IN THE CASE OF:
BOARD DATE: 4 December 2013
DOCKET NUMBER: AR20130019225
THE BOARD CONSIDERED THE FOLLOWING EVIDENCE:
1. Application for correction of military records (with supporting documents provided, if any).
2. Military Personnel Records and advisory opinions (if any).
THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE:
1. The applicant requests a review of the military disability evaluation pertaining to a mental health condition.
2. The applicant states, in effect, the case file should be reviewed in accordance with the Secretary of Defense directive for a comprehensive review of members who were referred for a disability evaluation between 11 September 2001 and
30 April 2012 and whose mental health diagnosis was changed during that process.
3. The applicant submitted an application through the DOD Physical Disability Board of Review (PDBR) Mental Health Special Review Panel (SRP).
CONSIDERATION OF EVIDENCE:
1. The PDBR SRP conducted a comprehensive review of the applicants submissions and records for evidence of inappropriate changes in the diagnosis of a mental health condition during processing through the military disability system. A copy of the SRP recommendation was forwarded to the applicant.
2. The Department of Defense memorandum, dated 27 February 2013, directed the Service Secretaries to conduct a review of mental health diagnoses for service members completing a disability evaluation process between 11 September 2001 and 30 April 2012 in order to determine if service members were disadvantaged by a changed diagnosis over the course of their physical disability process.
3. In the processing of this case, an advisory opinion was obtained from the PDBR SRP and the applicant was provided a copy.
4. The applicant did not respond to the advisory opinion.
DISCUSSION AND CONCLUSIONS:
1. After a comprehensive review of the applicants case, the SRP recommended his unfitting condition diagnosis be changed to Post-traumatic Stress Disorder (PTSD), and his prior separation be modified to reflect he was placed on the Temporary Disability Retired List (TDRL) at 50% for PTSD (plus 10% for the back condition) for the duration of his TDRL period and then a permanent PTSD rating of 70% with disability retirement.
2. The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the mental health condition during processing through the Disability Evaluation System. The evidence of the available records shows a diagnosis of anxiety disorder and depression were rendered in addition to PTSD. The SRP noted that the PTSD diagnosis was consistently diagnosed, but his medical evaluation board (MEB) psychiatry narrative summary (NARSUM) listed anxiety disorder.
3. The SRP agreed there was a change in diagnosis at the time of the MEB psychiatry NARSUM to the applicants possible disadvantage in the disability evaluation since PTSD is a more serious anxiety disorder. The final PEB diagnosis at TDRL exit, however, was PTSD.
4. The SRP acknowledged the Compensation and Pension examiners assertion of the development of a major depressive disorder secondary to PTSD and opined the evidence in the treatment records at the time of TDRL entry do not support an additional diagnosis of major depression since the symptoms of depression are within the PTSD spectrum and do not confer a separate diagnosis when full DSM-IV diagnostic criteria are not met. The SRP agreed the applicant fully met DSM-IV diagnostic criteria for PTSD; therefore, the diagnosis of PTSD was the appropriate diagnosis and that he met the inclusion criteria of the Terms of Reference of the Mental Health Diagnosis Review Project.
5. The SRP agreed that the provisions of Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) §4.129 were applicable in this case, noting the association with combat experiences. The SRP considered if there was evidence for a §4.130 rating higher than 50% at time of placement on the TDRL.
6. The SRP considered the record in evidence best supported the 50% rating for TDRL entry and there was insufficient reasonable doubt for recommending a 70% TDRL entry rating. The SRP agreed at the time of permanent retirement that the record adequately demonstrated an overall decline in the applicants mental functioning since TDRL entry and that his condition had stabilized as noted in the exit NARSUM and reflected the criteria for the 70% disability rating.
7. After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that a diagnosis of PTSD with application of §4.129 at TDRL entry was appropriate, but there was insufficient evidence to recommend a change in his PEB rating adjudication at the time of retirement.
8. The available evidence shows the SRPs assessment should be accepted.
BOARD VOTE:
___X____ ___X____ ___X____ GRANT FULL RELIEF
________ ________ ________ GRANT PARTIAL RELIEF
________ ________ ________ GRANT FORMAL HEARING
________ ________ ________ DENY APPLICATION
BOARD DETERMINATION/RECOMMENDATION:
The Board determined that the evidence presented was sufficient to warrant a recommendation for relief. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by
modifying his unfitting condition diagnosis to show PTSD, and that his prior separation be modified to reflect that the applicant was placed on the TDRL at 50% for PTSD (plus 10% for the back condition) for the duration of the TDRL period and then a permanent PTSD rating of 70% with disability retirement.
_______ _ X ___ ___
CHAIRPERSON
I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case.
ABCMR Record of Proceedings (cont) AR20040003532
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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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ABCMR Record of Proceedings (cont) AR20130019225
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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
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