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AF | PDBR | CY2012 | PD2012 00582
Original file (PD2012 00582.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXX       CASE: PD 12-00582      
BRANCH OF SERVICE: AIR FORCE     BOARD DATE: 20131016
DATE OF PLACEMENT ON TDRL: 20001216
Date of Permanent SEPARATION: 20020626           


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty A1C/E-3 (3S, Personnel Helper) medically separated for a mental disorder. In 2000, he experienced psychiatric symptoms during career field training. Despite life skills support and a 5-week hospitalization, the CI did not improve adequately to fully perform his required military duties, and he underwent a Medical Evaluation Board (MEB). The condition, characterized as “schizophreniform disorder” (with “neuroleptic induced akathisia”) was forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123. The informal PEB (IPEB) found the mental disorder to be Category I (unfitting, compensable, and ratable). The akathisia condition was adjudicated as Category II (not compensable or ratable). The CI was placed on the Temporary Disability Retired List (TDRL) at 30%. In March 2002, a second IPEB was convened. The mental disorder, characterized as “schizophrenia,” was found to be Category I. A 10% permanent disability rating was assigned. The CI did not accept the IPEB findings and submitted a written rebuttal. The case was reviewed by the Air Force Personnel Council, and the IPEB findings were upheld. The CI was removed from TDRL, and medically separated with a 10% Service disability rating.


CI CONTENTION: “I did not receive an evaluation for my back post discharge. One of the reasons for my discharge was for re accruing back spasms. It is clearly in my medical records. I was at a different address during the disability redetermination medical evaluation. I did not receive the appointment letter. Therefore, my disability was reduced from 30 percent to 10 percent. I also did not know the appeal process during that time.”


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 disorder is addressed below. The requested back condition was not identified by the PEB, and is not within the DoDI 6040.44 defined purview of the Board. Any conditions outside the Board’s defined scope of review may be eligible for consideration by the Air Force Board for Correction of Military Records (BCMR).


 RATING COMPARISON :

Final Service PEB - 20020329
 VA - Effective 20020314
On TDRL - 20001216
 Code Rating Condition Code Rating Exam
Condition
 TDRL Sep.
Schizophrenia 9204 30% 10% Schizophreniform Disorder 9205 10% STR
Neuroleptic Induced Akathisia NSC STR
No Additional MEB/PEB Entries.
 Other x 1
Combined: 30% → 10%
 Combined: 10%



ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed by the CI regarding the impairment with which his conditions have burdened him, and the impact they have had on his quality of life. It is noted for the record that the Board is subject to the same laws for Service disability entitlements as those under which the military Disability Evaluation System (DES) operates. The DES has neither the role nor the authority to compensate service members for future severity or potential complications of conditions. That role and authority is granted to the Veterans’ Administration (VA). The Board evaluates VA evidence in arriving at its recommendations, but its authority resides in evaluating the fairness of DES fitness and rating determinations. While the DES considers all of the CI's medical conditions, compensation can only be offered for those conditions that cut short a service member’s career. The Board cannot consider the CI’s back pain, because back pain was not included as an MEB/PEB condition. Furthermore, the Board acknowledges the CI’s assertion that certain improprieties may have occurred while the Air Force was processing his case. It is noted for the record that the Board has neither the jurisdiction nor authority to scrutinize or render opinions in regard to suspected Service improprieties. The Board’s role is confined to the review of medical records and all evidence at hand to assess the fairness of PEB fitness and rating determinations, based on severity of symptoms.

