RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  ARMY 
SEPARATION DATE:  20060329 

 
NAME:  XXXXXXXXXXXXXX 
CASE NUMBER:  PD12001034 
BOARD DATE:  20130201 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty,  MAJ/O-4  (21B/Combat  Engineer),  medically 
separated  for  bipolar  disorder,  Type  I.    The  CI  experienced  a  manic  episode  in  1997,  then  a 
major depressive episode in 2001, followed by waxing and waning depression in June 2004 with 
symptoms worsening in March 2005.  The CI did not improve adequately with medications and 
treatment to meet the physical requirements of her Military Occupational Specialty (MOS) or 
satisfy  physical  fitness  standards.    She  was  issued  a  permanent  S4  profile  and  referred for a 
Medical  Evaluation  Board  (MEB).    A  bilateral  knee  arthritis  condition,  identified  in  the  rating 
chart  below,  was  also  identified  and  forwarded  by  the  MEB.    The  Physical  Evaluation  Board 
(PEB) adjudicated the bipolar, Type I condition as unfitting, rated 10%, with application of the 
Veteran  Affairs  Schedule  for  Rating  Disabilities  (VASRD).    The  CI  made  no  appeals,  and  was 
medically separated with a 10% disability rating. 
 
 
CI CONTENTION:  “I feel my condition was more severe than it was rated at the time.  When I 
finally reopened my VA claim, they increased my disability rating for the bipolar from 10% to 
50%.” 
 
 
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 bipolar, Type I condition requested for 
consideration  meets  the  criteria  prescribed  in  DoDI  6040.44  for  Board  purview,  and  is 
accordingly addressed below.  Any condition 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: 
 

* Bipolar D/O 9432 increased to 50% effective 20101208 (date VA claim received) utilizing C&P exam 20110221 all documented 
in VARD 20111101 
 
 
ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding  the  significant  impairment  with  which  her  service-incurred  condition  continues  to 

Service IPEB – Dated 20051222 

Condition 

Bipolar Disorder, Type I 

Code 
9432 

Rating 
10% 

Bilateral Knee Arthritis 

Not Unfitting 

No Additional MEB/PEB Entries 

Combined:  10% 

VA (~4 Mos. Post-Separation) – All Effective Date 20060330 
Exam 

Condition 

Code 
9432 

5257-5003 

Rating 
10%* 
10% 

20060724* 
20060712 

Bipolar Disorder 
Degenerative Joint Disease, 
R Knee 
Degenerative Joint Disease, 
L Knee 
Residuals, Left Ankle Strain 

5257-5003 
5271-5024 
Combined:  40% 

10% 
10% 

20060712 
20060712 

burden her.  The Board also notes the current VA ratings listed by the CI for her bipolar Type I 
condition.  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.  The DES 
has neither the role nor the authority to compensate members for anticipated future severity 
or  potential  complications  of  conditions  resulting  in  medical  separation.    That  role  and 
authority is granted by Congress to the Department of Veterans Affairs (DVA), operating under 
a  different  set  of  laws  (Title  38,  United  States  Code).    The  Board  evaluates  DVA  evidence 
proximal to separation in arriving at its recommendations, but its authority resides in evaluating 
the  fairness  of  DES  fitness  decisions  and  rating  determinations  for  disability  at  the  time  of 
separation.  While the DES considers all of the member's medical conditions, compensation can 
only be offered for those medical conditions that cut short a member’s career, and then only to 
the  degree  of  severity  present  at  the  time  of  final  disposition.    The  DVA,  however,  is 
empowered to compensate service-connected conditions and to periodically re-evaluate said 
conditions  for  the  purpose  of  adjusting  the  Veteran’s  disability  rating  should  the  degree  of 
impairment vary over time. 
 
