Patient may go to primary care for medication targeting sleep problem 2 by aE3740s

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


FOR OFFICIAL USE ONLY


                                     ex-SN, USN
                                Docket No. ND06-00153

Applicant’s Request

The application for discharge review was received on 20051103. The Applicant requests
the Discharge Characterization of Service received at the time of discharge be changed to
honorable. The Applicant requests a documentary record discharge review. The
Applicant did not designate a representative on the DD Form 293.

Decision

A documentary discharge review was conducted in Washington, D.C. on 20060908.
After a thorough review of the available records, supporting documents, facts, and
circumstances unique to this case, no impropriety or inequity in the characterization of the
Applicant’s service was discovered by the NDRB. The Board’s vote was unanimous that
the character of the discharge and reason for discharge shall not change. The discharge
shall remain General (Under Honorable Conditions) for convenience of the government
due to a physical or mental condition, not a disability.
Docket No. ND06-00153


            PART I - APPLICANT’S ISSUES AND DOCUMENTATION

Issues, as stated

Applicant’s issues, as stated on the application:

“DD214 shows “General (under Honorable Conditions)” #28 “Condition, Not A
Disability”. By putting “General under Honorable” this is made me not eligible for use of
my educational benefits (that I paid in $1200 and it was not returned.) I earned the right
to go to school because I served my Country Honorably But had to leave due to medical
reasons. the Navy said it was not a disability But the VA Awarded Service Connected
Disability meaning it either was injury that was incurred while on active duty or was
aggravated by the Military. I am disabled-via the military there fore my DD214 should be
changed to “Honorable” and reason for separation “Medical”

Documentation

In addition to the service record, the following additional documentation, submitted by the
Applicant, was considered:

    Applicant’s DD Form 214 (member 4)
    Applicant’s DD Form 214 (member 1)
    Department of Veterans Affair Entitlement Decision, dtd August 4, 2005 (3 pgs)
    Department of Veterans Affair Rating Decision, dtd July 27, 2005 (4 pgs)
    Department of Veterans Affair Entitlement Decision, dtd December 2, 2004 (3 pgs)
    Department of Veterans Affair Rating Decision, dtd November 23, 2004 (4 pgs)
    34 pages from Applicant’s service and medical records




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Docket No. ND06-00153


                        PART II - SUMMARY OF SERVICE

Prior Service (component, dates of service, type of discharge):

       Inactive: USNR (DEP)          20010724 – 20010826               COG
       Active: None

Period of Service Under Review:

Date of Enlistment: 20010827                 Date of Discharge: 20040921

Length of Service (years, months, days):

       Active: 03 00 25
       Inactive: None

Time Lost During This Period (days):

       Unauthorized absence: none
       Confinement:          none

Age at Entry: 20

Years Contracted: 4

Education Level: 12                          AFQT: 49

Highest Rate: SN

Final Enlisted Performance Evaluation Averages (number of marks):

Performance: 3.0 (3)                 Behavior: 2.3 (3)            OTA: 3.05

Decorations, Medals, Badges, Citations, and Campaign Ribbons Awarded or
Authorized, (as listed on the DD Form 214): National Defense Service Medal, Global
War on Terrorism Expeditionary Medal.




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Docket No. ND06-00153



Character, Narrative Reason, and Authority of Discharge (at time of issuance):

GENERAL (UNDER HONORABLE CONDITIONS)/CONDITION, NOT A
DISABILITY, authority: MILPERSMAN, Article 1910-120 (formerly 3620200).

Chronological Listing of Significant Service Events:

020110:       Summary Court-Martial.
              Charge: violation of the UCMJ, Article 107: With intent to deceive, did
              make a false official statement.
              Finding: to Charge and the specification thereunder, guilty.
              Sentence: Forfeiture of $542.00 pay, confinement for 1 month (suspended
              for 90 days).
              CA action: Not found in record.

020201:       Retention Warning: Advised of deficiency (Article 107-False official
              statement.), notified of corrective actions and assistance available, advised
              of consequences of further deficiencies, and issued discharge warning.

