RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW
NAME: BRANCH OF SERVICE: ARMY
CASE NUMBER: PD0900025 COMPONENT: REGULAR
BOARD DATE: 20090604 SEPARATION DATE: 20070502
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SUMMARY OF CASE: This covered individual (CI) was an active duty NCO medically separated from the Army in 2007 with 5 years of service. The medical basis for the separation was Post Traumatic Stress Disorder (PTSD). The PTSD resulted from combat exposure to multiple traumatic incidents during OIF 2004-005. The CI manifested typical PTSD symptoms upon his return from theater which he initially attempted to manage on his own. He sought medical help in 2006 and was treated on an outpatient basis by Behavioral Health. He continued to perform his duties in a modified work environment, but his psychiatric symptoms did not significantly abate. He was additionally evaluated for a back injury, narcolepsy and TBI. He was referred to the PEB, found unfit for PTSD only and separated at 10% disability. On his first VA rating examination one year later, he was rated at 50% for PTSD. The CI’s contention notes the disparity between the PEB and VA ratings.
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BOARD FINDINGS: IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the PDBR to the extent they were inconsistent with the VASRD in effect at the time of the adjudication. The PEB adjudication was IAW the DoDI 1332.39 scale for rating psychiatric impairment. The PTSD features germane to the general rating formula for mental diseases in the VASRD, as documented in the service treatment record, were evaluated independently of the DoDI guidelines. The Board unanimously agreed that 50% was the fairest rating under the VASRD, although some criteria for a 70% rating were met. The CI’s additional conditions, noted above, were judged to have been accurately characterized by the PEB as not unfitting.
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RECOMMENDATION: The Board recommends that the CI’s prior separation be recharacterized to reflect that rather than discharge with severance pay, the CI was placed on the TDRL at 50% for a period of 6 months (PTSD at 50% IAW §4.129 and DoD direction) and then permanently retired by reason of physical disability with a final 30% rating as indicated below.
| Unfitting Condition | VASRD Code | TDRL Rating | Permanent Rating |
|---|---|---|---|
| POST-TRAUMATIC STRESS DISORDER | 9411 | 50% | 30% |
| COMBINED | 50% | 30% |
The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20090113, w/atchs.
Exhibit B. Service Treatment Record.
Exhibit C. Department of Veteran's Affairs Treatment Record.
AF | PDBR | CY2009 | PD2009-00151
The PEB found the CI unfit for PTSD only and he was medically separated with a disability rating of 10%. That was not very problematic in this case because the VA rating examination after two years was not significantly changed from the MEB and pre-separation VA psychiatric evaluations. There are therefore no additional conditions in this case appropriate for Board recommendation as additionally unfitting for separation rating.
AF | PDBR | CY2010 | PD2010-00423
The most proximate source of comprehensive evidence on which to base the permanent rating recommendation in this case is the VA psychiatric rating evaluation three months after separation. The VA had not rated the CI for PTSD as a disability until this examination. There are therefore no additional conditions in this case appropriate for Board recommendation as additionally unfitting for separation rating.
AF | PDBR | CY2009 | PD2009-00152
The CI contends for a higher rating for PTSD; VA rated 70%, Army rated 10%. CI’s later exams (20050822) demonstrated worsening of PTSD and his VA PTSD rating was increased to 100%. However, the exam of 20050419 was closest to the time provisions of §4.129, and that later rating changes indicated worsening of symptoms and were not reflective of CI’s condition at the 6-month post discharge timeframe.
AF | PDBR | CY2010 | PD2010-00882
RECOMMENDATION : The Board recommends that the CI’s prior determination be modified as follows; TDRL at 50% for 6 months following CI’s prior medical separation (PTSD at minimum of 50% IAW §4.129 and DoD direction) and then a permanent combined 30% disability retirement as below. After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation...
AF | PDBR | CY2009 | PD2009-00556
The CI was referred to the Physical Evaluation Board (PEB), determined to be unfit for continued military service, and separated at 10% disability using the Veterans Affairs Schedule for Ratings Disabilities (VASRD) and applicable Navy and Department of Defense regulations. However, the CI failed to show up for multiple scheduled VA Compensation and Pension (C&P) exams and the PTSD rating was decreased to 0% because of the lack of information to provide an accurate disability description. ...
AF | PDBR | CY2009 | PD2009-00276
The CI was determined to be unfit for PTSD which was rated for mild social and industrial impairment, and he was medically separated with a disability rating of 10%. It should also be noted that the CI remained employed at the time of his re-evaluation by the VA 16 months after separation. Right ankle and right shoulder conditions were rated by the VA at separation, but the Board does not have the authority under DoDI 6040.44 to render fitness or rating recommendations for any conditions...
AF | PDBR | CY2010 | PD2010-00416
Since the comprehensive VA Compensation and Pension (C&P) Initial PTSD examination was accomplished three months prior to separation, the most proximate source of evidence on which to base the permanent rating recommendation in this case are the VA mental health outpatient treatment notes from 20060626 to 20060814 (separation was 20051223). Right Knee Condition . Exhibit C. Department of Veterans' Affairs Treatment Record.
AF | PDBR | CY2009 | PD2009-00641
The medical basis for the separation was Major Depressive Disorder, Single Episode, and moderate in severity (MDD). The VA examination at four months post-separation stated “The Veteran has two Axis I diagnoses (PTSD and Depressive disorder, NOS) that mutually aggravate one another, and I cannot ascribe a specific degree of impairment of any one, independent of the other, with any medical certainty, without resorting to speculation.” The CI’s symptoms that would typically be attributable to...
AF | PDBR | CY2009 | PD2009-00484
PTSD Rating Recommendation . In the matter of the Post-Traumatic Stress Disorder with Generalized Anxiety Disorder condition, the Board unanimously recommends an initial TDRL rating of 50% in retroactive compliance with VASRD §4.129 as DoD directed; and a 30% permanent rating at 6 months IAW VASRD §4.130. RECOMMENDATION : The Board recommends that the CI’s prior determination be modified as follows; TDRL at 50% for 6 months following CI’s prior medical separation (PTSD at minimum of 50%...
AF | PDBR | CY2010 | PD2010-00217
(including Bipolar Disorder) The Board unanimously agrees with the PEB, that the Bipolar disorder was not separately unfitting but was related to the PTSD condition. Exhibit C. Department of Veterans' Affairs Treatment Record.