RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201093 SEPARATION DATE: 20031105 

BOARD DATE: 20130215 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty PFC/E-3 (91X/Mental Health Technician), medically 
separated for major depression. The CI was referred to mental health in April 2000 but did not 
receive any specific mental health treatment at that time. He was again seen in mental health 
in July 2001 and was referred to the Army Substance Abuse Program. In June 2002, he again 
sought treatment with mental health. He had repeat hospitalizations after presenting to the 
emergency room with intoxication and suicidal ideation. The CI did not improve adequately 
with treatment to meet the physical requirements of his Military Occupational Specialty (MOS). 
He was issued a permanent S3 profile and referred for a Medical Evaluation Board (MEB). 
Alcohol dependence in partial remission, migraine headaches, right knee chondromalacia, 
bilateral retropatellar pain syndrome, right shoulder tendinitis and pseudofolliculities barbae, 
identified in the rating chart below, were also identified and forwarded by the MEB as 
conditions meeting retention standards. The Informal Physical Evaluation Board (IPEB) 
adjudicated the major depressive disorder (MDD) as unfitting, rated 10%, with application of 
the Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The remaining conditions were 
determined to be not unfitting. The CI did not concur with the IPEB, but waived a Formal PEB 
(FPEB) and was medically separated with a 10% disability rating. The US Army Physical 
Disability Agency (USAPDA) reviewed the CIs rebuttal, and affirmed the IPEB findings. 

 

 

CI CONTENTION: “My depression, back issues and knee pain have been debilitating.” 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44, Enclosure 3, paragraph 5.e. (2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.” The ratings 
for unfitting conditions will be reviewed in all cases. The depression and knee pain as 
requested for consideration meet the criteria prescribed in DoDI 6040.44 for Board purview 
and are addressed below. The other requested condition, “back issues”, is not within the 
Board’s purview. 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 
Army Board for Correction of Military Records. 

 

 

 

 

 

 

 

 

 

 

 

 


RATING COMPARISON: 

 

Service IPEB – Dated 20030808 

VA (13 Mos. Post-Separation) – All Effective Date 20031106 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Major Depression 

9434 

10% 

Major Depression 

9434 

30% 

20041202 

B Knees; retropatellar pain 

Not Unfitting 

L knee Retropatellar Pain Syn 

5024 

10% 

20041202 

R knee Retropatellar Pain Syn 

5024 

10% 

20041202 

R Knee Chondromalacia 

Not Unfitting 

Migraine Headaches 

Not Unfitting 

Migraine Headaches 

8100 

10% 

20041202 

R Shoulder Tendinitis 

Not Unfitting 

R Shoulder, Grade 2 
Acromioclavicular joint Sep 

5203 

0% 

20041202 

Alcohol Dependence 

Not Unfitting 

NO VA ENTRY 

 

Pseudofolliculitis barbae 

Not Unfitting 

NO VA ENTRY 

 

.No Additional MEB/PEB Entries. 

Lumbosacral DDD 

5243 

10% 

20041202 

0% X 1 / Not Service-Connected x 0 

 

Combined: 10% 

Combined: 60% 



Major Depression increased to 50% 14 January 2008 

 

ANALYSIS SUMMARY: The Board acknowledges the CI’s contention that suggests ratings should 
have been conferred for other conditions documented at the time of separation. The Board 
wishes to clarify that it is subject to the same laws for Service disability entitlements as those 
under which the Disability Evaluation System (DES) operates. While the DES considers all of the 
member's medical conditions, compensation can only be offered for those medical conditions 
that cut short the member’s career; and then only to the degree of severity present at the time 
of final disposition. However the Department of Veterans Affairs (DVA), operating under a 
different set of laws (Title 38, United States Code), is empowered to compensate all service-
connected conditions and to periodically reevaluate said conditions for the purpose of adjusting 
the Veteran’s disability rating should the degree of impairment vary over time. 

