BOARD DATE: 8 October 2014 DOCKET NUMBER: AR20140015391 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documents provided, if any). 2. Military Personnel Records and advisory opinions (if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests a review of the military disability evaluation pertaining to a mental health (MH) condition. 2. The applicant states, in effect, the case file should be reviewed in accordance with the Secretary of Defense directive for a comprehensive review of members who were referred for a disability evaluation between 11 September 2001 and 30 April 2012, and whose MH diagnosis was changed during that process. 3. The applicant also states that his rating for Post-Traumatic Stress Disorder (PTSD) should have been higher and not rated with his other disabilities because they are different. He further states that his disability was incurred in a combat zone or incurred during the performance of duty related to combat. 4. The applicant submitted an application through the Department of Defense (DOD) Physical Disability Board of Review (PDBR) MH Special Review Panel (SRP). CONSIDERATION OF EVIDENCE: 1. The PDBR SRP conducted a comprehensive review of the applicant's submissions and records for evidence of inappropriate changes in the diagnosis of an MH condition during processing through the military disability system. 2. The DOD memorandum, dated 27 February 2013, directed the Service Secretaries to conduct a review of MH diagnoses for service members completing a disability evaluation process between 11 September 2001 and 30 April 2012, to determine if service members were disadvantaged by a changed diagnosis over the course of their physical disability process. 3. In the processing of this case, an advisory opinion was obtained from the PDBR SRP and the applicant was provided a copy. 4. The applicant did not respond to the advisory opinion. DISCUSSION AND CONCLUSIONS: 1. After a comprehensive review of the applicant's case, the SRP determined by unanimous vote that there should be no change to the applicant's disability and retirement determination. 2. The SRP considers the appropriateness of changes in the applicant's MH diagnoses; the appropriateness of Physical Evaluation Board (PEB) fitness determination for any MH condition; and, if unfitting, whether the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) section 4.129 were applicable. 3. The SRP further considers the fairness of disability ratings for MH conditions and makes recommendations for said ratings in accordance with VASRD section 4.130 and VASRD section 4.129 as appropriate. Although the formal diagnosis ultimately forwarded to the PEB was anxiety disorder with PTSD, the diagnosis upon entering the Disability Evaluation System (DES) proceedings was PTSD. The SRP concluded that the applicant met the inclusion criteria of the Terms of Reference of the MH Review Project. 4. The SRP considered whether a change in diagnosis to primary PTSD (rather than the PEB combined anxiety disorder/PTSD) should be recommended. The SRP noted that the Medical Evaluation Board (MEB) psychiatric rationale for the diagnosis change was premised solely on the lack of documentation of criterion A stressors, and the SRP agreed that the applicant’s inability to confirm the deployments posed significant probative concerns with regard to the criterion A stressors but must consider that earlier deployments (satisfying criterion A) were uncontested. It is also noted that the PEB diagnosis (anxiety disorder with PTSD) was adopted by the VA, even though an Axis I diagnosis of PTSD was conceded by the VA examiner. 5. The SRP agreed that since there were diverse psychiatric opinions and features of both MH diagnoses in evidence, there was not a preponderance of evidence supporting a change in the MH diagnoses at Temporary Disability Retired List (TDRL) and permanent retirement, further noting that any such distinction was moot to VASRD section 4.129 and VASRD section 4.130 rating considerations. 6. The SRP assessed whether one of the higher ratings of 70 percent or 100 percent was fairly recommended. The VASRD section 4.130 descriptions for a 70 percent rating is “occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.” The greatest occupational impediments at the time of TDRL placement were imposed by the non-MH conditions; social impairment as judged by the objective evidence was not severe; deficiencies in the other specified areas were not in evidence; and none of the referenced typical symptoms were in evidence. Therefore, the SRP agreed that the requirements for a 70 percent rating were not met. The SRP concluded that there was insufficient cause to recommend a change in the PEB’s TDRL rating for the anxiety disorder not otherwise specified (NOS). 7. The SRP finally considered if the permanent rating of 50 percent for the MH condition was fairly assigned. After due deliberation in consideration of the preponderance of the evidence, the SRP agreed that there was insufficient cause to recommend a change in the PEB’s permanent rating for anxiety disorder NOS, VASRD code 9411-9413. 8. The available evidence shows the SRP's assessment should be accepted. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ___x_____ ___x_____ ___x__ DENY APPLICATION BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined that the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. __________x_______________ CHAIRPERSON I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. ABCMR Record of Proceedings (cont) AR20040003532 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20140015391 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1