RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

                SEPARATION DATE:  20070430 

                                BRANCH OF SERVICE:  MARINE CORPS 

 
NAME:    
CASE NUMBER:  PD1200001  
BOARD DATE:  20121002   
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  LCpl/E-3  (7051/Aircraft  Fire  Fighting  &  Rescue 
Specialist),  medically  separated  for  bipolar  I  disorder,  single  manic  episode,  severe  without 
psychotic features.  The CI was “removed from theater in Iraq for suspected bipolar disorder 
after 4 months of deployment.”  He was started on medication and appeared normal on arrival 
at  home  station,  however,  he  demonstrated 
increasingly  bizarre  behavior  and  was 
psychiatrically  hospitalized  with  a  diagnosis  of  bipolar  disorder.    He  improved  during 
hospitalization on treatment and was discharged with referral to a Medical Evaluation Board 
(MEB).    Bipolar  I  disorder,  single  manic  episode,  severe  without  psychotic  features  was 
forwarded  to  the  Physical  Evaluation  Board  (PEB)  IAW  SECNAVINST  1850.4E.    No  other 
conditions appeared on the MEB’s submission.  The PEB adjudicated the bipolar I disorder as 
unfitting,  rated  10%  with  application  of  SECNAVINST  1850.4E,  and  a  skin  condition  was 
adjudicated  as  Category  III  (not  unfitting).    The CI  appealed  to  a  Reconsideration  PEB  (RPEB) 
which adjudicated the same determination as the PEB.  The CI was then medically separated 
with a 10% combined disability rating.   
 
 
CI CONTENTION:   “I Would Like to obtain a military I.D.”  He elaborates no specific contentions 
regarding rating or coding and mentions no additionally contended conditions.   
 
 
SCOPE OF REVIEW:  The Board wishes to clarify that the scope of its review as defined in the 
Department of Defense Instruction (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 unfitting bipolar disorder condition meets the criteria prescribed in DoDI 6040.44 
for  Board  purview,  and  is  accordingly  addressed  below.    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 Board for Correction of Naval Records (BCNR).   
 
 
RATING COMPARISON:   
 

Service RPEB – Dated 20070222 
Condition 
Code 

Rating 

VA (~1 Mo. Post-Separation) – All Effective Date 20070501 
Exam 

Condition 

Rating 

Code 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

0% x 0/Not Service Connected x 0 
Combined:  70%* 

* VA initial 9432 10% rating increased based on exam of 20080919 by VARD dated 20081113   
 

20070209 
20070209 

Bipolar I Disorder, Single Manic 
Episode, Severe without Psychotic 
Features 
History of Tinea (skin) … 

9432 

10% 

Bipolar Disorder Type I 

9432 

70%* 

20070209 

Not Unfitting 

Skin Condition … 

7899-7806 

NSC 

ANALYSIS SUMMARY:   
 
Bipolar I disorder, single manic episode, severe without psychotic features.  All service and VA 
summaries  indicated  that  the  CI  was  “removed  from  theater  in  Iraq  for  suspected  bipolar 
disorder  after  4  months  of deployment”  although  source  documents  from  Iraq,  Germany, or 
aeromedical transport were not in the record of evidence.  The narrative summary (NARSUM), 
accomplished 9 days after hospital discharge and 4 months prior to separation, indicated the CI 
was “diagnosed with bipolar disorder NOS on 11 November 2006 while deployed in Iraq” and 
was  on  psychoactive  medication  (Seroquel  [quetiapine])  and  doing  well  by  non-psychiatrist 
evaluation  upon  return  to  home  station.    While  on  medication,  the  CI  demonstrated 
increasingly bizarre behavior and was psychiatrically hospitalized from 29 November 2006 to 
11 December 2006 (discharged hospital day 11).  The NARSUM noted the psychiatric symptoms 
on  hospital  admission  as  tangential  thoughts  with  occasional  loose  association  and  lack  of 
coherency  manifested  in  delusions  of  grandeur.    He  was  highly  distractible,  not  oriented  to 
place and time; judgment showed significant impairment and insight was poor.  Risk of violence 
was considered moderate to high with an unstable mood.  [Hospital discharge summary noted 
that  admission  was  via  ambulance  transport  and  the  emergency  department,  with  global 
assessment  of  functioning  (GAF)  of  11-22,  indicating  some  danger  of  hurting  self  or  others.]  
The CI was an elopement risk and had emergent injected medication twice with at least one 
episode of four point restraints during his hospital course.  The CI improved on two medications 
(Seroquel and Depakote) and the hospital discharge GAF was 61-70, in the mild symptom range 
with  a  diagnosis  of  bipolar  disorder,  single  episode,  manic.    The  CI  was  on  Seroquel  and 
Depakote at the time of the NARSUM and was in the medical holding company.  The NARSUM 
diagnosis was bipolar I disorder, single manic episode, severe without psychotic features, the 
social and civilian adaptability was “Moderate” and he was considered a danger to himself and 
others in the environment of a USMC Lance Corporal.  The GAF of 51-61 was in the range of 
moderate symptoms.   
 
The  non-medical  assessment  (NMA)  was  dated  after  the  NARSUM,  and  indicated  the  CI  was 
away from duties for 9 hours per week, and was recommended for discharge due to failure to 
adapt and characterized as under other than honorable conditions.  There was one non-judicial 
punishment  and  an  additional  pending  charge  sheet  conviction.    The  NMA  indicates  the  CI 
“remains at high risk for continued misconduct, and he not only poses significant risk to himself, 
but to those that operate around him.”   
 
