IN THE CASE OF: BOARD DATE: 12 February 2015 DOCKET NUMBER: AR20140019555 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documents provided, if any). 2. Military Personnel Records and advisory opinions (if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests reconsideration of the previous Army Board for Correction of Military Records (ABCMR) decisions promulgated in Docket Numbers AR20040007339, dated 7 July 2005 and AR20130014701, dated 22 April 2014, wherein he requested: * an upgrade of his under other than honorable conditions (UOTHC) discharge * correction of his DD Form 214 (Armed Forces of the United States Report of Transfer or Discharge) to show his service in the Republic of Vietnam 2. The applicant states, in effect, that he has been diagnosed with post-traumatic stress disorder (PTSD) and that PTSD was the catalyst for his misconduct. He received a gunshot wound to his right hand and he was stabilized in a hospital in Vietnam. He was subsequently transferred to the 249th Army Hospital in Asaka, Japan. After several days there, he was flown back to Fort Polk, Louisiana. He began departing absent without leave (AWOL) after his arrival at Fort Polk. He tried to tell his superiors and doctors that something was wrong with him. After numerous instances of AWOL he was discharged with a UOTHC character of service. 3. The applicant provides: * ABCMR Docket Numbers AR20040007339, dated 7 July 2005, and AR20130014701, dated 22 April 2014, with allied documents * letters from the Army Review Boards Agency (ARBA), dated 14 November 2014 and 13 November 2014 * an email message from the office of his Member of Congress, addressed to Headquarters, Department of the Army, Office of the Chief, Legislative Liaison (OCLL), dated 6 November 2014 * a letter from his Member of Congress to OCLL, dated 5 November 2014 * a letter from ARBA to his Member of Congress, dated 3 November 2014 * a privacy act release form, dated 28 October 2014 * his letter to his Member of Congress, dated 22 October 2014 * an email message from the office of his Member of Congress to OCLL, dated 21 October 2014 * his letter to the Secretary of Defense (SECDEF), dated 21 October 2014 * letters from the Department of Veterans Affairs (VA), dated 16 October 2014 and 3 November 2006 * a memorandum from the SECDEF, dated 3 September 2014, subject: Supplemental Guidance to Military Boards for Correction of Military/Naval Records Considering Discharge Upgrade Requests by Veterans Claiming PTSD * a psychological report from a civilian psychologist, typed on 5 March 2013 * a letter from the Social Security Administration (SSA), dated 4 March 2013 * VA Form 21-0960A (Ischemic Heart Disease (IHD) Disability Benefits Questionnaire), dated 24 May 2012 * numerous pages of various military medical and personnel records * numerous pages of various civilian medical records * a letter from his employer, dated 4 June 2014 * a letter from his wife, dated 23 September 2014 * a form/statement/invoice from the State of Louisiana, Disability Determinations Authorization and Check Requisition, Office of Economic Stability and Self-Sufficiency, dated 24 September 2014 * a report of psychological evaluation, dated 25 September 2014 * DD Form 214, for the period ending 16 February 1973 * two DD Forms 215 (Correction to the DD Form 214), dated 30 October 1975 and 5 June 2014 CONSIDERATION OF EVIDENCE: 1. Incorporated herein by reference are military records which were summarized in the applicant's previous cases by the ABCMR in Numbers AR20040007339, dated 7 July 2005 and AR20130014701, dated 22 April 2014. 2. The applicant enlisted in the Regular Army on 9 November 1967 for a period of 3 years. He completed basic training and advanced individual training at Fort Polk, LA and was awarded military occupational specialty 11B (Light Weapons Infantryman). 3. He received orders transferring him to Fort Lewis, Washington for movement to the Republic of Vietnam. His report date was 12 June 1968; however, he failed to report as ordered and was reported as being AWOL. He remained absent until 24 June 1968. 4. On 29 June 1968, he accepted nonjudicial punishment (NJP) under the provisions of Article 15 of the Uniform Code of Military Justice (UCMJ) for being AWOL from 12 June 1968 to 24 June 1968. 5. On 6 July 1968, he was transferred to Vietnam and assigned to Headquarters and Headquarters Company, 1st Battalion, 35th Infantry Regiment. On 25 July 1968, his right hand was injured while test firing a grenade launcher. The grenade exploded and hit him in the hand. 6. On 8 August 1968, he was medically evacuated for treatment to the 249th General Hospital in Japan. On 18 August 1968, he was transferred to the U.S. Army Hospital at Fort Polk, Louisiana. He arrived and was subsequently admitted to the hospital on 20 August 1968. 7. His DA Form 20 (Enlisted Qualification Record) shows he was AWOL from 28 August 1968 to 25 September 1968, dropped from the rolls (DFR) on 27 September 1968, returned to military control on or about 22 October 1969, and in pre and post trial confinement from 1 November 1969 to 26 May 1970. 