD 214):	NDSM GWOTSM GCM OSR(x3) SSDR(x3) HSM NAVY "E" JMUC 

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

SCM:    SPCM:    CIVIL ARREST:   CC:   

NJP:  NFIR – Legal Counsel states SNM has two NJP’s. No disciplinary action is captured in applicants OMPF.

Retention Warning Counseling:  NONE

NDRB Documentary Review Conducted (date):	20210427
NDRB Documentary Review Docket Number:	ND20-01141
NDRB Documentary Review Findings:		Proper as issued and that no change is warranted.

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.  Naval Military Personnel Manual, (NAVPERS 15560D), Change 40, effective 21 July 2012 until 10 November 2021, Article 1910-140, SEPARATION BY REASON OF MISCONDUCT - PATTERN OF MISCONDUCT.

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 contends that his PTSD mitigates his misconduct.
2.	The Applicant contends that his in-service conduct warrants an upgrade.
Discussion

Date:  20231120		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. A review of the record revealed that the Applicant did not deploy in support of a contingency operation, and so this case did not warrant an expedited review in accordance with § 1553.

The Applicant's record of service included:

  for  of the Uniform Code of Military Justice (UCMJ): 

: The Applicant contends that his minor misconduct is mitigated by his PTSD and does not rise to the level of an Other than Honorable characterization.

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 mitigated the underlying basis/misconduct for the discharge; and d) the condition/experience outweighed 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, 
USN:  ADJUSTMENT DISORDER (against background of childhood trauma) WITH ANXIETY AND DEPRESSED MOOD;
 ALCOHOL DEPENDENCE (ALCOHOLISM); 
OCCUPATIONAL PROBLEMS (SEVERE), 
(claimed but undocumented PTSD).
VA: PTSD (9 years post discharge)	
2.	A.	Were these conditions present at time of misconduct?	Yes (uncertain regarding PTSD)	
	B.	Were these conditions mitigating for the misconduct?	Yes, though less than exculpatory.	
3.	Were all required mental health and/or medical evaluations conducted in accordance with regulations, prior to the administrative separation of the applicant?	Yes, though full discharge physical exam not located	
4.	Medical Board Member comments:	HISTORY INCLUDES (Note bolding added either for clarity or emphasis):

PRIOR TO ENLISTMENT:

FAMILY HISTORY:  
Autism (Older Brother).

DEVELOPMENTAL HISTORY: 

Per 26 Apr 2013 AHLTA note: “[Childhood included:] Patient was born and raised in Indianapolis, IN by biological parents until they divorced when he was about 3 years old. The patient stated that…his father re-married when he was about 4 or 5 and that his step mother and he never got along. The patient stated that his parents had joint custody and that he was physically, mentally, and verbally abused by his step mother and father [resulting in recurrent suicidal ideation]. The patient also stated that his mother’s family constantly judged and isolated themselves from them because of his mother’s lifestyle (of her being a lesbian) and his brother being autistic. The patient stated the he has always tried to help out his mother and brother and stated that he is very close to them. The patient also stated that he has not seen nor talked to his father since he was 16 years old.”  5 Jan 2021 VA mental health note, added. “

“He states that the only time he’s had thoughts of hurting himself where [sic] when he was middle school because of struggles in his home. [PAH testimony suggested the strongest impulse occurred on an occasion when he jumped from a tree with the knowledge his father was below and, indeed did, catch him].” [A 5 Jan 2021 VA Mental Health Note added, “…the only time he’s had thoughts of hurting himself where [sic] when he was middle school because of struggles in his home.”]

“[Per “PETITION,” the Applicant]…knew he wanted to join the Navy from an early age.I7 He participated in Boy Scouts of America for 12 years before joining the U.S. Naval Sea Cadets as a teenager.18 [The Applicant]…had an insatiable desire to serve his country and to help others through service. His lifelong dream finally came true when he began active service with the U.S. Navy on July 8, 2009.19”

Education Level:   12

MEPS:  
     AFQT:   80

08 Jul 2009—ENLISTMENT: @ Age 22

30 Jul 2009—“The Patient is an 18 year old male.
He reported: Encounter Background Information: Seaman Recruit presents for special physical for NSW/ SO (BUD/S) duty…Please see completed for DD 2807-1 and DD2808. No barriers to learning. Pt is motivated to follow treatment plan and recommendations”

VOLUNTARY WITHDRAWAL from BUD/S training.

