IN THE CASE OF: 

		BOARD DATE:	    19 February 2014

		DOCKET NUMBER:  AR20140000940 


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 (MH) 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 MH diagnosis was changed during that process.

3.  The applicant submitted an application through the Department of Defense (DOD) Physical Disability Board of Review (PDBR) MH Special Review Panel (SRP).

CONSIDERATION OF EVIDENCE:

1.  The PDBR SRP conducted a comprehensive review of the applicant’s submissions and records for evidence of inappropriate changes in the diagnosis of an MH condition during processing through the military disability system.  

2.  The DOD memorandum, dated 27 February 2013, directed the Service Secretaries to conduct a review of MH 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 applicant’s case, the SRP determined by unanimous vote that there should be no change to the applicant’s disability and separation determination. 

2.  The applicant elaborated on a highly stressful incident (she witnessed the death of her boyfriend) that occurred while she was deployed to Iraq.  After the incident, she had an on onset of tearful grief, anger and other symptoms.  She was seen at the MH clinic, given anti-depressant medication, and responded well to treatment.  She was later seen for follow-up.  She reported improved moods and sleep.  Her mental status exam (MSE) revealed no significant adverse findings.  

3.  The examiner's diagnostic assessment was major depression, single episode, in remission.  The applicant completed her deployment and returned to the United States with her unit.  She was referred to behavioral health, but did not follow through with that referral.

4.  The applicant was seen by a psychiatrist on 22 March 2010 at Blanchfield Army Community Hospital, Fort Campbell.  She had stopped taking the Zoloft, due to pregnancy.  Since stopping the medication, she had noted mild symptoms of intrusive thoughts about her ex-boyfriend's death.  She felt upset when such thoughts occurred and she avoided activities that reminded her of deployment. On MSE, appearance was normal and she was in no acute distress. 

5.  The examiner's diagnostic assessment was major depressive disorder, in partial remission, not unfitting for military duty and provided a summation of the applicant's situation.  The examiner indicated that such symptoms did not impact her work status subsequent to interventions in theater, which was why she did not seek further help.  Her depression was not unfitting for military duty.  

6.  The applicant did not fully agree with the examiner and submitted a written memorandum to the medical evaluation board (MEB), indicating that she had not been assessed for post-traumatic stress disorder (PTSD).  The examiner responded by saying that the comprehensive clinical evaluation conducted was extensive and thorough and did not show sufficient evidence to warrant a diagnosis of PTSD.
7.  The SRP carefully reviewed all evidentiary information available and searched for evidence of inappropriate changes in MH diagnoses during the Disability Evaluation System (DES) process.  The evidence in the DES record showed a diagnosis of depression.  During processing through the DES, no change in MH diagnosis was made. 

8.  Since no MH diagnoses were changed to the applicant's possible disadvantage in the DES process, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project. 

9.  Although PTSD was mentioned on DD Form 2807-1 (Report of Medical History), the majority agreed that the applicant's symptoms did not satisfy Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV) diagnostic criteria for PTSD, and therefore, the diagnosis of PTSD was not substantiated.

10.  The SRP considered the appropriateness of the MH diagnosis and determined that depression was the most appropriate MH diagnosis.  This condition was adjudicated as not unfitting by the Army physical evaluation board (PEB).  The SRP's main charge with respect to MH conditions found not unfitting by the PEB was an assessment of the appropriateness of the PEB's fitness adjudication. 

11.  The SRP's threshold for countering the PEB fitness determinations required a preponderance of evidence.  The MH condition was not profiled or implicated in the commander's statement and was not judged to fail retention standards by the MEB.  There was no indication in the record that the MH condition significantly interfered with satisfactory performance of military duties.

12.  After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the MH condition.  

13.  The SRP then considered the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129.  The applicant did experience a highly stressful event, which was severe enough to cause psychiatric symptoms.  However, the symptoms from the highly stressful event did not bring about the applicant's release from active military service.  The MH diagnosis was not unfitting.  

14.  The applicant's non-MH condition was the reason she was released from military service, and therefore the application of Section 4.129 was not appropriate in this case.

15.  The available evidence shows the SRP’s 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)                                  AR20140000940



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