8. On 16 December 1969, he was convicted by a general court-martial of being AWOL from 27 September 1968 to 22 October 1969. He was sentenced to a bad conduct discharge, a forfeiture of $10.00 per month for eight months, and confinement at hard labor for eight months. The bad conduct discharge was suspended for the period of confinement or until completion of the appellate review, whichever was the later date. The appellate review is not available. 9. His DA Form 20 shows he went AWOL from 3 September 1970 to 13 September 1970, and was then confined from 14 September 1970 to 18 September 1970. 10. A Federal Bureau of Investigation report, dated 17 September 1970, shows he was arrested by civil authorities on 8 September 1970 for interstate transportation of falsely made and forged securities. 11. His DA Form 20 shows he was AWOL/DFR from 19 September 1970 to 20 April 1971 and from 2 July 1971 to 23 January 1973. 12. On 31 January 1973, court-martial charges were preferred against him for being AWOL from 2 July 1971 to 24 January 1973. 13. On 30 January 1973, he underwent a mental status examination. The examining official stated his behavior was normal, he was fully alert and oriented, his mood was depressed and level, his thinking was clear, his thought content was normal, and his memory was good. The examining official indicated that while the probability of further rehabilitation was poor, the applicant had no significant mental illness, he was mentally responsible, able to distinguish right from wrong and adhere to the right, and he had the mental capacity to understand and participate in board proceedings. It was also noted that he met retentions standards. 14. On 31 January 1973, he consulted with legal counsel and voluntarily requested discharge for the good of the service under the provisions of Army Regulation 635-200 (Enlisted Separations – Enlisted Personnel), chapter 10. In doing so, he admitted guilt to the offense charged and he acknowledged that he might encounter substantial prejudice in civilian life and that he might be ineligible for many or all Army benefits administered by the VA if an undesirable discharge was issued. He elected to submit statements in his own behalf. He provided two statements, wherein he indicated/stated: a. When he went AWOL the first time he got into trouble with some other people and was picked up for AWOL at the same time he was picked up for the trouble he had gotten into and returned to military control. He returned to duty and went AWOL again after he had his court-martial and completed his confinement. During this period of AWOL, he was picked up by [civil] authorities for his old charges [interstate transportation of falsely made and forged securities]. b. He felt he had not lived up to the UCMJ and for that reason, he asked to be discharged for the good of the service. 15. On 12 February 1973, the separation authority approved his discharge under the provisions of Army Regulation 635-200, chapter 10 for the good of the Service with issuance of an Undesirable Discharge Certificate. 16. On 16 February 1973, he was discharged in the rank/grade of private (PVT)/E-1, under the provisions of Army Regulation 635-200, chapter 10 for the good of the service with a UOTHC character of service (undesirable discharge). His DD Form 214 shows he completed 1 year, 3 months, and 25 days of active military service with 1,442 days of lost time due to AWOL and confinement. 17. On 25 November 1975, he was granted a clemency discharge pursuant to Presidential Proclamation 4313 of 16 September 1974 and he was issued a DD Form 215. He was informed that he could apply to the Army Discharge Review Board (ADRB) for review and possible change of his discharge. 18. The applicant applied to the ADRB on an unknown date. His personnel records contain a document from a Project Officer at the ADRB which indicated the applicant's case was returned without action because he was not qualified for Project 4313 or the Extension. This document indicated that the applicant had no record of being wounded in action or receiving awards for valor. 19. On 22 April 2014, the ABCMR granted his request for correction of his DD Form 214 to show his foreign service in the Republic of Vietnam. On 5 June 2014, a DD Form 215 was issued that amended his DD Form 214 as follows: a. item 22c (Foreign and/or Sea Service) was amended to show he completed 1 month and 16 days of foreign service; and b. item 30 (Remarks) was amended to add the entry "Service in Vietnam 6 July to 21 August 1968." 