… Nevertheless, some servicemembers are still discharged on the basis of personality disorders, and the category deserves attention from attorneys and counselors. Command failure to do so is common, and may be used to challenge involuntary administrative discharges under these regulations. In many of these cases, counselors or attorneys can assist clients in seeking redress of their problems, often through complaints under Article 138 of the UCMJ (see MLTF’s memo, “Article 138 Complaints” at ) or through Congressional inquiries. A military discharge is given when a member of the armed forces is released from their obligation to serve. An R/O, or rule out, diagnosis is provisional, usually a doctor’s initial guess but occasionally a final diagnosis after hospitalization or treatment. In one Navy case, statements about symptoms made during a psychological evaluation were treated as threats against superior officers, leading to court-martial and a bad conduct discharge. DoD 1332.14, Enclosure 3, Part (8).c.1. The regulation gives a detailed explanation of personality disorders, and distinguishes combat exhaustion and other “acute situational maladjustments,” which are not bases for this discharge. The DSM currently lists eleven specific Any physical or mental illness that can interfere with a soldier's duty and performance can be used as grounds for discharge. (b) Personality Disorders When a DD-214 notes medical discharge or retirement or Conditions and Circumstances Not Constituting a Disability, the diagnosis is not normally given, but employers commonly ask, despite the protections of federal law. Members of the military may be referred to a mental health professional as part of an evaluation for discharge. Section 8 was also often given to cross-dressers, gay, lesbian, bisexual and transgender people. Under resulting regulations, personality disorder discharge can only be given to combat veterans if the diagnosis is confirmed by a peer mental health professional and reviewed by the service’s Surgeon General. not be used as, or substituted for, the explanation of the adverse effect of the condition on Servicemembers are frequently given medication (not always accompanied by therapy) in an effort to stabilize or improve the condition and permit retention in the service. Anxiety, somatoform, or dissociative disorders, 3–34. Major changes in procedures for medical discharge and retirement have occurred in the last several years, and an understanding of the system is essential for servicemembers trying to navigate it, and for counselors and attorneys assisting them. The section lists: (1) Enuresis (bedwetting). Another advantage of civilian evaluations is that unhelpful reports need not be presented to the command or military doctors, whereas military evaluations become part of members’ permanent records. (2) Chronic seasickness. (2) The Service member’s disability imposes unreasonable requirements on the military to maintain or protect the Service member. For a general introduction to the military medical discharge/retirement system, readers are referred to MLTF’s “Military Medical Policies” memo, available at , with an update in the October, 2015, issue of MLTF’s newsletter, On Watch, at . Serious psychiatric illnesses (refer to criteria in 5.3.12.2.1-4 above) that result in hospitalization require a MEB. In very broad terms, these warrant discharge or retirement if they are severe enough to interfere significantly with performance of duties, require continuing psychiatric support, seriously endanger the servicemember’s health or well-being, or prejudice the best interests of the government. These symptoms or behaviors are clinically significant, as evidenced by one or both of the following: Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation. Refusing psychiatric medication can be very difficult, as a practical matter. The stressors of military life can strongly influence the psychological well-being of Soldiers and their Families. (21)Certain anemias – in the absence of unfitting sequelae—including G6PD This must be supported by documentation of the effect on performance. 5.3.12.2.4. While Military OneSource does not provide health care services, it does point members of the military family to the resources available to help. The MILPERSMAN does not require that these conditions be diagnosed as so severe as to interfere with performance of duties, but only that they “can affect potential for continued naval service” and “impair a member’s performance.” (Para. Section 8 is a category of discharge from the United States military, used for a service member judged mentally unfit for service. Along with Unsatisfactory Performance and Entry Level Performance and Conduct discharges, this replaced the old category of Unsuitability in all of the services. Service members may face unwarranted discharge for psychiatric problems when none are present, while those seeking medical or administrative discharge on that basis often run into intransigence from commands and military doctors. Administrative discharge procedures for Conditions and Circumstances Not Constituting a Disability are discussed in some detail in MLTF’s memo, “Representing Servicemembers in Involuntary Discharge Proceedings,” available at . Discussion with other counselors and with attorneys suggests that many of these conditions are seldom used. Unless the condition has been “aggravated” by military service, medical retirement and its benefits are not available in these cases. The regulation states that evidence of actual performance problems should be documented. These include Army Regulation (AR) 40-501, Secretary of the Navy Instruction (SECNAVINST) 1850.4E, which covers the Marine Corps as well as the Navy, and Air Force Instruction (AFI) 48-123. When a military member has a medical condition (including mental health conditions) that renders them unfit to perform their required duties, they may be separated (or retired) from the military for medical reasons. Bipolar Disorder. weekly psychotherapy in order to function) beyond one year. This section does not follow the DoD Instruction carefully on the requirement of severity. This more closely matches the language of the DoD Instruction, but requires two forms of documentation: a psychiatrist’s or psychologist’s opinion that “the disorder is so severe that the Marine’s ability to function effectively in the military environment is significantly impaired” and “written nonmedical evidence….to show specific examples of how the Marine is unable to function in the Marine Corps.” (6203.3.b.