IN THE CASE OF:
BOARD DATE: 4 December 2013
DOCKET NUMBER: AR20130019729
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.
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 determined by unanimous vote that his unfitting condition diagnosis should be changed to post-traumatic stress disorder (PTSD) with major depressive disorder (MDD), and his prior separation should be modified to reflect he was placed on the Temporary Disability Retired List (TDRL) at 50% and then permanently retired with a combined 70% disability rating.
2. The SRP considered the appropriateness of changes in mental health diagnoses, whether the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) §4.129 were applicable, and a disability rating recommendation in accordance with VASRD §4.130.
3. The SRP first addressed the question of the appropriateness of the diagnosis and whether it had been changed during the course of Disability Evaluation System processing. The members agreed that while PTSD had been identified by the medical evaluation board (MEB) as a separate diagnosis from MDD, both diagnoses were combined by the physical evaluation board (PEB) as MDD with symptoms of PTSD.
4. The SRP considered the criteria for diagnosis according to the Diagnostic and Statistical Manual for Mental Disorders IV (DSM IV) including: the evidence for stressor (criterion A), re-experiencing of the event (criterion B), persistent avoidance of stimuli associated with the trauma (criterion C), hyperarousal (criterion D), duration and onset (criterion E), and presence of clinically significant distress or impairment in social, occupational or other important area of functioning (criterion F).
5. The SRP additionally considered that, in retrospect, there was a significant overlap of symptoms with schizoaffective disorder (never mentioned in the record) and that this might have more accurately reflected the clinical picture.
6 The SRP concluded the evidence supported a diagnosis of PTSD at the time of placement on the TDRL. The members determined that this case did meet the Terms of Reference of the Mental Health Special Review Panel.
7. After due deliberation in consideration of the preponderance of the evidence the SRP concluded that, based on the evidence available, a disability rating of 50% was appropriate at entry into the TDRL period. This 50% TDRL rating level meets the criteria for a temporary minimum 50% rating for PTSD.
8. The SRP also determined the applicants condition more nearly met the 70% criteria and there was not sufficient evidence to support a higher 100% rating. Finally, the SRP unanimously recommended a permanently retirement rating of 70% for MDD and PTSD code 9411-9434.
9. 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
changing his unfitting condition diagnosis to PTSD with MDD, and modifying his prior separation to reflect he was placed on the TDRL at 50% disabled and then permanently retired with a combined disability rating of 70%.
_______ _ 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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ABCMR Record of Proceedings (cont) AR20130019729
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