Otras designadas afecciones físicas y mentales (Other Designated Physical and Mental Conditions Discharge)

Marines

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MCO P1900.16F (MARCORSEPMAN) (15 FEB 2019) Other Designated Physical and Mental Conditions

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6203. Convenience of the Government

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2. Condition Not a Disability. This basis now includes personality and other mental disorders. See reference (ba) SECNAVINST 1850.4E.

Comentario: Para ver la versión actual de SECNAVINST 1850.4 de la serie, por favor, vaya a Discapacidad, Navy.

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 reference reference (aj) DoDI 6490.04 when referring a Marine for a mental health evaluation.

b. Service members with conditions that interfere with the performance of duty, but that are not specifically listed as compensable under the Veterans Affairs Schedule for Rating Disabilities (VASRD), may be eligible for involuntary administrative separation under this basis per references (x)
DoDI 1332.14,(y) DoDI 1332.18 and (au) SECNAVINST 1850.4E.

• (1) Medical officer health assessments and recommendations for administrative separation for a condition not constituting a disability must be endorsed by a Medical Evaluation Board (MEB) Convening Authority prior to delivery to the command. Convening authorities will provide a Convening Authority Separation Recommendation to the command within five business days for cases not requiring Flag medical department officer review and that document will include the appropriate International Statistical Classification of Diseases and Related Health Problems (ICD-10) code.
• (2) If one or more of the below conditions apply to a Marine, Convening Authorities will forward the Convening Authority Separation Recommendation to The Medical Officer/Director of Health Services of the Marine Corps (TMO) for endorsement and return to the command within 10 days; (a) personality disorder; (2) greater than four years of service, (3) ever deployed to an imminent danger pay area; or (4) ever completed or been flagged to complete a Post Deployment Health Assessment.

c. Some conditions may warrant that the Marine be provided a reasonable opportunity to correct any performance deficiencies prior to the initiation of administrative separation; and commanding officers, with the advice of appropriate medical providers, will make these determinations. In such cases, paragraph 6105 requires counseling and a reasonable opportunity to correct deficiencies, and failure to take corrective action must be documented. The opportunity to correct deficiencies need not extend for a protracted observation period. At any time after formal counseling, Marines repeating or continuing behaviors that interfere with the performance of their duties or disrupt the good order and discipline of their unit may be processed for administrative separation. Separation under this basis requires written notification per paragraph 6303 or 6304, as appropriate, and that the Marine’s condition does not qualify as a disability.

d. Marines who have been found fit by the PEB may not later be involuntarily administratively separated under this basis for the same medical condition(s) for which they were found fit without approval from the Secretary of Defense.

e. Characterization of service is honorable unless the separation is an entry-level separation or general, under honorable conditions of service is warranted. Use SPD codes for condition not a disability and assign reenlistment code RE-3P for this basis of separation. The command will retain a copy of the convening authority medical recommendation for separation with other separation documents as required in unit files and forward a copy of all required separation documents to MMRP-10 for inclusion in the OMPF.

f. Additional Requirements for Personality and Other Mental Disorders

• (1) Before initiating separation, the command must have counseled the Marine per paragraph 6105; given the Marine a reasonable opportunity to correct deficiencies; and have documentation of failure to correct those deficiencies. The opportunity to correct deficiencies need not extend for a protracted observation period. At any time after formal counseling, Marines repeating or continuing behaviors that interfere with the performance of their duties or disrupt the good order and discipline of their unit may be processed for administrative separation.
• (2) Written nonmedical evidence must be submitted to show specific examples of how the Marine is unable to function in the Marine Corps. These may be counseling entries on page 11 of the SRB/ESR or statements from witnesses.
• (3) The diagnosis will address PTSD, other mental illness and TBI comorbidity. Unless found fit by the disability evaluation system, a separation for personality or other mental disorder is not authorized if service-related PTSD or TBI is also diagnosed.

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7. Refusal of Medical Treatment

a. 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.

*b. In accordance with reference (p), 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 Marine who does not consent to the recommended procedure. When a Marine 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 reference (ba) SECNAVINST 1850.4E, 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 VA and Social Security Administration medical treatment for the Marine in the future.

c. If the refusal of medical treatment is determined to be reasonable, the Marine 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 disability may be appropriate with the assignment of reenlistment codes RE-3P or RE-3C.

d. 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:

• (1) Administrative separation for unsatisfactory performance per paragraph 6206 or misconduct per paragraph 6210.
• (2) Administrative reduction. See reference (cl) MCO P1400.32D W/CH 1-2, regarding non-punitive reductions relating to professional incompetence and competency review boards.
• (3) Characterization of Service. If a finding of intentional misconduct/willful neglect or other negative aspects of a Marine’s 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).

e. Refusing inoculations. Marines are required to submit to required immunizations according to reference (ao) United States Navy Regulations 1990 W/CH 1 Article 1144. The medical evaluation board and PEB procedures described in paragraph 6203.7b are not required for Marines refusing inoculations. Disciplinary action and separation for orders violations may be appropriate based upon the commander’s decision.

f. 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 Marine is separated for “unreasonable” refusal of medical treatment, the following items must be included as part of the written notification requirements of paragraph 6303 or 6304 as appropriate:

• (1) A reenlistment code of RE-4, not recommended for reenlistment, will be assigned and the Marine 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 Marine is not disabled and the condition did not occur in the line of duty.

(c) The VA and the Social Security Administration may deny future medical benefits for this condition.

• (3) The Marine’s condition does not qualify as a naval service disability.

8. Physical Standards. Marines may be involuntarily administratively separated under the convenience of the government basis of additional grounds, for failure to meet or obtain minimum standards required for a military occupational specialty (MOS).

Comentario: "MOS" significa "Military Occupational Specialty" (especialidad ocupacional militar).

Examples include failing to meet physical readiness requirements for MOS performance standards and deployment, combat fitness test, physical fitness test, etc. This basis may be used when failure to meet the standard results from personal limitations, lack of motivation, or lack of suitability caused by conditions or circumstances not ratable by the PEB and not covered by a more specific or appropriate discharge category. Use SPD code GFT, HFT, and JFT as appropriate and the narrative reason for separation shall be Physical Standards for these types of discharges. Prior to involuntary separation under this code, consideration must be given to the potential for conversion to a specialty that would enable the Marine to continue service vice administrative separation. This may be an appropriate basis when paragraph 6203.2, condition not a disability, is not warranted.

Separation under this basis requires written notification per paragraph 6303 or 6304, as appropriate, and that the Marine’s condition does not qualify as a naval service disability. See paragraph 6106.1.d for limitations on administrative separation for the same medical condition(s) for which a Marine was found Fit by the PEB.

9. Conscientious Objection. A Marine may be separated per reference (br) MCO 1306.16F.

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