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Military Discharges and Military Counseling

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Other Designated Physical and Mental Conditions

Comments: To view or download the complete regulation, click on the link to it in the box above these comments.

*2. Condition Not a Disability. See reference (ba) SECNAVINST 1850.4E.

Comments: To see the current version of SECNAVINST 1850.4 in the series, go to Navy 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 reference (bb) SECNAVINST 6320.24A and reference (bc) DoDI 6490.04 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. Condition(s) must be certified by an appropriately privileged medical provider as not ratable by the PEB.

*b. Certain conditions and defects of a developmental nature designated by the reference (ba) SECNAVINST 1850.4E do not constitute a physical disability and are not ratable in the absence of an underlying ratable causative disorder. These conditions include, but are not limited to, those listed below.

  • (1) Enuresis
  • (2) Sleepwalking and/or Somnambulism
  • (3) Dyslexia and other learning disorders
  • (4) Attention Deficit Hyperactivity Disorder
  • (5) Stammering or stuttering
  • (6) Incapacitating fear of flying confirmed by a psychiatric evaluation
  • (7) Airsickness, Motion, and/or Travel Sickness
  • (8) Phobic fear of air, sea and submarine modes of transportation
  • (9) Certain Mental Disorders including: (a) Uncomplicated Alcoholism or other Substance Use Disorder, (b) Personality Disorders, (c) Mental Retardation, (d) Adjustment Disorders (except Chronic Adjustment Disorders which are a ratable disability effective 10 April 2013, (e) Impulse Control Disorders,, (f) Sexual Gender and Identity Disorders and Paraphilia, (g) Sexual Dysfunction, (h) Factitious Disorder,
  • (10) Obesity
  • (11) Overheight
  • (12) Psuedofolliculitis barbae of the face and/or neck
  • (13) Medical contraindication to the administration of required immunizations
  • (14) Significant allergic reaction to stinging insect venom
  • (15) Unsanitary habits
  • (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.
  • (17) Allergy to uniformed clothing or wool
  • (18) Long sleeper syndrome
  • (19) Hyperlipidemia

*c. 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. 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.

*d. Marines who have been found Fit by the PEB may not later be involuntarily administratively separated for the same medical condition(s) for which they were found fit without approval from the SECDEF.

*3. Personality Disorder

*a. Basis for processing. Separation under this paragraph is authorized only if, due to personality disorder (PD), the Marine’s 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. Initiate separation proceedings per paragraph 6303 or 6304 as appropriate.

*b. 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. 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.

*c. Documentation. PD separation documentation requirements are as follows:

  • (1) Commanders must comply with reference (bb) SECNAVINST 6320.24A and reference (bc) DoDI 6490.04 when referring a Marine to a mental health evaluation. Diagnosis must be made by a psychiatrist or Ph.D.-level psychologist.
  • (2) Per reference (p), Article 15-23 of the MANMED, the diagnosis must include a statement from the psychiatrist or Ph.D.-level psychologist that the Marine’s disorder is so severe that the Marine’s ability to function effectively in the military environment is significantly impaired. 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/ESR or statements from witnesses.

Comments: "SRB" is the Selective Reenlistment Bonus Program.

  • (3) 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.
  • (4) Diagnosis must be corroborated by a peer psychiatrist or Ph.D.-level psychologist or higher level mental health professional.
  • (5) Diagnosis must address PTSD, TBI, or other mental illness co-morbidity. Unless found Fit by the disability evaluation system, a separation for personality disorder is not authorized if service-related PTSD is also diagnosed.
  • (6) Diagnosis must be endorsed by the Regional Naval Medical Commander.
  • (7) Separation solely for PD warrants a re-enlistment code of 3P.
  • (8) Characterization of service is honorable unless the separation is an entry level separation or a general, under honorable conditions characterization of service is warranted.

*d. The separation authority’s endorsement will include the following paragraph. “All requirements in MCO 1900.16, paragraph 6203.3, Personality Disorder Administrative Separation, have been completed and documented in the attached case file.”

...

*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.

Comments: To see the current version of SECNAVINST 1850.4 in the series, go to Navy Disability.

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 (be) MCO P1400.32D 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 Navy Regulations, 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).

Comments: "MOS" is Military Occupational Specialty.

Examples include failing to meet physical readiness requirements for MOS performance standards, 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.