030911:       Medical evaluation by Branch Medical Clinic NAVSTA.
              Background: “...NJP’s, Page 11’s, Masts were denied. She did, however,
              report, disciplinary action after being raped at A school and was ultimately
              charge with false statement. She has, however, done her best to forget this,
              denied PTSD symptoms currently....”
              Assessment:
              AXIS I: Adj/do with Mixed Anxiety and Depression, chronic; Learning
              disability NOS by hx
              AXIS II: Deferred, no significant traits noted
              AXIS III: Migraines
              AXIS: IV: occupational problem
              AXIS V: (current): low 50s
              AXIS V: (highest): 70s
              Pain: denied
              Plans and Recommendations:
              Safety: Low risk for harm to self or others at this time based on the above
              risk assessment. The patient is neither suicidal or homicidal and
              convincingly contracts for safety at this time. Crisis plans were reviewed
              and contact information was given.
              Medication: We discussed risks, benefits, and side effects of the below
              medications including alternatives and discontinuation procedures and the
              patient desired to proceed as follows (denied chance of pregnancy).
              Wellbutrin SR 100mg PO QAM target depressive symptoms. While
              known increase in panic may occur, overall goal to decrease appetite and
              improve frustration tolerance is judged to be more beneficial to the patient


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Docket No. ND06-00153

            at this time while hopefully increasing daytime energy and aide in
            reduction of appetite. Further, chronic concentration problems from
            learning disability may theoretically improved with dopaminergic activity
            of wellbutrin. May consider Effexor for same reasoning if panic persist or
            increases or prn coverage with Klonopin. D/C ETOH, D/C OTC
            supplements, D/C Caffeine. Education on importance of well-balanced
            diet, exercise, and routine sleep cycle stressed.
            Therapy: With next available. Relaxation group target panic sx non-
            pharmacologically. Also refer to Anxiety group for same reasons.
            Military: Fit and suitable for full duty at this time without restriction.
            Follow-up: F/U FMH PRN in interim prior to appointment for
            therapy/group/medication management in 3-4 weeks. Pt agrees to go to
            ED or call 911 if thoughts of harm to self or others recur. The patient
            voiced understanding, agreement, and there is no evidence suggesting the
            patient has any impairment of capacity to do so. Labs today, LBL, P2,
            LFT, Rpr, UA, AUG, DDS.

040107:     Medical evaluation by Fleet Mental Health, Branch Medical Clinic
            NAVSTA, San Diego, CA.
            Assessment:
            AXIS I: Adjustment Disorder with Mixed Anxiety and Depressio
            AXIS II: Deferred, Dependent traits
            AXIS III: Migraines No pain reported
            AXIS: IV: Military life and occupational stressors
            AXIS V: GAF (current) 60’s
            Plan:
            1. Medications: per Dr. S_.
            2. Therapy: Brief outpatient psychotherapy and Relaxation Group.
            3. Military: limited duty for migraines (10/04)
            4. Follow-up: RTC as scheduled.

040128:     Medical evaluation by Fleet Mental Health, Branch Medical Clinic
            NAVSTA, San Diego, CA.
            Assessment:
            AXIS I: Adjustment Disorder with Mixed Anxiety and Depression
            Bereavement (dx change)
            AXIS II: Deferred, Dependent traits
            AXIS III: Migraines No pain reported
            AXIS: IV: Military life and occupational stressors
            AXIS V: GAF (current) 60’s
            Plan:
            1. Medications: per Dr. S_. Patient may go to primary care for medication
            targeting sleep problem 2/2 to recent SIDS death of infant son.
            2. Therapy: Brief outpatient psychotherapy and Relaxation Group. Patient
            also referred to community support group for SIDS


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Docket No. ND06-00153

            3. Military: limited duty for migraines (10/4)
            4. Follow-up: RTC as scheduled.

040225:     Medical evaluation by Fleet Mental Health, Branch Medical Clinic
            NAVSTA, San Diego, CA.
            Assessment:
            AXIS I: Adjustment Disorder with Mixed Anxiety and Depression
            Bereavement (dx change)
            AXIS II: Deferred, Dependent traits
            AXIS III: Migraines No pain reported
            AXIS: IV: Military life and occupational stressors
            AXIS V: GAF (current): 60’s
            Plan:
            1. Medications: per Dr. S_. Patient may go to primary care for medication
            targeting sleep problem 2/2 to recent SIDS death of infant son.
            2. Therapy: Brief outpatient psychotherapy and Relaxation Group. Patient
            also referred to community support group for SIDS.
            3. Military: limited duty for migraines (10/4)
            4. Follow-up: RTC as scheduled.

040409:     Medical Board Evaluation, Naval Medical Center, San Diego: Board
            agrees with MIXED HEADACHES diagnosis and believes the Applicant
            has a condition that prevents her from performing her duties and refers
            Applicant’s case to the central physical evaluation board for adjudication.

