RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXX CASE: PD1201565 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130320 

SEPARATION DATE: 20080527 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (68P/Radiology Technician) medically 
separated for bipolar disorder (BPD). She was initially diagnosed with premenstrual dysphoric 
disorder (PMDD). In 2007, her psychiatrist noted significant worsening of symptoms, and 
changed the diagnosis to BPD. She was treated, but did not improve adequately to fully 
perform her military duties. She was issued a permanent profile and referred for a Medical 
Evaluation Board (MEB). Bipolar disorder was forwarded to the Physical Evaluation Board (PEB) 
IAW AR 40-501. The MEB also forwarded four other conditions (patellofemoral syndrome, 
chronic right rotator cuff sprain, migraine headaches, and mild hypercholesterolemia), judged 
to meet retention standards. The Informal PEB (IPEB) adjudicated bipolar disorder as an 
unfitting condition not service incurred or permanently aggravated and therefore ineligible for 
disability compensation. The remaining conditions were determined to be not unfitting and 
therefore not ratable. The CI appealed to the Formal PEB (FPEB) stating that the board finding 
of existed prior to service (EPTS) was incorrect. Her appeal stated that she received no medical 
treatment for depression prior to November 2005 and outlined the stressors of the military as 
causing service aggravation. The FPEB changed the disability description to note she had no 
manic episodes or formal diagnosis with treatment until after service entry. She was then 
medically separated with a 10% disability rating. 

 

 

CI CONTENTION: “Physical Disability Evaluation Board combined rating and VA rating for the 
same condition are inconsistent for same condition (VDRS code 9432).” 

 

 

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 rating for the unfitting bipolar disorder 
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 Army Board for Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Service FPEB – Dated 20080131 

VA - (4 Mos. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Bipolar Disorder 

9432 

10% 

Bipolar Disorder 

9432 

30% 

20080922 

Patellofemoral Syndrome 

Not Unfitting 

Chondromalacia Rt Knee 

5260-5024 

10% 

20080922 

Chronic Rt Rotator Cuff Sprain 

Not Unfitting 

Right Shoulder Pain 

5201 

20% 

20080922 

Migraine Headaches 

Not Unfitting 

Migraine Headaches 

8100 

30% 

20080922 

Mild Hypercholesterolemia 

Not Unfitting 

No VA Entry for Hypercholesterolemia 

No Additional MEB/PEB Entries 

Other x 1 

20080922 

Combined: 10% 

Combined: 70% 



Derived from VA Rating Decision (VARD) dated 20090202 (most proximate to date of separation [DOS]). 


ANALYSIS SUMMARY: 

 

Bipolar Disorder (BPD). The CI has a long history of psychiatric problems. During her teen years 
she suffered from depression, irritability, and self-mutilation. After joining the Army, she was 
diagnosed with PMDD, and was treated with anti-depressant medications. She then developed 
symptoms of paranoia, restlessness, racing thoughts, and insomnia; alternating with 
hyperphagia, memory loss, and crying spells. She was seen by psychiatry and was diagnosed 
with BPD. Due to her psychiatric illness, an MEB was initiated. At her October 2007 psychiatric 
visit, the CI appeared calm, had soft speech, and had mildly depressed mood. She denied 
suicidal/homicidal behavior, or psychotic symptoms. She was cognitively intact. Global 
Assessment of Functioning (GAF) was 60. As noted above, the CI was medically separated from 
the Army in May 2008. 

 

The Board carefully reviewed all evidentiary information available. The Board debated the 
applicability of the Veterans’ Administration Schedule for Rating Disabilities (VASRD) §4.129 in 
this case. The Board determined that the CI’s psychiatric symptoms did not result from a highly 
stressful event, and did not meet the implicit intent of VASRD §4.129. After much discussion, 
the Board unanimously agreed that VASRD §4.129 did not apply in this case. The Board then 
directed its attention to its rating recommendation, based on the evidence in the record. 

 

The best source of information on which to base the psychiatric rating recommendation is the 
September 2008 VA Compensation and Pension (C&P) exam performed just 4 months after 
separation. At that time, she was working full time as a receptionist at a hospital. She was 
married, and was raising three young children. Her medications included Zyprexa and Seroquel. 
On examination, she was groomed and dressed normally. She related to the examiner in a 
pleasant and cooperative manner. Speech was normal. She denied any flight of ideas or 
pressured speech. She denied hallucinations or delusions, and there was no grandiosity. Affect 
was appropriate, and she denied any suicidal or homicidal ideation. Her memory, fund of 
knowledge, calculations, spelling, insight, and judgment were all good. GAF score was 57. 
Were it not for her borderline personality disorder, her GAF would have been about five points 
higher. It was clear that her symptoms were fairly mild and that the CI was functioning 
reasonably well. This was evidenced by her good supportive employment, and her good family 
relations. She enjoyed reading novels, watching television, and surfing the internet. With 
regard to the psychiatric rating recommendation, all Board members agreed that 10% was 
appropriate. The Board determined that the CI’s mild symptoms would decrease work 
efficiency and ability to perform certain tasks, only during periods of significant stress. 
Therefore, 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 BPD 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. The Board did not surmise 
from the record or PEB ruling in this case that any prerogatives outside the VASRD were 
exercised. In the matter of the BPD and IAW VASRD §4.130, the Board unanimously 
recommends no change in the PEB adjudication. 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 

Bipolar Disorder 

9432 

10% 

COMBINED 

10% 



 

 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120829, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxxxxxxxx, AR20130007482 (PD201201565) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)