(2)). Persistence or recurrence of symptoms sufficient to require extended or recurrent hospitalization; or, Persistence or recurrence of symptoms necessitating limitations of duty or duty in protected environment; or. (8) Phobic fear of Air, Sea and Submarine Modes of Transportation (2) Sleepwalking and/or somnambulism. (7) Airsickness, Motion, and/or Travel Sickness Bipolar Disorder is a serious mental illness. DSM-V describes personality disorder generally as: This allows clients and counselors or attorneys to weigh options before raising any issues with the military and to consider the accuracy of military diagnoses. In July 2017, the VA announced an expansion of urgent mental health care services to former service members with other-than-honorable administrative discharges as a means of aiding those who are in distress or may be at risk for suicide. Finally, there is a shortage of mental health professionals serving our Active Duty troops, Reservists, and Veterans. DSM-5, unlike its predecessors, does not use “Axes” to divide groupings of mental, medical and social problems, though older military regulations and psychiatric reports may use this system. (16)Overheight. (See, for example, AR 40-501, Chapter 2.) If you are discharged from the army under Chapter 5-17, it means you had a physical or mental condition that prevented you from fulfilling your military duties. Conditions that are expected to have persistent duty impairment (more than 1 year despite treatment). Soldiers and sailors sometimes find that commands view emotional distress as an indication of weakness and unreliability. 5.3.12.2.3. (5) Dyslexia. Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional six months. This. Only conditions in item (8) require a showing of severity. (16) Certain Anemias (in the absence of unfitting sequelae) including Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD), other inherited Anemia Trait, and Von Willebrand’s Disease. The boards should be more kind in looking at your discharge upgrade application. While members are entitled to refuse medical treatment, in some cases it may affect entitlement to disability benefits or even the reason for discharge. While currently having mental health conditions or a history of a serious mental disorder technically prohibits military service, research data suggests that many are skirting the rules. They may include but are not limited to: (1) Chronic airsickness. The DoD Instruction and the services require that members be formally counseled, in writing, about performance deficiencies, and given an opportunity to overcome these deficiencies, before discharge may be initiated. (19)Significant allergic reaction to stinging insect venom. Under current wartime conditions, monitoring of medication use is often sporadic, making it difficult to determine whether there is really sufficient improvement to retain a servicemember, or whether side-effects may exacerbate the psychiatric condition or create other medical problems. (15) Unsanitary habits Short-term or less serious conditions such as adjustment disorders were not grounds for administrative or medical discharge in the past, largely because they are expected to have less effect on performance of duties and to improve with time or treatment. The settlement will ensure that the Army reconsiders the discharge status of thousands of Iraq- and Afghanistan-era veterans who received these bad paper discharges due to behavioral health conditions such as post-traumatic stress disorder, traumatic brain injury and military sexual trauma. A medical separation is a type of military discharge that stems from a soldier, sailor, or Marine having a physical or mental condition that affects their ability to serve. The onset of personality disorder is frequently manifested in the early adult years and may reflect an inability to adapt to the military environment as opposed to an inability to perform the requirements of specific jobs or tasks or both. The changes certainly give commands greater latitude in eliminating problem soldiers or sailors. To some extent, they may be a response to successful challenges to military attempts to discharge members for personality disorders on the basis of entirely different disorders and conditions which did not warrant this discharge. On Monday, two Army veterans filed a federal class-action lawsuit against the Army that seeks relief for the thousands of veterans of Iraq and Afghanistan who developed post-traumatic stress disorder (PTSD) and other mental health conditions during service and received unfair less-than-honorable discharges. The Air Force has come up with its own grouping of discharge categories. This memo was first written for the Winter 2004, issue of the MLTF newsletter, On Watch, and was updated in April, 2017. Soldiers discharged under Chapter 5-17 usually receive an honorable discharge. 5.11.8 Other conditions as outlined in DODI 1332.38, Physical Disability Evaluation, Enclosure 5, that interfere with duty performance and are not within the purview of the AFI 36-3212, Physical Evaluation for Retention, Retirement, and Separation, disability evaluation system and provided a basis for separation is not addressed elsewhere in this instruction. The Marine Corps has also separated personality disorder discharge from other conditions, in Marine Corps Separation and Retirement Manual (MARCORSEPMAN) Section 6203.3. Suicide Mental health is just as important for military and family readiness as physical fitness. Axis II included personality disorders and mental retardation. (h) Factitious Disorder In personality disorder discharges, those words are normally used as the narrative reason for discharge on the DD-214. In fact, adjustment disorders are one of the most prevalent mental health disorders in both military and civilian populations, and they are the most commonly diagnosed group of disorders among active duty service members. Organic Mental Disorders. (g) Sexual Dysfunction Most have designated personality disorder as a separate discharge category and all have added various other grounds for this discharge. [an inflammation of the If the Air Force decides to separate you, it will be a Medical Discharge with your Mental Health treatment covered and possiblity to return to AD if the issues resolve. This report may DSM-5 includes adjustment disorders under a general category of “Trauma- and Stressor-Related Disorders.” The diagnostic criteria include: DoD has recognized that adjustment disorders are occasionally chronic rather than short-term; in such cases, the condition is regarded as unfitting, warranting referral to a medical evaluation board and medical discharge or retirement. 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