040416:     Medical evaluation by Branch Medical Clinic NAVSTA.
            Assessment:
            AXIS I: Adj/do with Mixed Anxiety and Depression, chronic
            Onset: DNEPTE
            Industrial Impairment: minimal
            Military Impairment: moderate
            Bereavement, uncomplicated
            Onset: DNEPTE
            Industrial Impairment: minimal
            Military Impairment: moderate
            Learning Disability NOS by patient history, EPTS
            AXIS II: Deferred, no significant traits noted
            AXIS III: Migraines (primary medial board)
            AXIS: IV: occupational problem
            AXIS V: (current): low 50s, moderate symptoms and impairment in
            functioning
            AXIS V: (highest): 70s
            Pain: denied
            Plans and Recommendation:




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Docket No. ND06-00153

            Safety: Low risk for harm to self or others at this time based on the above
            risk assessment. The patient is neither suicidal or homicidal and
            convincingly contracts for safety at this time. Crisis plans were reviewed
            and contact information was given.
            Medication: We discussed risks, benefits, and side effects of the below
            medications including alternatives and discontinuation procedures and the
            patient desired to proceed as follows (denied chance of pregnancy).
            Continue Zoloft 50mg PO daily and Wellbutrin SR 150mg PO BID as she
            is satisfied with regimen at this time despite ongoing symptoms.
            Continue to D/C ETOH, D/C OTC supplements, D/C Caffeine. Education
            on importance of well-balanced diet, exercise, and routine sleep cycle
            stressed.
            Therapy: Continue with Dr H_ as arranged or individual supportive
            therapy, Bereavement Group as arranged weekly. Relaxation group target
            panic sx non-pharmacologically.
            Military: Fit and suitable for full duty at this time without restriction.
            Follow-up: F/U FMH PRN in interim prior to appointment for
            therapy/group/medication management in 3-4 weeks. Pt agrees to go to
            ED or call 911 if thoughts of harm to self or others recur. The patient
            voiced understanding, agreement, and there is no evidence suggesting the
            patient has any impairment of capacity to do so.

040503:     Medical evaluation by Fleet Mental Health, Branch Medical Clinic
            NAVSTA, San Diego, CA.
            Assessment:
            AXIS I: Adjustment Disorder with Mixed Anxiety and Depression
            Bereavement (dx change)
            AXIS II: Deferred, Dependent traits
            AXIS III: Migraines 7/10 today
            AXIS: IV: Military life and occupational stressors
            AXIS V: GAF (current): 60’s
            Plan:
            1. Medications: per Dr. S_. Patient may go to primary care for medication
            targeting sleep problem 2/2 to recent SIDS death of infant son.
            2. Therapy: Bereavement Group, brief outpatient psychotherapy and
            Relaxation.
            3. Military: limited duty for migraines (10/4)
            4. Follow-up: RTC as scheduled.

040617:     Physical Evaluation Board, Naval Council of Personnel Boards,
            Washington D.C., found Applicant fit for continued active duty.
            [Document provided by Applicant]




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Docket No. ND06-00153

040712:       Physical Evaluation Board, Naval Council of Personnel Boards,
              Washington D.C., reconsidered Applicant’s case and made no change to
              the preliminary finding; fit for continued naval service.

040805:       Applicant found not fit for sea duty.

040825:       NAVPERS 1070/613 warning issued. [Extracted from CO’s ltr of
              040915]

040915:       Commanding Officer, Naval Base, San Diego, informed CNPC that the
              Applicant was being processed for separation by reason of convenience of
              the Government due to physical or mental conditions, not a disability, with a
              character of service as general (under honorable conditions). Commanding
              Officer’s comments: “SN C_’s (Applicant) medical condition renders her
              incapable of being worldwide assignable. Her medical condition impacts
              the safe, reliable, and proficient performance of her duties.”

040921:       DD Form 214: Applicant discharged with a general (under honorable
              conditions) character of service by reason of condition, not a disability,
              authority MILPERSMAN 1910-120.


Service Record contains a partial Administrative Discharge package.




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Docket No. ND06-00153


           PART III – RATIONALE FOR DECISION AND PERTINENT
                                 REGULATION/LAW

Discussion

The Applicant was discharged on 20040921 for convenience of the government due to a
physical or mental condition, not a disability (A) with a service characterization of
general (under honorable conditions). After a thorough review of the available records,
supporting documents, facts, and circumstances unique to this case, the Board found that
the discharge was proper and equitable (B and C). The Board presumed regularity in the
conduct of governmental affairs (D).

The government enjoys a presumption of regularity in the conduct of its affairs. The
Applicant bears the burden of overcoming this presumption through the presentation of
substantial and credible evidence to support his issue. In the Applicant’s case, in the
absence of a complete discharge package and without credible and substantial evidence to
refute the Board’s presumption, the Board invoked the presumption of regularity.
Specifically, the Board presumed that the Applicant was properly notified of her
Commanding Officer’s intent to administratively process the Applicant for separation and
that the Applicant was afforded all rights which she elected at notification.