20. He provided a Psychological report, dated 5 March 2013 that shows he was seen by a clinical/medical psychologist on 26 February 2013. The examining psychologist stated/found that based on the applicant's history/record review and a clinical interview: a. The applicant was seen at the request of Dr. Dxx Lxxxxxxx. The applicant had been experiencing some mental health functioning problems and health problems for quite some time. The applicant noted he was a member of the U.S. Army on and off for about 5 years. He received a general discharge. His rank upon discharge was PFC and he notes he never rose above PFC. He was in the Vietnam combat arena for two months and had battlefield experience when he received the injury to his right hand. He notes he eventually returned to the United States and about 6 months after that the problems began to surface. He has a history of being AWOL on multiple occasions and was even court-martialed. He reports he continues to have occasional intrusive auditory recollections of his war-time experiences and to some degree perhaps they have gotten worse as he has aged. He has been in trouble with law enforcement twice in his life, the last time being in 1992 for forgery. b. In terms of general health he notes that he has high blood pressure, high cholesterol, and he had one heart bypass surgery in May 2012. He has chronic obstructive pulmonary disease; he had an aneurysm in 1986 with neurosurgery and clipping; and he has acid reflux. He also notes he has arthritis which leads to constant and variable pain. He notes his mental health is not good and feels it has been this way for over 40 years or since his military experience. He previously has one mental health contact and that was secondary to his aneurysm. He was on a number of prescriptions, none of which were psychoactive. He noted his sleep was chronically restless with occasional bad dreams. He also noted the bad dreams have increased following, and his appetite has decreased since his heart surgery. His energy is poor, he tires easily, and his libido is poor. He usually keeps to himself and tends to avoid crowds. His general routine was nondescript. His primary hobby or pleasure was listening to music. Occasionally he helps with food preparation or household chores. He can manage independent and local travel and is able to shop, manage money, communicate and manage time independently. c. On examination it was noted the applicant was verbally receptive and he had expressive language skills that were good for every day conversational purpose. His dress and groom was good. His social skills were good. His recent and remote memories were intact. His ability to attend and concentrate was good. His intellect appeared to be within normative limits. His judgment, reasoning, and reflective cognition were good. His insight was fair to good, his cognitions clear and cogent, and his mood one of agitated dysphoria and his affect was mood congruent. There was no evidence of hallucinatory phenomena, though again he noted occasional intrusive auditory recollections of wartime experience. He noted a chronic mistrust of others. There was no suicidal ideation but there was occasional reactive assaultive ideation. His self-image was positive with positive goal orientation. He noted frequent frontal headaches but no dizziness. He is a chronic worrier. He is easily upset and usually tends to attempt to escape to avoid the stressor. He has occasional dysphoria with infrequent crying spells. There was occasional but brief happiness. He indicated he was happy 50 percent (%) of the time and sad 50% of the time. He was alert, oriented, and responsive to all four spheres. He was polite, cooperative, and tried his best. d. The examining psychologist's impressions and recommendations were that the applicant had some long standing mental health problems. The examining psychologist states "The impression would be one of a PTSD (DMS-IV, 309.81), chronic, untreated, with a degree of impairment moderate and prognosis fair and this seemingly extends back to his military years; dysthymic Disorder (DSM-IV, 300.40), chronic untreated with a degree of impairment moderate and prognosis fair; complaints of chronic pain; and a personality disorder, not otherwise specified (DSM-IV, 301.90) with avoidant features. 21. He provided 8 pages of medical records that appear to be from the same medical facility or a "Physicians Group." The print quality of these records is poor in that the edges/or margins on the left hand side have been cut off short. As such, the full name of the treatment facility and information pertaining to the dates and types of treatment he received are not fully visible. Nevertheless, these pages show various treatments or prescriptions he received between January and August of 2014. PTSD was included and listed with other medical issues/conditions; however, it is unclear if it was listed because it had been diagnosed and was being treated, or if it was only a suspected condition. It appears he was seen in January and August 2014 for PTSD. The medical notes from the August 2014 appointment state a psychiatry referral had been ordered and there should be a follow up within 1 week of the appointment at Alexandria Mental Health for PTSD and anxiety/depression. 