IN THE CASE OF:
BOARD DATE: 18 December 2013
DOCKET NUMBER: AR20130019732
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 determined by unanimous vote that there be no change in her disability and retirement.
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. While post-traumatic Stress Disorder (PTSD) had been mentioned in several places prior to the medical evaluation board (MEB), there was no source record from any of the providers in the available record to indicate that they felt her symptoms fulfilled the criteria for that disorder during the Disability Evaluation System (DES) timeframe.
3. The SRP noted that there was no mental health evaluation or provider note including an Axis I diagnosis of PTSD prior to the applicant's retirement. However, PTSD was listed on the DA Form 3349 (Physical Profile) and noted on the DD Form 2807-1 (Report of Medical History). The SRP found It unclear if the diagnosis of depression from the neuropsychiatric evaluation was considered during or prior to the start of the DES, but agreed that depression was not a diagnosis on the MEB narrative summary (NARSUM) or physical evaluation board (PEB). The SRP agreed that the applicant did appear to meet the inclusion criteria in the Terms of Reference of the Mental Health Diagnosis Review Project.
4. The SRP agreed that the constellation of anxiety symptoms reported by the applicant and documented in the NARSUM was consistent with the DSM-IV definition of generalized anxiety disorder. The SRP noted in their review that there are some overlap in symptoms between PTSD and generalized anxiety disorder, but there did not appear to be clear documentation of such symptoms as those representing Criterion B (re-experiencing of the traumatic event), for example, prior to retirement.
5. The SRP found the applicant's increased symptomatology which was documented in the compensation and pension examination 7 months after retirement could possibly be explained on the basis of after-retirement-worsening. However with regard to her allegations of sexual assault, that data appeared to have not been reported prior to her retirement and thus not documented. The SRP noted that if this were the case, it could not have been considered either by the applicants providers in their diagnosis and treatment of the applicant in the period leading up to the DES processing nor by the MEB or PEB in their evaluation and adjudication of the case.
6. After due deliberation in consideration of the preponderance of the evidence the SRP concluded that there was not sufficient evidence to support a rating higher than 50 percent at the time of retirement.
7. The available evidence shows the SRPs assessment should be accepted.
BOARD VOTE:
________ ________ ________ GRANT FULL RELIEF
________ ________ ________ GRANT PARTIAL RELIEF
________ ________ ________ GRANT FORMAL HEARING
___x____ ___x____ ___x____ DENY APPLICATION
BOARD DETERMINATION/RECOMMENDATION:
The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined that the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned.
_______ _ 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) AR20130019732
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