RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXX CASE: PD 12-01249 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130430 

SEPARATION DATE: 20070412 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (19K10 / Tank Crewman) medically separated 
for depression. He was diagnosed with major depressive disorder after his tank was hit by an 
improvised explosive device (IED) while deployed to Iraq in 2005. He underwent a trial of 
medications and outpatient therapy, but failed to improve adequately to meet the operational 
requirements of his Military Occupational Specialty (MOS). He was issued a permanent S3 
profile and referred for a Medical Evaluation Board (MEB). “Major depressive disorder, single 
episode” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other 
conditions were submitted by the MEB. The informal PEB adjudicated “major depressive 
disorder, requiring psychotropic medication and outpatient treatment” as unfitting, rated 10% 
citing criteria of the US Army AR 635-40, Appendix B-107, paragraph e. The CI made no 
appeals, and was medically separated with that Service disability rating. 

 

 

CI CONTENTION: “I believe the rating should be changed because for the exact same condition 
the Army rated me 10% the VA rated me 50% (PTSD w/Major Depression).” 

 

 

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, 
paragraph 5.e.(2). It is limited to those conditions determined by the PEB to be unfitting for 
continued military service and those conditions identified but not determined to be unfitting by 
the PEB when specifically requested by the CI. The Service rating for the unfitting mental 
health condition is addressed below; and no additional conditions are within the DoDI 6040.44 
defined purview of the Board. Any conditions or contention not requested in this application, 
or otherwise outside the Board’s defined scope of review, remain eligible for future 
consideration by the respective Service Board for Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20070309 

VA – (2 days Pre-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Major Depressive Disorder 

9434 

10% 

Post-Traumatic Stress Disorder with 
Major Depression, Single Episode 

9434-9411 

50%* 

20070410 

No Additional MEB/PEB Entries 

Other x 2 

20070305 

Combined: 10% 

Combined: 50% 



Derived from VA Rating Decision (VARD) dated 20070508 (most proximate to date of separation [DOS]). 

*VA rating based on application of §4.129 with plan for follow up examination in September 2007 however no examination was 
accomplished. 

 

 

 

 


ANALYSIS SUMMARY. 

 

Major Depressive Disorder Condition. The CI denied any mental health evaluation or treatment 
prior to entering active duty in July 2003. Between January 2005 and January 2006 he was 
deployed to Iraq. According to the MEB NARSUM, he described several stressful events that 
occurred during this deployment: was shot at many times by sniper fire, his tank hit many IEDs 
saw some of his friends injured or killed. On August 15, 2005, his tank hit an IED igniting a fire 
inside the tank resulting in second degree burns on areas of his back, abdomen and elbows. He 
was treated at a military hospital in theater 15 to 25 August with wound care and pain control. 
During this period, the CI experienced nightmares with flashbacks of the fire episode, as well as 
depression, confusion and anger. At one point he contemplated suicide but stated “the 
thought of his wife stopped him”. He also complained of insomnia for which he received one 
month treatment with sleep inducing medication (Ambien). After the two weeks 
hospitalization period, the CI was sent back to his unit and completed his deployment in 
January 2006. According to the CI, after return from deployment he “did well” for the first 50 
to 90 days, then he started experiencing behavioral and anger issues as well as apathy, low 
energy and poor concentration. He enrolled in therapy and also received treatment with 
medication. He was treated in the outpatient clinic and in June 2006 he was referred to mental 
health where he continued individual, group therapy and medication management. Treatment 
records from June 2006 indicated there had been no nightmares for the preceding six months 
and no problems with re-experiencing traumatic event. A 14 September 2006 mental health 
clinic entry also indicated no further problems with nightmares, flashbacks, exaggerated startle 
response, or avoidance. Psychiatry examination 20 October 2006 noted deployment to field 
training caused distress but otherwise there were no nightmares, hypervigilance, avoidance, or 
re-experiencing of the trauma. His complaint was of depressed mood and irritability. 
According to a 27 October 2006 clinic report the CI was working at HQ due to his profile without 
conflicts. Review of medical and therapy reports up to December 2006 evidenced complaints 
of sleep disturbances, irritability, decreased energy level, apathy, poor concentration and 
memory with some improvement of symptoms at times. One psychiatric note from 6 
December 2006 mentioned good sleep and remission of anxiety symptoms as evidenced by the 
CI Christmas shopping trip which was uneventful and enjoyable. The MEB narrative summary 
(NARSUM) mental status exam from 4 December 2006, less than 5 months prior to separation 
noted a casually dressed and groomed male, generally cooperant with the interview but 
becoming irritable and angry at times. The CI had good eye contact, normal speech, intact 
thoughts processing, insight and judgment. Mood was described as “depressed”, affect was 
restricted, congruent with mood. There was no evidence of suicidal/homicidal ideations, 
psychosis or delusional thinking. The examiner assigned a diagnosis of major depressive 
disorder, single episode, without psychotic features. He considered a marked degree of 
psychiatric impairment for military duty and a definite degree of impairment for social and 
industrial adaptability. Service treatment records from 6 December 2006 through 8 March 
2007 reflect improving symptoms including improved mood, decreased irritability, and 
improved marital relationship. He was sleeping seven hours per night without nightmares and 
awakening rested. He continued to complain of poor concentration and low energy. A 14 
December 2006 mental health clinic encounter noted the CI was going on leave and reported 
doing well without any problems. On examination mood and affect were normal. Although he 
experienced increased depressed mood with irritability in January 2007 while deployed to field 
training where he served in a support role, his symptoms improved upon return. By the time of 
an 8 March 2007 mental health clinic appointment, modestly improved depression, anxiety and 
irritability were noted. There were no nightmares and he continued to get seven hours of 
sleep. Work was “ok” and his marriage was “going better”. The commander’s letter 8 March 
2007 reported the CI was working full duty days satisfactorily performing administrative duties 
that included 24 hour shifts. At the VA Compensation and Pension (C&P) exam performed on 
10 April 2007, 2 days before separation, the CI reported recurrent dreams of deployment 
events, nightmares, intense distress in crowded places, anxiety attacks. Also complained of 