“[Per “PETITION] trained to become a Gas Turbine Systems Technician Mechanical (GSM) and was soon deployed on the U.S.S. COWPENS.”

2010—1st OFFENSE: trouble falling asleep and depression; struggled to awake in a.m.; overslept and arrived late for work. NO RECORD OF NJP.

2011—

“Pt shared that he has had on-going depressive symptoms [and ‘increased alcohol abuse’] since his uncle’s death in 2011.”

SOMETIME, PRESUMABLY, BETWEEN 12 Mar and 14 May 2011—Aboard the USS COWPENS:  The Applicant participated in Operation Tomodachi (in wake of a devastating earthquake and Tsunami that struck Japan)…including, reportedly participating in contamination clean up operations aboard the  (“was frightening” due to radiation risk).  “After successfully completing the relief efforts in Japan, [he] …[Per “PETITION”] felt he was doing his part to help others, realizing the goals he set for himself when he joined the military.”

07 Mar 2013—ETOH drinking “with other Sailor…overslept…BAC .078/.002 BELOW THE LEGAL LIMIT.”  Note: this sample would appear to have been taken at least 6 hours post previous night’s drinking, thereby, suggesting a BAC likely significantly higher at 11 pm (when he reportedly fell asleep form his imbibing).

2nd NJP:  Recommended for GUHC for dereliction of duty.

25 Apr 2013—Yokosuka “Mental” Diagnosis Record: “ADJUSTMENT DISORDER WITH ANXIETY AND DEPRESSED MOOD (309.28)”

26 Apr 2013—“USNH YOKOSUKA MENTAL HEALTH CLINIC
PROGRESS NOTE” signed by a LT/MSC/USN/LCSW MH Clinic USNH Yokosuka:

“Patient (pt) is a 22y/o…w/ 3 years and seven months CAD w/the Navy. Pt’s EAOS is in May. Clinician met w/pt on 25 APR 2013 from 1115 to 1215 at the Mental Health Clinic from a referral from SARP counselor MA1 _______. The limits of confidentiality were reviewed prior to the start of treatment and the patient stated that he understood; he denied any barriers to learning or participating in psychotherapy.”

CC/HPI
Current Session (60 minutes): Pt was referred by SARP counselor ______MA1 to discuss possible treatment options. Pt reports that he is currently awaiting a response to his recent Captain’s Mast. Pt states that he should find out tomorrow if he is going to remain in the Navy or being administratively separated. Pt states that this is his second Captain’s Mast w/this command. This most recent one was for being UA and disobeying an order. Alcohol was
involved so pt was referred for a SARP assessment. Pt was recommended to outpatient treatment by the SARP counselor however it’s unsure if he’ll be able to attend. Pt’s EAOS is also scheduled for May 4th. He states that he wants out of the Navy due to what he sees are multiple injustices from his command. 

“[FROM 05 JAN 2021—VA Outpatient Mission Valley Consult Note
 (see below):] Reports trauma from childhood, abuse from step-mother, ‘then some stuff from upper chain of command’ regarding feelings of mistreatment that brought back memories of growing up.’

Pt shared a long history of multiple interactions that have led up to his most recent situation. Pt shares little responsibility for most of what’s occurred in his Navy career. He blames most of what’s happened to him on his command. Pt shared that he has had on-going depressive symptoms since his uncle’s death in 2011. 