 

Major Depression Disorder (MDD). Although the treatment records indicated a mental health 
referral in April 2000 for attention and impulse issues, the CI was not diagnosed with a mental 
health disorder until May 2002. At that time he was diagnosed with adjustment disorder. He 
received talk therapy and was assigned a Global Assessment of Functioning (GAF-an objective 
description of how well a person is functioning at home, on the job, and in the community, 
family) score of 65 in June 2002 (mild impairment). Shortly thereafter his wife left and his 
symptoms of poor sleep, decreased energy and loss of interest were exacerbated, and he was 
placed on medication. On 26 August 2002, he was hospitalized for 6 days for suicidal thoughts 
and alcohol intoxication, and improved after treatment with medication for depression. A 
month later the CI was enrolled in a 29-day inpatient alcohol treatment program. His 
depression went into partial remission 31 January 2003 and he had been sober for about 2 
months. His mood and affect were in normal range and he continued on medication. Three 
weeks after the psychiatry narrative summary (NARSUM) (24 June 2003) the CI presented to 
emergency room for suicidal thoughts but was not admitted. A month later, August 2003, he 
was admitted to psychiatric facility for suicidal ideation and discharged 2 days later. The last 
mental health encounter note was 12 September 2003, approximately 2 months prior to 
separation. He had mild transient suicidal ideation, no intent or plan and was noted to be in 
partial remission of both depression and alcohol dependence, and stable on medication. The CI 
had a S3 Profile dated 30 July 2003 with assignment limitations of no access to or handling of 
firearms and no assignment to units remote from definitive medical care. At the time of the 
MEB exam (24 June 2003), 5 months prior to separation and approximately a month prior to 
inpatient treatment for suicidal ideation, the CI endorsed symptoms of depressed mood, 
reduced interest in activities, reduced motivation and decreased energy. He denied crying 
spells, guilt feelings, difficulty with concentration, appetite, and sleep, although he indicated 
decreased in hours of sleep. He denied psychotic and anxiety symptoms. The CI reported that 
his symptoms had improved somewhat since seeking treatment, but indicated ongoing 
stressors of occupational demand, right knee injury and recovery from his divorce. The mental 


status exam (MSE) was remarkable for mildly constricted, depressed affect and passive suicidal 
thoughts of “sometimes not wishing he was around.” Thought content was without active 
suicidal ideation, and no evidence of psychosis or cognitive impairment. The MEB psychiatrist 
diagnosed MDD, single episode, in partial remission and assigned a GAF score of 65 connoting 
mild degree of impairment. The examiner opined that the CI’s “degree of impairment for 
civilian, social, and industrial adaptability is mild.” At the psychiatric NARSUM addendum (28 
July 2003), post hospitalization, the CI disclosed he experienced increased stress and anxiety 
over leaving the military which led to suicidal thoughts and hospitalization. His MSE did not 
differ significantly from previous exam, thus, mild impairment was recorded with a GAF of 65. 
The VA Compensation and Pension (C&P) exam was completed 13 months after separation. 
The CI’s symptoms and level of impairment were not distinctly different from that found at the 
MEB. At the time of the C&P exam the CI indicated he felt better overall and had stopped 
taking medication about 3 months prior to the C&P exam. He acknowledged occasional 
depressed mood and sleep disturbance. He was noted to be socially and occupationally 
functional, had remarried and had been working as a salesperson “just below 40 hours per 
week” for about 10 months post separation. The MSE noted depressed mood and flat affect. 
He denied suicidal thoughts, problems with appetite, symptoms of anxiety and psychosis. 
There was no evidence of cognitive impairment and no evidence of psychosis. The VA 
psychiatrist diagnosed MDD and assigned a GAF of 70 connoting mild impairment. 