22. He provided a letter from his employer/Supervisor at Dominos Pizza, Mr. Jxxx Mxxxxxx, dated 4 June 2014, wherein Mr. Mxxxxxx stated: a. He has known the applicant for many years; however, the applicant is not the same person he grew up with. He is always on alert when people are around. If there are more than two persons around, he will find an excuse to leave the room. He watches everyone at all times. Most people on the job do not associate with him out of fear. b. He is the applicant's immediate supervisor and has to continually monitor the applicant with customers, both in person and on the phone because he has a tendency to curse them out if they changed their order or he feels disrespected. The applicant is always ready for a fight and keeps bricks, clubs, and knives within reach. c. The applicant only has a job as long as Mr. Mxxxxxx is at the work place because the other managers do not want the responsibility. The applicant is scheduled to work the same times as Mr. Mxxxxxx, 95% of the time for a reason. The work place loves him, but they also know how far to go with him. Leaving him alone with a customer is not an option. Mr. Mxxxxxx thinks the applicant trusts him, but only to a point because the applicant does not trust anyone. Mr. Mxxxxxx does not fear the applicant much because he knows how to escape if things get heated; however, it would not surprise Mr. Mxxxxxx to hear the applicant had hurt or killed someone, or that he had burned someone's house down to the ground. There is no doubt in Mr. Mxxxxxx's mind that the applicant is a danger to himself and others because he has no remorse. Mr. Mxxxxxx stated he recognized these symptoms because his son was in the Iran War [sic] and was suffering from PTSD. 23. He provided a letter from his wife, dated 23 September 2014, wherein she stated she had known the applicant since 1979, began dating him in 1991, and finally married him in 2007. She stated he had been diagnosed with chronic PTSD related to his military years, chronic depression, and an anxiety disorder with avoidance features. She further stated he served in the Army during the Vietnam era, and that after receiving an injury to his right hand he began going AWOL in 1968. He was subsequently discharged with an under other than honorable conditions discharge due to the AWOLs, and has basically continued going AWOL ever since. She further stated: a. He has other symptoms that include: * disappearing for days or weeks at a time for no obvious reason * he is distrustful of everyone * he avoids crowds including family * compulsive behavior * depression, insomnia, panic attacks, anxiety * violent tendencies * he is always on guard * he is always armed with bricks and a knife * he is estranged from 5 of his 7 children and has minimal contact with one son and frequent contact with one daughter * he is estranged from his 5 siblings * avoids problems and tends to stick his head in the sand b. His nightmares include: * seeing dead people, the dead people try to kill him * hiding in the closet because the "VC" are just around the bend * crying * screaming "Search and Destroy!" and "I've been shot!" * frequently winding up between the bed and the wall scared to death * images of him grabbing his wife by the throat, choking her in his sleep – she fights him off and once he wakes up he is very remorseful * frequently waking up crying and saying, "I should have died over there, I wasn't supposed to survive!" c. He enjoys listening to music and watches a little television; however, he avoids action and war movies. Any sudden eruption of gunfire on the television sends him diving for the floor in duck and cover mode. He also has an obsession with locks on doors and is constantly making sure they are triple locked. 24. He provided a report of psychological examination, dated 25 September 2014, and showing he received a mental status examination on 24 September 2014, as required by the State of Louisiana, Disability Determinations Service. The examining official was a licensed clinical psychologist with a doctorate in education, based his recommendations and findings in this report on a function report (not provided), the previously addressed letters from the applicant's wife and supervisor, and the mental status examination he conducted. The psychologist stated: a. The applicant was born in Louisiana, to unwed parents and was raised by his maternal grandmother and two aunts, along with 3 half-sisters, and 2 half-brothers (mother's side). He also has 2 half- sisters and 2 half-brothers on his father's side. He does not maintain contact with his siblings. He has been married a total of three times. His first two marriages resulted in 5 children. He keeps in contact with a daughter from his first marriage and has minimal contact with one son from his second marriage. He currently lives with his wife and 28 year old step-son. He reports a satisfactory home life but admits to losing his temper about 3 or 4 times per week. He works for Dominos Pizza as a delivery man and performs other tasks as well. He reports that he keeps to himself and has a low