having anger outbursts, difficulties concentrating, being hypervigilant and feeling detached 
from other people. He stated he planned on studying business administration. Mental status 
exam described the CI as cooperant, with good grooming and hygiene and appropriate 
behavior. Affect was described as anxious, intense and appropriate to thoughts content. 
Speech was normal, good recollection of events, attention and concentration. No evidence of 
panic or anxiety attacks, no delusions, hallucinations, suicidal or homicidal thoughts. Judgment 
was described as intact. The psychiatrist diagnosed the CI condition as post traumatic stress 
disorder, mild and major depressive disorder, single episode, in partial remission and assessed a 
global assessment of functioning (GAF) of 80-85 (mild symptoms). 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB adjudicated a 10% rating at separation. The VA adjudicated a temporary 50% rating based 
on application of VASRD §4.129 and planned a follow up examination in September 2007, 
however there is no evidence this examination was accomplished. The PEB rating, as noted 
above, was derived from DoDI 1332.39 and preceded the promulgation of the National Defense 
Authorization Act (NDAA) 2008 mandate for DOD adherence to VASRD (Veterans 
Administration Schedule for Rating Disabilities) §4.129. IAW DoDI 6040.44 and DoD guidance 
(which applies current VASRD 4.129 to all Board cases), the Board is obligated to consider if the 
definition of §4.129 is met for any psychiatric condition resulting in medical separation; i.e., “a 
mental disorder that develops in service as a result of a highly stressful event”. Regardless of 
final PEB diagnosis, §4.129 does not specify a diagnosis of PTSD, rather it states “mental 
disorder due to a highly stressful event”, and its application is not restricted to PTSD. If the 
Board judges that application of §4.129 is appropriate, it must recommend a minimum 50% 
rating for a retroactive six-month period on the Temporary Disability Retired List (TDRL). The 
Board must then determine the most appropriate fit with VASRD 4.130 criteria at six months for 
its permanent rating recommendation. The Board first addressed if the tenant of §4.129 
(Mental disorders due to traumatic stress) were applicable. The Board determined that the 
major depression was due to a “highly stressful event” as used in the VASRD, and that 
application of §4.129 is appropriate in this case. All Board members agreed that the §4.130 
criteria for a rating higher than 50% were not met at the time of separation, and therefore IAW 
§4.129 the minimum 50% TDRL rating is applicable. 

