IN THE CASE OF: BOARD DATE: 28 May 2015 DOCKET NUMBER: AR20150006496 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 he has many supporting documents concerning his Post-Traumatic Stress Disorder (PTSD) that the Army did not review. 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 reviewed the records for evidence of inappropriate changes in diagnosis of the applicant's MH condition during processing through the Disability Evaluation System (DES). The evidence of the available records showed a diagnosis of PTSD was rendered during the DES process. PTSD was noted in consults and testing during Temporary Disability Retired List (TDRL) placement, but was not a final narrative summary (NARSUM) diagnosis upon TDRL removal. 3. The SRP noted that the NARSUM at TDRL removal noted the historical diagnosis of PTSD and adjudged that it met retention standards at the time of the applicant's TDRL placement, but that PTSD symptoms had worsened and no longer met retention standards. The Physical Evaluation Board (PEB) at TDRL removal addressed the PTSD diagnosis as not ratable, as it was not unfitting on TDRL placement. At TDRL placement, the neuropsychological testing listed PTSD and the Report of Medical History (DD Form 2807) referred to counseling for PTSD; however, there was no MH condition listed on the Medical Evaluation Board (MEB) or PEB. At TDRL removal, the PEB included the diagnosis of PTSD. Therefore, the SRP determined that the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project. 4. The SRP next considered whether any mental condition was unfitting for continued military service at the time of the applicant's placement on the TDRL. The SRP agreed that the record reflected non-limiting symptoms in the period of time leading into the initial MEB. At no time during the applicant’s military service did he require a psychiatric hospitalization, emergency care or psychotropic medication management. No MH condition was permanently profiled or was judged to fail retention standards. There was no indication from the record that any MH condition significantly interfered with satisfactory duty performance. 5. The SRP therefore concluded that there was insufficient evidence that any MH condition rose to the level of being unfitting at the time of TDRL placement. PTSD was a diagnosis by the PEB at TDRL removal, and the SRP adjudged that there was not sufficient evidence for any change to the PTSD diagnosis. 6. The SRP then deliberated if the PTSD condition was compensable at TDRL removal. Conditions other than those found unfitting at TDRL placement are not ratable at TDRL removal, regardless of disease progression, unless caused by or directly related to treatment of the unfitting condition. The SRP considered if the psychiatrist’s (Chief of Behavioral Health) analysis of the relationship of PTSD symptoms and the opioid medication used to treat the unfitting right ulnar nerve neuralgia (pain) condition linked the worsening of the PTSD to the treatment of the neuralgia sufficiently to make it ratable at TDRL removal. 7. The SRP could not find sufficient evidence that the worsening of the applicant’s PTSD was caused by the unfitting right arm neuralgia condition or due to treatment of the neuralgia. The SRP therefore concluded that no MH condition was ratable at the time of TDRL removal. 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 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) AR20150006496 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1