 

The Board directs its attention to the rating recommendation based on the evidence just 
described. The PEB’s rating of 10% coded 9434 citing mild social and civilian industrial 
impairment. The VA rated the CI’s condition using data acquired more than a year after 
separation at 30% coded 9434 based on §4.130 criteria. The Board first unanimously agreed 
that VASRD §4.129 was inapplicable in this in the absence of a highly stressful causative event. 
The MEB examination had numerous criteria from the general description for a §4.130 rating of 
70% (“occupational and social impairment with deficiencies in most areas, stressors of divorce, 
SI, hospitalizations, Articles for missing work”), despite assessed “mild” GAF and “mild 
interference with social adaptability and civilian industrial adaptability,” especially considering 
the two hospitalizations for suicidal ideations. However, the CI had been in partial remission 
for months, continued to work in his MOS, and had demonstrated the ability to remain safe and 
to commit to safety. A year after separation he remarried, was working nearly 40 hours a week 
and discontinued his medication with no repeated hospitalizations. At the time of separation 
the Board agreed that the §4.130 threshold for a 50% rating (occupational and social 
impairment with reduced reliability and productivity) was not approached. The deliberation 
settled on arguments for a 10% versus a 30% permanent rating recommendation. The 30% 
description (“occupational and social impairment with occasional decrease in work efficiency 
and intermittent periods of inability to perform occupational tasks”) is difficult to support given 
that the CI reported very few symptoms and presented no evidence of occupational or social 
impairment at the time of the VA exam. The 10% description, “occupational and social 
impairment due to mild or transient symptoms which decrease work efficiency only during 
periods of significant stress, or; symptoms controlled by continuous medication”, more 
accurately reflects the CI’s condition at separation. All evidence considered there is not 
reasonable doubt in the CI’s favor supporting a change from the PEB’s rating decision for the 
MDD condition. After due deliberation, considering all of the evidence and mindful of VASRD 
§4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend 
a change in the PEB adjudication for the major depression condition. 

 

Contended PEB Conditions. The other conditions forwarded by the MEB and adjudicated as not 
unfitting by the PEB were bilateral knee retro patellar pain and right knee chondromalacia. The 
Board’s first charge with respect to these conditions is an assessment of the appropriateness of 
the PEB’s fitness adjudications. The Board’s threshold for countering fitness determinations is 
higher than the VASRD §4.3 (reasonable doubt) standard used for its rating recommendations, 
but remains adherent to the DoDI 6040.44 “fair and equitable” standard. 1) Bilateral knee 


condition: Service treatment records (STRs) indicated CI complained of pain in both knees and 
upon evaluation he had full range of motion, no effusions, and no evidence of knee instability; 
2) Right knee chondromalacia: MRI dated 20 June 2000 recorded a normal exam. On 25 April 
2003 arthroscopy was performed revealing normal knee structures and a Grade 2 
chondromalacia of the medial patella. A shaving of the area (chrondroplasty) was performed. 
Neither of these conditions was implicated in the commander’s performance statement, on the 
permanent profile, or noted as failing retention standards. All were reviewed and considered 
by the Board. There was no indication from the record that either of these conditions 
significantly interfered with satisfactory duty performance. After due deliberation in 
consideration of the preponderance of the evidence, the Board concluded that there was 
insufficient cause to recommend a change in the PEB fitness determination for either 
contended conditions involving the knees; and, therefore, no additional disability ratings can be 
recommended. 

 

 

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. In the matter of the 
MDD, and IAW VASRD §4.130, the Board unanimously recommends no change in the PEB 
adjudication. In the matter of the contended bilateral knee retropatellar pain and right knee 
chondromalacia conditions, the Board unanimously recommends no change from the PEB 
determinations as not unfitting. There were no other conditions within the Board’s scope of 
review for consideration. 

 

 

RECOMMENDATION: The Board, therefore, recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Major Depression Disorder 

9434 

10% 

COMBINED 

10% 



 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120612, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxx, AR20130006169 (PD201201093) 

 

 

I have reviewed the enclosed Department of Defense Physical Disability Board of 
Review (DoD PDBR) recommendation and record of proceedings pertaining to the 
subject individual. Under the authority of Title 10, United States Code, section 1554a, 
I accept the Board’s recommendation and hereby deny the individual’s application. 

This decision is final. The individual concerned, counsel (if any), and any Members of 
Congress who have shown interest in this application have been notified of this decision 
by mail. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)