 

The most proximate source of comprehensive evidence on which to base both the constructive 
TDRL and permanent rating recommendation is the VA compensation and pension psychiatric 
examination performed two days before separation and service treatment records proximate 
to separation. There is no follow-up psychiatric evaluation or other useful rating information 
from the post-separation period. The Board must therefore weigh the evidence contained in 
the MEB psychiatric NARSUM, pre-separation treatment records, and initial VA PTSD C&P 
examination, in order to extrapolate an estimation of the ratable impairment at six months 
after separation. DoDI 6040.44 specifies a 12 month interval for special consideration to VA 
findings, rendering the probative value of the later VA evidence in this case somewhat 
diminished. Therefore the Board decided that the permanent rating recommendation is most 
appropriately based primarily on the April 2007 C&P examination and service treatment records 
close to separation with consideration of the psychiatry MEB NARSUM five months prior to 
separation. Next, the Board considered its recommendation for a permanent rating for PTSD 
based on the most appropriate fit with VASRD §4.130 criteria at six months following 
separation from active duty and placement on the constructive period of TDRL. The Board 
discussion centered on the degree of social and occupational impairment at the time of 
removal from the constructive TDRL at six months. All Board members agreed that the 
preponderance of evidence did not approach the 50% rating, therefore, the Board deliberations 
centered on a 10% versus a 30% rating. Social and occupational impairment consistent with a 
30% evaluation (“Occupational and social impairment with occasional decrease in work 
efficiency and intermittent periods of inability to perform occupational tasks…”), could be 
surmised from some of the reported symptoms at the time of separation including depressed 


mood, irritability, fatigue, and decreased concentration. However, the CI was sleeping well, 
denied significant interpersonal problems and was satisfactorily performing administrative 
duties that included 24 hour shifts. The commander’s statement from March 2007 did not 
reflect problems with work relationships and reported satisfactory performance in assigned 
duties. The numerous troubling symptoms of PTSD reported at the time of the VA C&P 
examination were not corroborated by service treatment records. There were no panic attacks, 
and although restricted affect and anxious mood were noted on the C&P examination, there 
was no indication that it contributed to significant impairment in social or occupational 
function. There was no indication of family conflict or impaired relations with 
friends/coworkers. The mental status examinations reflected normal interaction including 
normal thought processes and communication and absence of suicidal thoughts. There was no 
evidence of abuse of alcohol or illegal drugs or any other type of dangerous or self destructive 
behavior indicative of good coping skills. The Board concluded that while he continued to 
manifest symptoms requiring medication, the impairment from the depressive disorder at the 
time of separation was mild which would decrease work efficiency and ability to perform 
occupational tasks only during periods of significant stress. After due deliberation, considering 
all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a six 
month period of constructive TDRL at 50% and a permanent disability rating of 10% for the 
major depressive disorder condition. 

 

 

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 Board to the extent they were 
inconsistent with the VASRD in effect at the time of the adjudication. As discussed above, PEB 
reliance on DoDI 1332.39 for rating major depressive disorder was likely operant in this case 
and the condition was adjudicated independently of that instruction and policy by the Board. In 
the matter of the major depressive disorder condition, the Board unanimously recommends an 
initial TDRL rating of 50% in retroactive compliance with VASRD §4.129 as DOD directed, and a 
10% permanent rating at six months IAW VASRD §4.130. There were no other conditions 
within the Board’s scope of review for consideration. 

 

 

RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as 
follows, effective as of the date of his prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

TDRL 

PERMANENT 

Major Depressive Disorder 

9434 

50% 

10% 

COMBINED 

50% 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120704, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxxx, AR20130011066 (PD201201249) 

 

 

1. Under the authority of Title 10, United States Code, section 1554(a), I approve the enclosed 
recommendation of the Department of Defense Physical Disability Board of Review (DoD PDBR) 
pertaining to the individual named in the subject line above to constructively place the 
individual on the Temporary Disability Retired List (TDRL) at 

50% disability for six months effective the date of the individual’s original medical separation 
for disability with severance pay and then following this six month period no recharacterization 
of the individual’s separation or modification of the permanent disability rating of 10%. 

 

2. I direct that all the Department of the Army records of the individual concerned be corrected 
accordingly no later than 120 days from the date of this memorandum as follows: 

 

 a. Providing a correction to the individual’s separation document showing that the 
individual was separated by reason of temporary disability effective the date of the original 
medical separation for disability with severance pay. 

 

 b. Providing orders showing that the individual was separated with a permanent 
combined rating of 10% effective the day following the six month TDRL period with no 
recharacterization of the individual’s separation. 

 

 c. Adjusting pay and allowances accordingly. Pay and allowance adjustment will 
provide 50% retired pay for the constructive temporary disability retired six month period 
effective the date of the individual’s original medical separation and adjusting severance pay as 
necessary to account for the additional TDRL time in service. 

 

 

 

 

 

3. I request that a copy of the corrections and any related correspondence be provided to the 
individual concerned, counsel (if any), any Members of Congress who have shown interest, and 
to the Army Review Boards Agency with a copy of this memorandum without enclosures. 

 

BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)