Bipolar  Disorder  Condition.    The  Board  first  addressed  if  the  tenants  of  §4.129  (Mental 
disorders due to traumatic stress) were applicable.  The Board noted that there was no “highly 
stressful event” for which provisions of §4.129 would apply, and therefore concludes that its 
application is not appropriate to this case.  Consequently, the rating recommendation will be 
premised  on  the  psychiatric  acuity  at  the  time  separation.    Waxing  and  waning  depressive 
symptoms led to a manic episode with associated hallucinations and delusions that required 
hospitalization  in  March  2005.    A  10  day  inpatient  treatment  program  resulted  in  marked 
improvement  in  her  condition,  “close  to  her  self-stated  baseline.”    The  mental  status  exam 
(MSE)  at  time  of  discharge  on  28  March  2005  (12  months  prior  to  separation)  noted 
appropriate grooming and normal orientation.  Speech displayed a mildly increased rate, but 
thought processes were normal and there was no evidence of suicidal or homicidal ideations, or 
of hallucinations or delusions.  Mood was “good” and affect euthymic and reactive.  Judgment, 
impulse control and insight were good, and memory was unimpaired.  Global Assessment of 
Functioning (GAF) was 65 (connoting mild symptoms or impairment).  She was discharged on 
one  psychotropic  medication.    At  the  time  of  a  psychiatric  narrative  summary  (NARSUM) 
update on 23 November 2005 (4 months prior to separation) the CI was considered to be in a 
depressive  episode  of  bipolar  disorder.    Despite  good  compliance  with  medications  and 
individual  psychotherapy,  she  had  continued  to  experience  recurrent  mild  to  moderate 
depressive symptoms during the previous 6 months.  However, the current depressive episode 
occurred in the context of discontinuation of her two psychotropic medications due to possible 
side effects.  MSE revealed normal orientation and intact memory, concentration, and speech.  
Mood was depressed, but affect was full ranging, reactive and appropriate to content.  There 
was no agitation.  Thought processes were normal and thought content showed no evidence of 
suicidal  or  homicidal  ideations,  delusions  or  hallucination.    Judgment,  insight  and  impulse 
control  were  unimpaired.    Because  a  new  medication  regimen  was  just  being  instituted,  the 
examiner  could  not  yet  assess  a  therapeutic  response.    Degree  of  military  impairment  was 
considered “marked” and impairment for social and industrial adaptability “definite.”  GAF was 
51 (connoting moderate symptoms or impairment).  Five years after separation a VA examiner 
(see below) referred to a prior to separation evaluation performed on 12 January 2006 by the 
NARSUM  examiner  (2  months  prior  to  separation),  at  which  time  the  bipolar  condition  was 
considered  to  be  in  partial  remission  and  the  GAF  was  80+.    At  the  VA  Compensation  and 
Pension (C&P) exam on 24 July 2006 (4 months after separation) the CI reported living with her 
sister and stated she “wants to find work but can’t get motivated.”  She last worked while in the 
service in April 2005.  Some problems with sleep initiation and maintenance were noted.  She 
expressed being recently mildly depressed “somewhat chronically.”  MSE revealed appropriate 
grooming and normal orientation.  Mood was anxious and affect was congruent.  Speech was 
not pressured.  Thought was coherent and unimpaired, and there were no signs of delusions or 
hallucinations.    There  were  no  apparent  short  or  long  term  memory  difficulties,  and  no 

   2                                                           PD1201034 
 

problems with impulsivity.  Panic attacks were denied.  The GAF was 75 (connoting transient 
symptoms,  no  more  than  slight  impairment).    The  assessment  was  bipolar  disorder  with  a 
recent episode of mild depression considered to be in partial remission.  At a C&P evaluation on 
21 February 2011 (5 years after separation), the examiner stated that since separation the CI 
had  been  unable  to  maintain  full-time  employment  at  a  level  commensurate  with  her 
educational background and experience due to work inefficiency and absenteeism caused by 
depressive symptoms. 
 
The Board directs attention to its rating recommendation based on the above evidence, and 
considered  if  a  rating  higher  than  the  10%  adjudicated  by  the  PEB  was  justified.    Board 
members agreed that the 50% rating criteria were not met at the time of separation; therefore, 
deliberations centered on a 10% versus a 30% rating.  The 10% rating specifies “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.”  The 
next higher 30% rating specifies “occupational and social impairment with occasional decrease 
in work efficiency and intermittent periods of inability to perform occupational tasks.” The two 
threshold  symptoms  of  depressed  mood  and  sleep  impairment  documented  by  the  first  VA 
examiner could suggest the 30% level of disability.  In this regard, the Board also deliberated 
the significance of the CI’s unemployed status due to lack of motivation at the time of the first 
VA exam, and the last VA examiner’s statement regarding a history since separation of work 
inefficiency  and  absenteeism.    Board  members  further  considered  that  although  manic  and 
psychotic  symptoms  did  not  recur  after  her  hospitalization,  some  depressive  symptoms  did 
appear to persist in a waxing and waning fashion.  However, the episode of depression proximal 
to the time of separation occurred in the context of discontinuing a medication, and the prior to 
separation follow-up  visit  by the NARSUM  examiner  and the  post-separation  C&P  evaluation 
both  documented  a  positive  response  to  the  new  medication  regimen.    The  status  of  the 
condition at the time of separation was described by both examiners as “in partial remission” 
and GAF scores denoted no more than slight impairment.  The Board also considered that all 
MSE evidence described above was essentially unremarkable.  On balance, the Board concluded 
that there was not adequate reasonable doubt favoring the next higher 30% rating, and agreed 
that at the time of separation the condition more nearly approximated the criteria for the 10% 
rating.  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 the bipolar 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.    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 bipolar disorder 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 

9432 

COMBINED 

10% 
10% 

Bipolar Disorder, Type I 

 
 

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The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120427, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXX, DAF 
           Acting Director 
           Physical Disability Board of Review 

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SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / xxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxxx, AR20130003105 (PD201201034) 
 
 
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 
 
 
 
 

     xxxxxxxxxxxxxxxxxxxxxxx 
     Deputy Assistant Secretary 
         (Army Review Boards) 

 
 
 

 
 
 

 

 
 
 

 
 
 

   5                                                           PD1201034 
 

 
 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / XXXXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation 
for XXXXXXXXXXXX, AR20130003105 (PD201201034) 
 
 
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 
 
 
 

     XXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards) 

 
 
 

 
 

 
 
 

 
 
 

 
 
 

 
 
 

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