tolerance for younger employees. However, the letter he hand-carried from his manager to the examination reports that he had a volatile temper with customers and employees and that other managers do not want to work with him. His previous employment included 8-9 years working on a crisis intervention team at Central State Hospital and his work at a number of nursing homes. b. The applicant reported joining the Army and serving in Vietnam. He reported that he wounded his hand in Vietnam and began to go AWOL, which eventually led to a dishonorable discharge. The applicant's wife also presented a letter outlining his medical and mental diagnosis. The mental conditions include depression, PTSD, and anxiety disorder with avoidant features. The applicant reports he was diagnosed with PTSD in February 2013 by a psychologist. His psychotropic medications included sertraline. He also reported he was arrested for failure to pay child support, and in 1995 for forgery. He also reported he used morphine and barbiturates after Vietnam, but denied any current substance abuse. c. During the mental status examination the applicant's sensorium was intact and his flow of thought was logical, linear, tight, and goal directed, and the content of thought was relevant. His mood was slightly anxious and his affect was appropriate. He responded appropriately to humor. He was able to repeat four digits forward and three digits reversed, which was a below average performance. He was able to perform simple math, such as addition, subtraction, multiplication, and division problems. His general fund of information and auditory registration was intact. His short term recall was impaired as evidenced by his inability to recall any of three unrelated words after a short delay and an intervening task. His concentration was intact as evidenced by his ability to spell the word "world" backward. He was able to give a correct real world solution to a simple judgment problem. His reasoning was abstract and he was able to give a correct, abstract interpretation to a proverb. His insight and judgment were also intact. d. The psychologist stated his diagnostic impressions and conclusions were consistent with a DSM-5 diagnosis of PTSD, major depressive disorder- recurrent, and anxiety disorder. 25. Army Regulation 635-200 sets forth the basic authority for the separation of enlisted personnel. Chapter 10 of the version in effect at the time provided that a member who committed an offense or offenses for which the authorized punishment included a punitive discharge could submit a request for discharge for the good of the service at any time after court-martial charges were preferred. Commanders would ensure that an individual was not coerced into submitting a request for discharge for the good of the service. Consulting counsel would advise the member concerning the elements of the offense or offenses charged, type of discharge normally given under the provisions of this chapter, the loss of Veterans Administration benefits, and the possibility of prejudice in civilian life because of the characterization of such a discharge. An undesirable discharge certificate would normally be furnished an individual who was discharged for the good of the Service. 26. On 16 September 1974, President Gerald Ford issued Presidential Proclamation 4313, which provided an opportunity for deserters to work their way back into American society. Three categories of service members were eligible beneficiaries of Proclamation 4313. One group was prior members of the Armed Forces who had been discharged with a punitive or undesirable discharge for violation of Articles 85, 86 or 87 (desertion, AWOL, and missing movement, respectively) of the UCMJ. This group could apply to a Presidential Clemency Board, which was made up of individuals appointed by the President (members were civilians, retired military and members of the Reserve Components) who would establish a period of alternate service of not more than 24 months that the individuals would perform. If they completed the alternate service satisfactorily, they would be entitled to receive a Clemency Discharge. The Presidential Board was authorized to award a Clemency Discharge without the performance of alternate service (excusal from alternate service). The Clemency Discharge did not affect the underlying discharge and did not entitle the individual to any benefits administered by the VA. 27. On 19 January 1977, President Ford issued a Presidential Memorandum that is sometimes referred to as Presidential Proclamation (PP) 4313 Extension. This memorandum mandated the issuance of a general discharge to individuals who had: (1) applied for consideration under PP 4313; (2) been wounded in action or decorated for valor; and (3) records free of any compelling reason to deny relief. This was a mandate to the ADRB from the President and was to be applied by the ADRB without any application from the affected individuals. Whether the individuals had performed alternate service was not an issue to be considered. 