The Applicant contends that she is “disabled-via the military” and therefore her discharge
should be changed to honorable. The Board could find no connection between the
Applicant’s medical condition, narrative reason for separation or Veterans’
Administration assessment of disability and the Applicant’s character of service. When
the service of a member of the U.S. Navy has been honest and faithful, it is appropriate to
characterize that service as honorable. A general discharge is warranted when significant
negative aspects of a member’s conduct or performance of duty outweigh the positive
aspects of the member’s military record. The Applicant’s service was marred by a
retention warning and a Summary Court-Martial conviction for violation of Article 107 of
the UCMJ. The Applicant’s violation of Article 107 of the UCMJ is the commission of a
serious offense. The Applicant also received a retention warning on 20040825. The
Applicant’s conduct, which forms the primary basis for determining the character of her
service, reflects her willful failure to meet the requirements of her contract with the U.S.
Navy and falls short of that required for an upgrade of her characterization of service.
Relief is not warranted.

The Applicant implies that her discharge should be changed to honorable in order to be
eligible for educational benefits. The Veterans Administration determines eligibility for
post-service benefits not the Naval Discharge Review Board. There is no requirement or
law that grants recharacterization solely on the issue of obtaining Veterans' benefits and this
issue does not serve to provide a foundation upon which the Board can grant relief.
Additionally, the Board has no authority to upgrade a discharge for the sole purpose of
enhancing employment or educational opportunities. Relief denied.



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Docket No. ND06-00153

The Applicant states that her narrative reason for separation should be changed to
“Medical” because she is “disabled-via the military.” The NDRB, under its responsibility
to examine the propriety and equity of an Applicant's discharge, will change the reason for
discharge if such a change is warranted. Reference (A) indicates that members with
physical or behavioral conditions which impair a member’s service, but do not amount to
a physical disability meet the criteria for separation by reason of condition not a
disability. Neither the evidence of record nor in the documentation submitted by the
Applicant show that the Applicant should have been separated for any other reason. No
other Narrative Reason for Separation could more clearly describe why the Applicant was
discharged. Relief denied.

The following is provided for the edification of the Applicant. Normally, to permit relief,
a procedural impropriety or inequity must have occurred during the discharge process for
the period of enlistment in question. The Board discovered no impropriety after a review
of Applicant’s case. There is no law or regulation, which provides that an unfavorable
discharge may be upgraded based solely on the passage of time or good conduct in
civilian life subsequent to leaving Naval service. The NDRB is authorized to consider
post-service factors in the recharacterization of a discharge 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. Examples of documentation that
should be provided to the Board include proof of educational pursuits, verifiable
employment records, documentation of community service and certification of non-
involvement with civil authorities. As of this time, the Applicant has not provided any
relevant post-service documentation for the Board to consider. Relief denied.

The Applicant remains eligible for a personal appearance hearing, provided an application
is received, at the NDRB, within 15 years from the date of discharge. Representation at a
personal appearance hearing is recommended but not required.




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Docket No. ND06-00153



Pertinent Regulation/Law (at time of discharge)

A. Naval Military Personnel Manual, (NAVPERS 15560C), re-issued October 2002,
effective 22 Aug 2002 until 22 Sep 2004, Article 1910-120 (formerly 3620200),
SEPARATION BY REASON OF CONVENIENCE OF THE GOVERNMENT -
PHYSICAL OR MENTAL CONDITIONS.

B. Secretary of the Navy Instruction 5420.174D of 22 December 2004, Naval Discharge
Review Board (NDRB) Procedures and Standards, Part V, Para 502, Propriety.

C. Secretary of the Navy Instruction 5420.174D of 22 December 2004, Naval Discharge
Review Board (NDRB) Procedures and Standards, Part V, Para 503, Equity.

D. Secretary of the Navy Instruction 5420.174D of 22 December 2004, Naval Discharge
Review Board (NDRB) Procedures and Standards, Part II, Para 211, Regularity of
Government Affairs.

                PART IV - INFORMATION FOR THE APPLICANT


If you believe that the decision in your case is unclear, not responsive to the issues you
raised, or does not otherwise comport with the decisional document requirements of DoD
Directive 1332.28, you may submit a complaint in accordance with Enclosure (5) of that
Directive. You should read Enclosure (5) of the Directive before submitting such a
complaint. The complaint procedure does not permit a challenge of the merits of the
decision; it is designed solely to ensure that the decisional documents meet applicable
requirements for clarity and responsiveness. You may view DoD Directive 1332.28 and
other Decisional Documents by going online at “http://Boards.law.af.mil”.

The names, and votes of the members of the 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




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