(ALSO from below “JAN 05, 2021—VA Outpatient Psychiatry Consult Note:”  “Pt reports he has been diagnosed with bipolar, PTSD, depression, and anxiety being treated in the last 2.5 years [hence, starting ~July 2019]. He has been seeing psychiatry in the community, but wants to transition to the VA for care…”)
However, he never considered getting help because “if I can’t help myself, no one can.” Pt states that he’s always been use to helping others and being the strong one, so he’s never considered getting help for himself. Clinician utilized supportive confrontation to challenge some of the rigid thinking he displays in terms of asking for help. He states that he would be more willing to get help if there was more time. However, due to the pending decision on his career and his EAOS, he does not see how therapy could be beneficial. He denies any active suicidal and/or homicidal ideation. He states that the only time he’s had thoughts of hurting himself where [sic] when he was middle school because of struggles in his home. Pt was encouraged to return to therapy should he find the need for support or guidance.
(O) MSE: Pt presented on time; groomed appropriately, wearing the uniform of the day. Pt was calm and cooperative during the interaction. Pt was very open with information. Mood was calm and affect was mood congruent and appropriate to situation. Pt’s speech was of normal intensity, volume, and tone. Pt presents w/no psychomotor agitation or retardation. Pt denies and does not present w/any symptoms of psychosis or auditory, visual, tactile, or olfactory
hallucinations. Pt’s thoughts were linear and logical. Thought content was help-seeking.   Insight was fair; judgment and impulse present intact. Pt’s concentration was appropriate and consistent throughout the session. Pt denies any current suicidal and/or homicidal ideation.
DSM-IV DIAGNOSIS:
AXIS I: Adjustment D/O w/Mixed Depression and Anxiety
Alcohol Abuse [No mention of PTSD]
AXIS II: Diagnosis Deferred on Axis II
AXIS III: None
AXIS IV: Occupational Problems (Severe)
AXIS V: GAF= 65-68 (current)
(P) RECOMMENDATIONS/TREATMENT PLAN:
…The patient does not want or need acute psychiatric hospitalization at this time…”

25 & 26 Apr 2013—Naval Hospital Yokosuka STR Notes for:
ALCOHOL ABUSE & ADJUSTMENT DISORDER WITH ANXIETY
AND DEPRESSED MOOD

“This 22 year old, single, Caucasian, male, Active Duty GSMFN/E-3 USN, 3 year 9 months of active duty service and about 3 year 2 months in Japan assigned to USS Antietam (CG-54) (UIC: 21387). The patient command referred to SARP for a substance abuse evaluation IAW DAPA paperwork dated 22 APR 2013: On 07 MAR 2013 GSMFN [the Applicant]… overslept for work and when he arrived at approximately… he was administered a breathalyzer test that resulted in a BAC of .075. The patient went to NJP for Unauthorized Absence and Drunkenness and was awarded and was awarded 65/45 restriction/extra duty, forfeiture of1/2 months pay 2 X months, and reduction in pay grade. The patient was briefed on the limits of confidentiality and denied any SI/HI. The patient appears receptive to discussing/exploring potential issues in her [sic] life. Patient reported a current pain level of 0 on a scale of 1-10. Provisional diagnosis is 303.05 Alcohol Abuse and recommends Outpatient Treatment ASAMS Level 1.

 ADJUSTMENT DISORDER WITH ANXIETY AND DEPRESSED MOOD on 26 Apr 2013

04 May 2013—REPORTED OFFICIAL EAOS DATE [See above].

???14 or 17 May 2013—NH Yokosuka ALCOHOL DEPENDENCE (ALCOHOLISM) (303.90) Encounter Date Clinic Clinician Facility Nutrition note
 
17 May 2013—Naval Hospital Intensive Outpatient Program completion:

“The patient is a 22 year old, single, Caucasian, male, Active Duty GSMFN/E-3, assigned to with 3 year 9 months of active. The patient met criteria for Alcohol Abuse (305.00) as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The patient was diagnosed with substance use disorder by______ LCSW, LT, MSC, USN, at the Substance Dependence Rehabilitation Program (SARP), U.S. Naval Hospital, Yokosuka, Japan on 06 MAY 2013 and admitted in the (ASAM Level 1.0) Outpatient Treatment Program on 17 MAY 2013.

