IN THE CASE OF:	

		BOARD DATE:	  5 March 2014

		DOCKET NUMBER:  AR20140001526 


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 responded to the advisory opinion and provided three exhibits with her rebuttal as follows:

* Department of Veterans Affairs (VA) Rating Decision
* DA Form 3947 (Medical Evaluation Board (MEB) Proceedings)
* Psychiatric Temporary Disability Retired List (TDRL) Narrative Summary

5.  In her rebuttal, the applicant stated:

	a.  She requested a review of all documents provided in appropriate or ethical areas.  She was awarded a 100-percent rating for paranoid schizophrenia on 30 September 2002 and is currently disabled and unemployable.  Her MEB proceedings indicated she was severely impaired for social and industrial adaptability and that her schizophrenia did not exist prior to service.  She was prescribed several medications for her illness which caused her severe side effects.  These drugs are involved in ongoing class action lawsuits.

	b.  She requested inclusion of a decision of post-traumatic stress disorder (PTSD) as an additional award or awarded as secondary to paranoid schizophrenia.  The SRP indicated that a primary diagnosis of schizophrenia was a more serious diagnosis than PTSD and neither was distinctly different in symptoms.  However, it is important that all conditions be described as MH diagnoses and be rated even though one can be more serious than another.  She stated that all conditions should be accounted and recognized when an individual applies for disability of any origin.

6.  In summary, she stated she had a beautiful career in the Army and requested award of a higher disability rating from the Army Board for Correction of Military Records.

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 of the applicant's disability and medical retirement determination.

2.  The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the MH (MH) condition during processing through the Disability Evaluation System (DES).

3.  The available evidence of record shows the only diagnosis rendered during the DES process was paranoid schizophrenia.  Therefore, the SRP determined the MH diagnoses were not changed to the applicant's possible disadvantage and the applicant did not appear to meet the inclusion criteria in the Terms of Reference of the MH review project.

4.  The SRP acknowledged the addition of a PTSD diagnosis during the TDRL period; however, the SRP concluded the applicant's primary diagnosis of schizophrenia was a more serious diagnosis and symptoms recorded as PTSD were not distinctly different from the symptoms of schizophrenia.  The SRP agreed the physical evaluation board (PEB) adjudication of unfitting schizophrenia was well supported by the evidence.

5.  The applicant fully met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria for schizophrenia.  Therefore, the diagnosis of paranoid schizophrenia was the appropriate diagnosis.  Due to symptom instability, the applicant was placed on the TDRL without application of the provisions of the VA Schedule for Rating Disabilities (VASRD), section 4.129, which was correct (mental disorders due to traumatic stress).

6.  The SRP considered whether there was evidence for a section 4.130 rating higher than 50 percent at time of placement on the TDRL.  The higher 70-percent rating was for "occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood."

7.  The SRP agreed the applicant displayed impairment in judgment, work, and thinking at the time of TDRL entry.  Her symptoms interfered with social and occupational functioning.  However, she was able to care for her minor children and there were no legal issues, no aggressive behaviors, no suicidal or homicidal thoughts, no emergency room visits, and no psychiatric hospitalizations.

8.  The SRP determined the records in evidence best supported the 50-percent rating for TDRL entry and there was insufficient reasonable doubt in accordance with VASRD, section 4.3 or section 4.7, for recommending a 70-percent TDRL entry rating.

9.  The SRP agreed the records adequately demonstrated the applicant's symptoms at the time of permanent retirement had not significantly improved since initiation of the TDRL.  Her condition remained stable and her symptoms reflected the criteria for the 50-percent disability rating.

10.  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 adjudication for the applicant's MH conditions at TDRL entry or upon permanent retirement.

11.  After careful consideration of the available evidence and the applicant's response to the advisory opinion, the SRP 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 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)                                  AR20140001526



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