Mental Disorder. In September 2000, the CI was admitted to the inpatient psychiatric unit at Keesler Medical Center, Mississippi. The diagnosis was “Schizophreniform disorder.” After five weeks of inpatient treatment, he was discharged from the hospital, and underwent an MEB and PEB. The December 2000 Air Force PEB found him unfit for duty, but the mental condition was not sufficiently stable for permanent adjudication. The CI was placed on the Temporary Disability Retired List (TDRL) with a rating of 30%. The Board carefully considered all the evidence, and determined that a higher rating at that time was not warranted. The CI’s mental disorder was not the result of a highly stressful event. Therefore, the VA Schedule for Rating Disabilities (VASRD) §4.129 (Mental disorders due to traumatic stress) did not apply. Furthermore, IAW the VASRD §4.130 General Rating Formula for Mental Disorders, a rating of 50% would require occupational and social impairment, with reduced reliability and productivity due to such symptoms as: flattened affect, abnormal speech pattern, panic attacks, difficulty understanding commands, impaired memory, impaired judgment, impaired thinking, disturbances of motivation and mood, or difficulty in work and social relationships. Since the treatment record did not show sufficient evidence of these findings, the Board has no basis to recommend a rating higher than 30%, at the time of initial placement on TDRL.

On 22 February 2002, after fourteen months of TDRL, the CI had a psychiatric evaluation at Malcolm Grow Medical Center (MGMC). He was not taking any medication or receiving any mental health (MH) treatment. He denied any current delusions, hallucinations, or other psychotic symptoms. He denied feeling depressed, or having racing thoughts. Sleep, appetite, energy, motivation, concentration, and memory were all good. He denied suicidal or homicidal ideation. He was working 35 hours per week as a sales associate at The Sports Authority. He was also enrolled in college, and was nearing completion of a two year degree in Computer Science. He had a 14 month old son, and was taking care of his son every weekend. He had a girlfriend, and spent much of his free time with her. He also enjoyed playing basketball. Mental status exam (MSE) was normal. The global assessment of functioning (GAF) was 70. The examiner opined that the mental disorder was in remission. In June 2002, the CI was removed from TDRL and permanently separated from military service with a rating of 10%.

The Board carefully reviewed all evidentiary information available. As noted above, the Board debated the applicability of VASRD §4.129 in this case. The Board determined that the CI’s mental disorder did not result from a highly stressful event, and did not meet the implicit intent of VASRD §4.129. Therefore, 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 permanent disability rating is the February 2002 MH exam performed just four months prior to separation. At that time, he was working 35 hours per week, and was enrolled in college. He was not taking medication or receiving any MH treatment. He denied having delusions or hallucinations. He denied feeling depressed, or having racing thoughts. Sleep, appetite, energy, motivation, concentration, and memory were all good. He denied suicidal or homicidal ideation. He appeared to have a good relationship with his girlfriend and son. He also enjoyed playing basketball. MSE was normal, GAF was 70, and his mental disorder was in remission.

It was clear that the CI was asymptomatic, and was functioning well. This was evidenced by his effective employment, his success in college, and his interpersonal relationships. With regard to the psychiatric rating recommendation, all Board members agreed that 10% was appropriate. The Board determined that the CI may experience decreased work efficiency and decreased ability to perform certain 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 concluded that there was insufficient cause to recommend a change in the Air Force IPEB adjudication of the mental disorder (schizophrenia).


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 mental condition 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
TDRL PERMANENT
Schizophrenia 9204 30% 10%
COMBINED 30% 10%


The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20 12 0605 , w/atchs
Exhib it B. Service Treatment Record
Exhibit C. Department of Veterans ’ Affairs Treatment Record




         XXXXXXXXXXXXXXXXXXXX , DAF
         President
         Physical Disability Board of Review



SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762
Dear XXXXXXXXXXXXXXXXXXXX :

          Reference your application submitted under the provisions of DoDI 6040.44 (Title 10 U.S.C. §  1554a), PDBR Case Number PD-2012-00582.
         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 system processing was appropriate. Accordingly, the Board recommended no re-characterization or modification of your separation.
         I have carefully reviewed the evidence of record and the recommendation of the Board. I concur with that finding and their conclusion that re-characterization of your separation is not warranted. Accordingly, I accept their recommendation that your application be denied.
                                                               Sincerely,





 XXXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency
Attachment:
Record of Proceedings



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