SUBSTANCE USE HISTORY:
The patient command referred on 07 Mar 2013 after he overslept for work and when he arrived late and was administered the breathalyzer test that resulted in a BAC of .075. The patient went to NJP for Unauthorized Absence and Drunkenness and was awarded was awarded 45/45 restriction/extra duty,
forfeiture of 1/2 months pay X 2 months, and reduction in pay grade. The patient stated that he has gained an awareness that hat his drinking is excessive and potentially self destructive, which could interfere with his Navy career if not curtailed. The patient's first use of alcohol was at 19 years old in the
amount of I mixed drink, at ages 16-19 his consumption was 1 mixed drink 2-3 X a year, at age 20 he was consuming 1 beer 1-2 X a week on weekends, at age 21 he was consuming 7-8 mixed drinks 3-4 X per week, at age 22 he was consuming 3-4 mixed drinks -3-4 X per week, at age 22 3-4 mixed drinks 6-7
days a week, and on the night of his incident he consumed 10 + mixed drinks. The patient reported last use of alcohol was on 07 MAR 2013 in the amount of 10 + mixed drinks. Patient GSMFN _______ current tobacco usage of ½ pack of cigarettes a day & ½ of chewing tobacco a week.  

21 May 2013—LT MSC USN Mental Health Clinic AHLTA NOTE: 
“Primary Dx: NO PSYCHIATRIC DIAGNOSIS OR CONDITION ON AXIS I
Subjective / Objective:
This patient did not present for today’s out-patient therapy appointment. Records were reviewed to assess if patient represents a potential safety risk and if active intervention is necessary to reduce this risk.”
 
21 Jun 2013—FITREP:  SIGNIFICANT PROBLEMS
ITA=2.67
Evaluation submitted on the occasion ¢:t  GSN:f'N·P. rson's Administrative Separation Under General Condition. 
Block 36.  Repeated discipline issues.  GMFN __________ is a sincere Sailor who didn't acclimate to shipboard living.”

ARMED FORCES PHYSICAL EXAM, ABBREVIATED SEPARATION (V70.5)
Encounter Date Clinic Clinician Facility
28 Jun 2013
 
28 Jun 2013—1. ARMED FORCES PHYSICAL EXAM, ABBREVIATED SEPARATION(PHYSICAL EXAM, ABBREVIATED SEPARATION): Fit for
Separation
Reviewed DD Form 2807 & 2697
Signed / Completed SF 600

OATil

!i!::b!

“Chief complaint
The Chief Complaint is: Seps Physical.
History of present illness
The Patient is a 22 year old male.
History was placed in error and meant for a different sailor. Correct hx is annotated below on SF 600. AHLTA was down during this
appointment. Member is still fit for separation.
<<Note accomplished in TSWF-CORE>>”

28 Jun 2013—DISCHARGE:  GUHC/DD214 in OMPF
ENLISTMENT Details: PATTERN OF MISCONDUCT 
Length of Service:  03 Year(s)  11  Month(s)  21  Day(s) () [? EAOS?]
 Performance/Proficiency: 3.0 (3)   Behavior/Conduct: 2.33 (3)   OTA: 2.95

POST SEPARATION:

Per Applicant’s PAH testimony, he returned home to a cool reception reminiscent of prior to enlistment conflicts/abuse and given, a “bus ticket” to elsewhere.

“[From below 05 JAN 2021 Note] Reports when he got out of the Navy, ‘did a bunch of drugs, for a long time. Made a bunch of bad decisions, used to drink a lot, also drank a lot when I was in the Navy.’"

2017-2018—Started regular use of THC (when “legalized”) to cope with psychological issues, per Applicant’s PAH testimony but discontinued due to health risk related concerns.

~July 2019 (about 6 years post discharge)—Reportedly, began treatment in the “civilian community [eventually resulting in diagnoses of] bipolar, PTSD, depression, and anxiety.”

17 Feb 2021—NDRB ND20-01141:  Reportedly, the Applicant contended active duty adjustment adversely affected due to he was dealing with “serious family issues…disciplinary problems were the result of stress caused by the death of his uncle.”  No claim of PTSD.  NDRB unanimous vote was for a recommendation of NO CHANGE.

07 Aug 2022 (~9 years post discharge)—Effective Date of VA Evaluation of a 100% disability for 
“9411-POST-TRAUMATIC STRESS DISORDER” with no supporting Compensation & Pension/clinical history included.