28. The Department of the Army Special Discharge Review Program (SDRP) was based on a memorandum from Secretary of Defense Brown and is often referred to as the "Carter Program." It mandated the upgrade of individual cases in which the applicant met one of several specified criteria when the separation was not based on a specified compelling reason to the contrary. The ADRB had no discretion in such cases other than to decide whether recharacterization to fully honorable as opposed to a general discharge was warranted in a particular case. An individual who had received a punitive discharge was not eligible for consideration under the SDRP. 29. PTSD can occur after someone goes through a traumatic event like combat, assault, or disaster. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA) and provides standard criteria and common language for the classification of mental disorders. In 1980, the APA added PTSD to the third edition of its DSM-III nosologic classification scheme. Although controversial when first introduced, the PTSD diagnosis has filled an important gap in psychiatric theory and practice. From an historical perspective, the significant change ushered in by the PTSD concept was the stipulation that the etiological agent was outside the individual (i.e., a traumatic event) rather than an inherent individual weakness (i.e., a traumatic neurosis). The key to understanding the scientific basis and clinical expression of PTSD is the concept of "trauma." 30. PTSD is unique among psychiatric diagnoses because of the great importance placed upon the etiological agent, the traumatic stressor. In fact, one cannot make a PTSD diagnosis unless the patient has actually met the "stressor criterion," which means that he or she has been exposed to an event that is considered traumatic. Clinical experience with the PTSD diagnosis has shown, however, that there are individual differences regarding the capacity to cope with catastrophic stress. Therefore, while most people exposed to traumatic events do not develop PTSD, others go on to develop the full-blown syndrome. Such observations have prompted the recognition that trauma, like pain, is not an external phenomenon that can be completely objectified. Like pain, the traumatic experience is filtered through cognitive and emotional processes before it can be appraised as an extreme threat. Because of individual differences in this appraisal process, different people appear to have different trauma thresholds, some more protected from and some more vulnerable to developing clinical symptoms after exposure to extremely stressful situations. 31. The DSM-5 was released in May 2013. This revision includes changes to the diagnostic criteria for PTSD and Acute Stress Disorder. The PTSD diagnostic criteria were revised to take into account things that have been learned from scientific research and clinical experience. The revised diagnostic criteria for PTSD include a history of exposure to a traumatic event that meets specific stipulations and symptoms from each of four symptom clusters: intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. The sixth criterion concerns duration of symptoms; the seventh assesses functioning; and the eighth criterion clarifies symptoms as not attributable to a substance or co-occurring medical condition. a. Criterion A, stressor: The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: (one required) (1) Direct exposure. (2) Witnessing, in person. (3) Indirectly, by learning that a close relative or close friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental. (4) Repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties (e.g., first responders, collecting body parts; professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies, or pictures. b. Criterion B, intrusion symptoms: The traumatic event is persistently re-experienced in the following way(s): (one required) (1) Recurrent, involuntary, and intrusive memories. (2) Traumatic nightmares. (3) Dissociative reactions (e.g., flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness. (4) Intense or prolonged distress after exposure to traumatic reminders. (5) Marked physiologic reactivity after exposure to trauma-related stimuli. c. Criterion C, avoidance: Persistent effortful avoidance of distressing trauma-related stimuli after the event: (one required) (1) Trauma-related thoughts or feelings. (2) Trauma-related external reminders (e.g., people, places, conversations, activities, objects, or situations). d. Criterion D, negative alterations in cognitions and mood: Negative alterations in cognitions and mood that began or worsened after the traumatic event: (two required) (1) Inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol, or drugs). (2) Persistent (and often distorted) negative beliefs and expectations about oneself or the world (e.g., "I am bad," "The world is completely dangerous"). (3) Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences. (4) Persistent