The VA exam, 2 months prior to separation, indicated the CI was without significant symptoms, 
and the examiner indicated records stated “(the CI) was in sustained remission.”  The CI was 
taking  his  medications  and  was  “employed  on  a  full-duty  basis  on  medical  hold.”    He  was 
functioning  well,  but  was  socially  isolated.    Mental  status  exam  was  essentially  normal.  
Diagnosis was “Bipolar disorder type 1, single episode, on medications, did not exist prior to 
enlistment,  in  partial  remission.”    GAF  was  55  in  the  range  of  moderate  symptoms.    GAF 
comments indicated “his bipolar disorder in almost full-sustained remission with medications.”  
VA  treatment  records  from  1  and  2  months  post-separation  indicate  the  CI  had  stopped  his 
medications, had grandious thinking and refused medication or treatment.  His GAF remained 
in the moderate range.  VA records from 16 months remote from separation indicated rapid 
cycling bipolar disorder with serious symptoms, a GAF of 48, and inability to maintain work or 
relationships since military discharge.   
 
The Board directs attention to its rating recommendation based on the evidence just described.  
There was not sufficient evidence to indicate that the CI’s mental disorder was due to a highly 
stressful event and the provisions of VASRD §4.129 were not adjudged to be applicable to this 
case.    Rating  was  therefore  IAW  VASRD  §4.130  at  separation.    All  members  agreed  that  the 
§4.130 threshold for a 50% rating was not approached and that the criteria for a 0% rating were 

   2                                                           PD1200001 
 

well-exceeded.    The  deliberation  settled  on  arguments  for  a  10%  versus  a  30%  permanent 
rating recommendation.   
 
The  severity  of the  CI’s bipolar  condition  as  evidenced  by  the  MEB  evaluation  could  best  be 
described as moderate, and in conjunction with the NMA statement and GAF of 51-60 justified 
a DoDI 1332.9 rating of 30% for moderate social/industrial impairment.  The severity of the CI’s 
condition  at  the  VA  psychiatric  rating  examination  could  best  be  described  as  mild.    The  CI 
denied significant symptoms; however, the VA examiner’s indication of the CI being “full-time 
employed  while  on  medical  hold”  was  without  details  and  was  considered  of  questionable 
probative  value  for  occupational  functioning.    The  VA  examiner’s  indication  of  “almost  full-
sustained  remission”  was  not  supported  by  the  record,  which  indicated  psychiatric  hospital 
discharge 2 months prior to the exam.  The GAF score was 55, similar to the GAF assigned by 
the MEB psychiatrist.  The VA assigned a §4.130 rating of 10% based on this examination.  VA 
treatment  notes  within  2  months  of  separation  indicated  some  grandious  thinking,  self-
stopping of medication that was proximate to separation, and refusal of treatment.  Remote VA 
treatment notes indicated a history of poor occupational adaptability since separation from the 
service.   
 
The  30%  description,  “occupational  and  social  impairment  with  occasional  decrease  in  work 
efficiency  and  intermittent  periods  of  inability  to  perform  occupational  tasks,  although 
generally functioning satisfactorily, with routine behavior, self-care, and conversation normal” 
is a better fit with the occupational functioning in evidence since the psychiatric MEB examiners 
and the NMA statement indicated that the CI’s reliability was affected.  After due deliberation, 
considering  all  of  the  evidence  and  mindful  of  VASRD  §4.3  (reasonable  doubt),  the  Board 
recommends a disability rating of 30% 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,  the  Board  unanimously 
recommends a disability rating of 30% coded 9432 IAW VASRD §4.130.  There were no other 
conditions within the Board’s scope of review for consideration.   
 
 

   3                                                           PD1200001 
 

RECOMMENDATION:  The Board recommends that the CI’s prior determination be modified as 
follows  and  that  the  discharge  with  severance  pay  be  recharacterized  to  reflect  permanent 
disability retirement, effective as of the date of his prior medical separation:   
 

VASRD CODE 

RATING 

9432 

COMBINED 

30% 
30% 

UNFITTING CONDITION 

Bipolar I Disorder, Single Manic Episode, Severe Without 
Psychotic Features 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20111214 w/atchs. 
Exhibit B.  Service Treatment Record. 
Exhibit C.  Department of Veterans’ Affairs Treatment Record. 
 
 
 
 
 
 
 

             
           President 
           Physical Disability Board of Review 

   4                                                           PD1200001 
 

      
 

                COMMANDER, NAVY PERSONNEL COMMAND 
                                       

MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS 
 
 
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS           
 
Ref:   (a) DoDI 6040.44 
          (b) PDBR ltr dtd 2 Nov 12   
          (c) PDBR ltr dtd 6 Nov 12   
          (d) PDBR ltr dtd 14 Nov 12   
                               
1.  Pursuant to reference (a) I approve the recommendations of the Physical Disability Board of 
Review set forth in references (b) through (d). 
 
2.  The official records of the following individuals are to be corrected to reflect the stated 
disposition: 
 
    a.  former USMC:  Retroactive increase in disability rating from 30 percent to 50 percent for 
the period member was on the Temporary Disability Retired List with a final disability rating of 
10 percent effective 1 October 2001. 

    b. former USMC:  Disability retirement with a final disability rating of 30 percent and 
assignment to the Permanent Disability Retired List effective 15 July 2005. 

    c. former USMC:  Disability retirement with a final disability rating of 30 percent and 
assignment to the Permanent Disability Retired List effective 30 April 2007. 
 
3.  Please ensure all necessary actions are taken, included the recoupment of disability severance 
pay if warranted, to implement these decisions and that subject members are notified once those 
actions are completed. 
 
 
 
 
 
 
 

   
  Assistant General Counsel 
    (Manpower & Reserve Affairs)  

 
 
 

 
 
 

 
 
 

 

 

 

 
 
 

 
 
 

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