05 JAN 2021—VA Outpatient Mission Valley Consult Note
STANDARD TITLE: PSYCHIATRY OUTPATIENT CONSULT: 
“Pt reports he has been diagnosed with bipolar, PTSD, depression, and anxiety being treated in the last 2.5 years. He has been seeing psychiatry in the community, but wants to transition to the VA for care. Takes sertraline 200mg, bupropion 200mg daily, hydroxyzine

Reports trauma from childhood, abuse from step-mother, "then some stuff from upper chain of command" regarding feelings of mistreatment that brought back memories of growing up. Reports sleep is ok, not having dreams or nightmares of past events. Reports he does not really remember anything from growing up, but also states his step mother was abusive, always smacking him around. "she would smack me for everything." Says he was a small child, she was significantly overweight, outweighing him by a lot. Says "I was always the focus of her rage about everything." Also says about intrusive memories, " I guess they pop up once in a while. Says he feels somewhat on edge. Reports symptoms of PTSD have been on and off. He was seeing a therapist weekly, but due to insurance changes, he was not able to continue. Regarding bipolar disorder, says "I would swing from highs to lows. Feeling like I was on top of the world, then feel depressed, SI, all the time." Says he was more having intrusive thoughts of death or vague SI. Reports when he got out of the Navy, "did a bunch of drugs, for a long time. Made a bunch of bad decisions, used to drink a lot, also drank a lot when I was in the Navy."

Reports mood has "not really" been low or depressed recently, "more feeling grey" wife had miscarriages this year so his mood went form feeling great, to then depressed, then more numb. Anxiety, reports he "worry all the time," feels tense on edge, and fatigued. Denies any panic attacks but history of feeling excessive anxiety build up, "then trying to calm myself down." Last time for this type of anxiety was two years ago. Worries about bills, worries about relationship. Continues to use cannabis daily. Dinks occasionally. No treatment history. He was separated from the Navy, OP treatment 2 weeks long in SARP, 2013. Reports his biggest concern currently is quitting smoking. Though he continues to use cannabis daily.
Mood wise, feels some feelings of being on edge, also feeling "blah." Feels
like he is more zoning off, or worrying to himself, feels more numb. Some libido problems as well. He denies any current thoughts of self harm.

----------Social Hx:
Grew up in Indiana living "on and off with mom and partner, and dad and step mother. Reports step-mother was physically and verbally abusive. Often would slap him around, "I was the target of her rage and hatred all the time. She would slap me in the face. " Reports he [and his older autistic brother per PAH testimony] has also sexually abused by an older boy in the neighborhood growing up. He is married, in second marriage, no children. Living with wife. Social supports are more limited to his wife, but also started talking to his mom more recently. Does not really have many friends. 
Currently he works delivering produce overnight to individuals. Denies any legal history. Denies any spirituality or religious. No real hobbies…

Assessment:
Biopsychosocial Formulation:
30yo married male with history of PTSD, mood disorder, and substance abuse including alcohol and heroine. He was raised in Indiana with mom and her partner, then dad and step mother. His step mother was verbally and physically abusive. He also reports sexual abuse from older neighborhood boy growing up. He has been divorced and now remarried. He has no children. He is working full time on nights. Current medications have been working well for him and he would like to continue for now. Will also place RCT for treatment planning. He is not interested in ADTP services, and continues to use MJ.

Diagnosis Code      Diagnosis
F43.10           Post-traumatic stress disorder, unspecified
F33.2           Major depressive disorder, recurrent severe without psychotic features
F12.20           Cannabis dependence, uncomplicated

03 Oct 2023—VA MENTAL HEALTH NURSE PRACTITIONER Note
DIAGNOSTIC ASSESSMENT:
Bipolar II disorder
Chronic PTSD, by Hx
PLAN:
Medication recommendations: Continue LITHIUM SA 900MG by mouth at bedtime for mood stabilization and chronic SI.

