When discharging service members for nondisability mental conditions, the three services separated most under the label "condition, not a disability," instead of using one of five separation codes specifically designated for mental conditions, according to the Government Accountability Office.

Defense Department policy requires the services to use specific codes, but Army and Marine Corps officials told GAO they didn't use the codes because they did not want separating troops to be stigmatized by a diagnosis when seeking future employment.

The Navy did not give a reason for why it preferred using the broad code.

The "condition, not a disability" separation code not only encompasses nondisability mental conditions but nondisability physical conditions as well, such as obesity and travel sickness.

The mix further obscures the exact reason a service member may have been dismissed from the military, according to the report.

GAO Health Care Director Randall Williamson said that without specific discharge information, DoD cannot know whether the services follow proper procedures for separating troops and ensure that those with combat-related conditions like post-traumatic stress disorder or traumatic brain injury are not discharged improperly.

"Absent an effective process for monitoring and reporting compliance, DoD and the military services cannot assure that the military services are complying with DoD requirements," Williamson wrote.

The fiscal 2014 National Defense Authorization Act directed GAO to evaluate the services' use since 2007 of personality disorder and adjustment disorder diagnoses to discharge personnel.

The issue has been a concern since at least 2008, when GAO reported that the services were not properly following separation requirements for personality disorder discharges.

Since 2001, the services have discharged at least 31,000 troops for personality or adjustment disorders, a family of mental health diagnoses characterized by inflexible and dysfunctional behaviors that are not considered to be service-related.

After the GAO report and revelations in 2012 that the Army downgraded diagnoses for some soldiers at Madigan Army Medical Center, Washington, to personality or adjustment disorder after they had been clinically diagnosed with PTSD, critics and lawmakers pressed for reform.

But problems appear to continue plaguing the system. An investigation last year by the Colorado Springs Gazette found that annual misconduct discharges have increased more than 25 percent since 2009, with an even sharper rise among combat veterans.

The review found that some troops were dismissed for offenses that could have resulted from symptoms of traumatic brain injury and PTSD.

In its report, GAO made several recommendations, including that DoD and noncompliant military services use the specific separation codes created for nondisability mental conditions.

The office also recommended that the Air Force, which was found to be using the full array of separation codes when discharging airmen, extend its processes to ensure that members of the Air National Guard and Air Force Reserve are identified and tracked correctly.

In a written response, DoD officials largely agreed with the recommendations. But they also noted concerns from the Army and other services that disclosure of specific conditions could stigmatize veterans.

"There is a need to develop alternative methods to track this information ... and as well, to conduct a comprehensive review of [the] codes and the information portrayed on various copies on a DD-214," wrote Juliet Beyler, director for officer and enlisted personnel management in the Office of Military Personnel Policy.

About Patricia Kime

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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