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6203. CONVENIENCE OF THE GOVERNMENT. A Marine may be separated for the Convenience of the Government for the reasons set forth below. Characterize service as honorable, general (under honorable conditions), or uncharacterized under the rules in paragraph 1004 and table 6-1.
2. Condition Not a Disability
a. Whenever a Marine's performance deteriorates or has an adverse effect on others in the unit, commanding officers and subordinate leaders will try to determine the cause. When the command suspects a physical or mental condition interferes with the Marine's effective performance of duty, the Marine should be referred to the appropriate medical authority. Commanders must comply with SECNAVINST 6320.24 series and DODD 6409.1 series when referring a Marine for a mental health evaluation. If examination by a medical officer confirms that the Marine is suffering from a physical or mental condition apparently beyond the individual's control and indicates that the condition is not a disability, initiate separation proceedings per paragraph 6303 or 6304 as appropriate. Such conditions may include the following:
(1) Obesity. Separation under this basis requires certification by a medical officer or medical board report that the Marine's overweight condition is due to pathological factors, not of a temporary nature, and apparently beyond the Marine's control. See MCO P6100.12 series.
(2) Bed-wetting (enuresis).
(4) Chronic airsickness.
(5) Chronic motion sickness.
(6) Pseudofolliculitis Barbae. Refer to MCO 6310.1 series, Pseudofolliculitis Barbae, for details or treatment required before initiation of separation action.
(7) Allergy. This includes, but is not limited to, allergy to clothing, boots, bedding, and bee stings, or illness such as asthma and hay fever.
(8) Disqualifying Height. Separation on this basis is appropriate when, after a proper enlistment, a Marine cannot be assigned duties appropriate to grade and MOS due to increased height. Before separation, the commander should investigate reassignment options for the Marine.
Comentario: "MOS" significa "Military Occupational Specialty" (especialidad ocupacional militar).
(9) Any additional physical condition which interferes with duty, as determined by the commanding officer and medical officer, that is not considered a physical disability.
b. Refusal of Medical Treatment. A Marine may be separated for refusing medical treatment and that refusal interferes with duty. The commander must determine if the refusal is "reasonable" or "unreasonable" and warrants separation based upon the situation and the following considerations.
(1) Navy Medical Publication P-117, The Manual of the Medical Department (MANMED), article 18-22, states that medical, dental, and surgical treatment will not be performed on a mentally competent member who does not consent to the recommended procedure. When a member refuses medical treatment a medical evaluation board must be convened per the MANMED article and the results forwarded to the Physical Evaluation Board (PEB). See chapter 8 regarding the medical board and PEB process. The PEB will make a determination of "reasonable" or "unreasonable" refusal of medical treatment according to SECNAVINST 1850.4 series, paragraph 3413.
Comentario: Para ver la versión actual de SECNAVINST 1850.4 de la serie, por favor, vaya a Discapacidad, Navy.
A medical evaluation board and PEB action are necessary because a determination of unreasonable refusal and intentional misconduct/willful neglect will result in denial of Department of Veterans Affairs and Social Security Administration medical treatment for the member in the future.
(2) If the refusal of medical treatment is determined to be reasonable, the member may still be separated at the commander's discretion per this Manual. If unsatisfactory performance of duty or misconduct are not considerations, separation, for physical condition not a disabilty, may be appropriate with the assignment of reenlistment codes RE-3P or RE-3C.
(3) If the PEB determines that the refusal of medical treatment was "unreasonable" or provides a finding of intentional misconduct/willful neglect, the commander may consider the following:
(a) Administrative separation for unsatisfactory performance per paragraph 6206 or misconduct per paragraph 6210.
(b) Administrative reduction. See MCO P1400.32 series regarding nonpunitive reductions relating to professional incompetence and competency review boards.
(c) Characterization of Service. If a finding of intentional misconduct/willful neglect or other negative aspects of a Marines performance outweigh positive aspects of performance, to include proficiency and conduct average markings, and administrative separation is warranted, the least favorable characterization of service is general under honorable conditions.
(4) Refusing innoculations. Service members are required to submit to required immunizations according to Navy Regulations, article 1144. The medical evaluation board and PEB procedures described in paragraph 6203.2.b(1) are not required for members refusing innoculations. Disciplinary action and separation for orders violations may be appropriate based upon the commander's decision.
c. Separation processing may not be initiated until the Marine has been counseled and allowed an opportunity to correct the deficiency per paragraph 6105. If a member is separated for "unreasonable" refusal of medical treatment, the following items must be included as part of the notification requirements of paragraph 6303:
(1) A reenlistment code of RE-4, not recommended for reenlistment, will be assigned and the member will be discharged and not transferred or eligible for service in the IRR.
(2) A finding of intentional misconduct/willful neglect requires the following notifications:
(a) Assignment of separation code _____ (basis determined).
(b) The member is not disabled and the condition did not occur in the line of duty.
(c) The Department of Veteran Affairs and the Social Security Administration may deny future medical benefits for this condition.
3. Personality Disorder
a. Basis for processing. Separation under this paragraph is authorized only if, due to personality disorder, the Marines ability to function effectively in the military environment is significantly impaired and if no other basis for separation applies. For example, if separation can be based on another basis, including another basis under Convenience of the Government, misconduct, or unsatisfactory performance, use one of those bases in spite of the existence of personality disorder. Initiate separation proceedings per paragraph 6303 or 6304 as appropriate.
b. Documentation. Two forms are required in all cases.
(1) Medical. Separation under this paragraph is authorized only if a diagnosis by a psychiatrist or psychologist concludes, under Article 15-23 of the MANMED, that the disorder is so severe that the Marine's ability to function effectively in the military environment is significantly impaired. Personality disorders are described in Axis II of the multiaxial classification in the Diagnostic and Statistical Manual (DSM-IV) of Mental Disorders. Commanders must comply with SECNAVINST 6320.24 series and DoD Directive 6409.1 series when referring a Marine to a mental health evaluation.
(2) Nonmedical. Written nonmedical evidence must be submitted to show specific examples of how the Marine is unable to function in the Marine Corps. These can be counseling entries on page 11 of the SRB or statements from witnesses.
Comentario: "SRB" significa "Selective Reenlistment Bonus Program" (el programa de los pluses por realistamiento).
c. Documentation. Documentation for separation under this paragraph must include evidence not only that the Marine is unable to function effectively because of a personality disorder, but also that the disorder of personality was clearly evident prior to enlistment.
d. Counseling. Before initiating separation, the command must have counseled the Marine in accordance with paragraph 6105; given the Marine a reasonable opportunity to correct deficiencies; and have documentation of failure to correct those deficiencies. However, counseling is not required if a psychiatrist or psychologist determines that the Marine is an immediate danger to himself or others.