COMMENT:  
The Applicant’s formative background included a substantially harsh upbringing including Grew up in Indiana (socioeconomically disadvantaged neighborhood) living "on and off with mom and [her] partner, and dad and step mother...  [Parental authority set tone of harsh discipline, acquiescence to abuse and unwavering intolerance of complaint per PAH testimony]… step-mother was physically and verbally abusive. Often would slap him around, ‘I was the target of her rage and hatred all the time. She would slap me in the face.’  Reports he [and his older autistic brother per PAH testimony] had additionally been sexually abused by an older boy in the neighborhood…”  The foregoing cumulative challenges made him vulnerable to suicidal ideation and one possible ambivalent suicide attempt when he fell out of a tree in the presence of his father who “caught me [per moving PAH testimony].” 
 The Applicant appears to have found inspiration and psychological salvation in his abiding dedication to a future in Naval service, including the ambition to become a SEAL for which he physically prepared.  Against the above background, he looked forward to his enlistment only to have his hopes to become a SEAL dashed by experiencing physical difficulties and having second thoughts about the wisdom of attempting to persist in the prolonged training period, leading him to withdraw from BUD/S training which was unfortunately followed by suffering the tragic loss of his uncle to which he credited his misconduct as well as encountering what he perceived as an unhealthily, uncompromisingly intolerant command environment leading to what was diagnosed as an Adjustment Disorder and Alcohol Use Disorder for which he received IOP treatment.  The Service Treatment Record makes no reference to PTSD; and the Applicant indicated he made only one unrecorded and unfruitful attempt to share his concerns with a chaplain whom he viewed as connected to his command.
He reported “when he got out of the Navy, ‘did a bunch of drugs, for a long time. Made a bunch of bad decisions, [continued] to drink a lot…” the Applicant appears to have made remarkable strides at self- improvement (including seeking treatment and professional /personal development) eventually resulting in the additional diagnosis of Service Connected PTSD by the VA with a 100% disability at about 9 years post discharge in accord with evidentiary regulations governing VA determinations of Service Connection.  

Summary, considering his Adjustment Disorder likely would be considered as having been “chronic” (lasting longer than 3 months), it would no longer qualify as a Condition Not a Disability.  Accordingly, while less than exonerating, a mitigating nexus between the Applicant’s formally diagnosed (arguably Chronic) Adjustment Disorder and the misconduct resulting in his discharge warrants consideration.	

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 accordance with the above, the Board found the Applicant’s service generally meets the standard of acceptable conduct and performance for naval personnel. In making its determination, the Board considered the Applicant’s conduct forms the primary basis for consideration.  The Applicant’s in-service conduct included two nonjudicial punishments for alcohol related incidents; this was a willful failure to meet the requirements of his contract honorably.  However, the Applicant contends his undiagnosed PTSD as well as his diagnosed mental health condition were mitigating factors in his misconduct.  The Applicant’s official military service record diagnosis of adjustment disorder, coupled with additional post-service diagnosis of PTSD provided by the Applicant, support the Applicant’s contention that his PTSD was a mitigating factor associated with the in-service misconduct.

The Applicant was the subject of two nonjudicial punishments for alcohol related incidents. The first nonjudicial punishment was due to the Applicant oversleeping due to excessive alcohol consumption the night before.  In this incident, the Applicant did not miss the entire day of work and was only charged for being late.  The second offense was due to the Applicant showing up to work under the influence of alcohol.  In review of the Applicant’s misconduct, the NDRB identified the repetitive nature of his commissions, but did not observe acts that rose to the level of significant misconduct.  The Board viewed the Applicant’s misconduct as disciplinary infractions that compromise the rank and structure of a military organization, but none that jeopardized the reputation of the Marine Corps, endangered the lives of others or compromised the integrity of the Applicant.  While the record of evidence does reflect disciplinary issues that required corrective action and punishment, these acts do not merit an enduring General (Under Honorable Conditions) discharge.  Based on the Applicant’s record of service, the NDRB determined the Applicant’s service generally meets the standard of acceptable conduct and performance for Naval personnel.  In review of the issues raised by the Applicant and in context of his complete record of service, the Board determined that an upgrade was warranted.  By unanimous vote, the NDRB voted to upgrade the Applicant’s discharge with a corresponding narrative reason for the discharge of Secretarial Authority.

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  HONORABLE, the narrative reason for separation shall  SECRETARIAL AUTHORITY with a corresponding separation code of jff, and the reentry code shall  RE-4.  The Applicant is not eligible for further reviews by the NDRB.  The Applicant may petition the Board for Correction of Naval Records, 701 South Courthouse Road, Suite 1001, Arlington, VA 22204-2490 for further review using DD Form 149.  

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.