negative trauma-related emotions (e.g., fear, horror, anger, guilt, or shame). (5) Markedly diminished interest in (pre-traumatic) significant activities. Feeling alienated from others (e.g., detachment or estrangement). (6) Constricted affect: persistent inability to experience positive emotions. e. Criterion E, alterations in arousal and reactivity: Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event: (two required) (1) Irritable or aggressive behavior (2) Self-destructive or reckless behavior (3) Hypervigilance (4) Exaggerated startle response (5) Problems in concentration (6) Sleep disturbance f. Criterion F, duration: Persistence of symptoms (in Criteria B, C, D, and E) for more than one month. g. Criterion G, functional significance: Significant symptom-related distress or functional impairment (e.g., social, occupational). h. Criterion H, exclusion: Disturbance is not due to medication, substance use, or other illness. 32. As a result of the extensive research conducted by the medical community and the relatively recent issuance of revised criteria regarding the causes, diagnosis and treatment of PTSD the Department of Defense (DOD) acknowledges that some Soldiers who were administratively discharged UOTHC may have had an undiagnosed condition of PTSD at the time of their discharge. It is also acknowledged that in some cases this undiagnosed condition of PTSD may have been a mitigating factor in the Soldier's misconduct which served as a catalyst for their discharge. Research has also shown that misconduct stemming from PTSD is typically based upon a spur of the moment decision resulting from temporary lapse in judgment; therefore, PTSD is not a likely cause for either premeditated misconduct or misconduct that continues for an extended period of time. 33. In view of the foregoing, on 3 September 2014 the Secretary of Defense directed the Service Discharge Review Boards (DRBs) and Service Boards for Correction of Military/Naval Records (BCM/NRs) to carefully consider the revised PTSD criteria, detailed medical considerations and mitigating factors when taking action on applications from former service members administratively discharged UOTHC and who have been diagnosed with PTSD by a competent mental health professional representing a civilian healthcare provider in order to determine if it would be appropriate to upgrade the characterization of the applicant's service. 34. BCM/NRs are not courts, nor are they investigative agencies. Therefore, the determinations will be based upon a thorough review of the available military records and the evidence provided by each applicant on a case-by-case basis. When determining if PTSD was the causative factor for an applicant's misconduct and whether an upgrade is warranted, the following factors must be carefully considered: * Is it reasonable to determine that PTSD or PTSD-related conditions existed at the time of discharge? * Does the applicant's record contain documentation of the occurrence of a traumatic event during the period of service? * Does the applicant's military record contain documentation of a diagnosis of PTSD or PTSD-related symptoms? * Did the applicant provide documentation of a diagnosis of PTSD or PTSD-related symptoms rendered by a competent mental health professional representing a civilian healthcare provider? * Was the applicant's condition determined to have existed prior to military service? * Was the applicant's condition determined to be incurred during or aggravated by military service? * Do mitigating factors exist in the applicant's case? * Did the applicant have a history of misconduct prior to the occurrence of the traumatic event? * Was the applicant's misconduct premeditated? * How serious was the misconduct? 35. Although DOD acknowledges that some Soldiers who were administratively discharged UOTHC may have had an undiagnosed condition of PTSD at the time of their discharge, it is presumed that they were properly discharged based upon the evidence that was available at the time. Conditions documented in the record that can reasonably be determined to have existed at the time of discharge will be considered to have existed at the time of discharge. In cases in which PTSD or PTSD-related conditions may be reasonably determined to have existed at the time of discharge; those conditions will be considered potential mitigating factors in the misconduct that caused the UOTHC characterization of service. Corrections Boards will exercise caution in weighing evidence of mitigation in cases in which serious misconduct precipitated a discharge with a characterization of service of UOTHC. Potentially mitigating evidence of the existence of undiagnosed combat-related PTSD or PTSD-related conditions as a causative factor in the misconduct resulting in discharge will be carefully weighed against the severity of the misconduct. PTSD is not a likely cause of premeditated misconduct. Corrections Boards will also exercise caution in weighing evidence of mitigation in all cases of misconduct by carefully considering the likely causal relationship of symptoms to the misconduct. DISCUSSION AND CONCLUSIONS: 1. The applicant's discharge proceedings were conducted in accordance with law and regulations in effect at the time. The characterization of his discharge was commensurate with the reason for discharge and overall record of military service in accordance with the governing regulations in effect at the time. 2. At the time of the applicant's discharge, PTSD was largely unrecognized by the medical community and DOD. However, both the medical community and DOD now have a more thorough understanding of PTSD and its potential to serve as a causative factor in a Soldier's misconduct when the condition is not diagnosed and treated in a timely fashion. 3. Soldiers who suffered from PTSD who were separated solely for misconduct subsequent to a traumatic event warrant careful consideration for the possible recharacterization of their overall service. 4. A review of the applicant's record and the evidence he provided shows: a. He enlisted in the Regular Army on 9 November 1967, and upon completing basic training and advanced individual training, he received orders transferring him to Fort Lewis, Washington for movement to Vietnam. However, instead of reporting to Fort Lewis for movement to Vietnam, he went AWOL and was not returned to military control until 24 June 1968. He accepted NJP for his misconduct. As such, it appears that his pattern of going AWOL began prior to his arrival in Vietnam. b. He arrived in Vietnam on or about 6 July 1968 and injured his hand while test firing a grenade launcher on 25 July 1968. Therefore, he only served in Vietnam with his unit from 6 July 1968 to 25 July 1968, which equates to a total of 19 days. He was assigned to the hospital in Vietnam from 25 July 1968 until 7 August 1968 (13 days), at which point he was transferred to the hospital in Japan. The hospital in Japan admitted him on 8 August 1968 and he remained there until 18 August 1968 (11 days), when that hospital had him transported to a hospital at Fort Polk. He arrived and was admitted to the hospital at Fort Polk on 20 August 1968 and departed AWOL 28 August 1968, 8 days after his arrival in country. c. He was AWOL and/or DFR on 5 additional occasions, and for one of these he was convicted by a General Court-Martial and sentenced to a BCD, though the sentence was not executed. 5. Subsequent to these experiences, medical evidence shows he was diagnosed with PTSD/PTSD-related symptoms by a two different psychologists, who provided reports on their findings. Therefore, it is reasonable to believe the applicant's PTSD condition existed at the time of his discharge. a. These reports show only one of the psychologists indicated his PTSD might be related to his military service by stating his PTSD "seemingly extends back to his military years." b. Neither of the psychologists indicated his misconduct resulted from PTSD. c. He does not appear to have mentioned that his pattern of AWOL began before his service in Vietnam. d. His psychiatric evaluations do not include, other than the accidental injury to his hand, any mention of an incident or traumatic event that prompted the onset of the PTSD. In fact, other than to state he injured his hand, he served in Vietnam, and he went AWOL, was court-martialed, and received an undesirable discharge, the applicant does not appear to have mentioned his military service to either psychologist. 6. His record shows he departed AWOL before going to Vietnam, for which he received an Article 15. During one of his subsequent periods of AWOL, he was arrested by civil authorities for the interstate transportation of falsely made and forged securities (counterfeiting), a serious offense. His pattern of AWOL is not isolated to the period after his return from Vietnam, nor does it appear to have been the result of an uncharacteristic lapse in judgment. 7. It cannot be concluded that the applicant’s PTSD conditions were the causative factor in the misconduct that led to his discharge, because his pattern of AWOL started before he arrived in Vietnam and he was apprehended for the previous offense of counterfeiting. After carefully weighing these facts against the severity of his misconduct, there is insufficient mitigating evidence to warrant upgrading the characterization of his service to an under honorable conditions (general) or honorable discharge. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ___x____ ___x____ ___x____ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined the overall merits of this case are insufficient as a basis to amend the decision of the ABCMR as set forth in Docket Numbers AR20040007339, dated 7 July 2005 and AR20130014701, dated 22 April 2014. __________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. ABCMR Record of Proceedings (cont) AR20140019555 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20140019555 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1