IN THE CASE OF:	

		BOARD DATE:	  2 April 2014

		DOCKET NUMBER:  AR20140003670 


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 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 of the applicant's disability and separation determination.

2.  The SRP considered the appropriateness of changes in the MH diagnoses; whether the provisions of the Department of Veterans Affairs (VA) Schedule for Rating Disabilities (VASRD), section 4.129, were applicable; and a disability rating recommendation in accordance with VASRD, section 4.130.

3.  The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the MH condition during processing through the military disability evaluation system and determined the MH diagnosis was not changed to the applicant's possible disadvantage in the disability evaluation.  Therefore the applicant did not meet the inclusion criteria in the terms of reference of the MH review project.

4.  The SRP noted the physical evaluation board (PEB) placed the applicant on the Temporary Disability Retired List (TDRL) with a rating of 50 percent and the provisions of VASRD, section 4.129 (mental disorders due to traumatic stress) were met.  However, the SRP also considered if there was evidence for a VASRD, section 4.130, rating higher than 50 percent at time of the applicant's placement on the TDRL.

5.  The SRP noted the evidence shows the VA initially assigned a 50-percent rating based on a review of the PEB proceedings, but in a June 2010 decision, assigned a 100-percent rating (effective on the date of TDRL entry) based on the Compensation and Pension (C&P) examination performed in August 2009.  Factors underlying that decision appeared to be that the applicant was considered an imminent danger to himself or others, was incapable of managing financial affairs, and was hallucinating.

6.  The SRP noted, however, that the C&P examiner explicitly stated the 
100-percent rating criteria ("total occupational and social impairment") were not present.  It also noted that the narrative summary (NARSUM) psychiatric examiner, less than a month after that C&P exam, specifically stated that hallucinations and homicidal ideations (which are two of the 100-percent rating threshold symptoms) were absent.  This was confirmed by the VA psychiatrist soon after TDRL entry, who further stated the applicant was not a danger to himself or others.

7.  The SRP questioned the C&P examiner's conclusion regarding financial management competency, given the subsequent assessment and conclusions by the NARSUM psychiatrist (including a Global Assessment of Function score of 60).  It was agreed that a 100-percent rating was not supported and the debate settled on whether a 70-percent rating was warranted.  The 70-percent rating required "occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood."

8.  The SRP also considered that one 70-percent threshold symptom (impulsivity) may have been present, as indicated by the psychometric examiner and the C&P examiner.  However, the applicant denied being impulsive and the NARSUM psychiatrist stated the symptom was not present.  Other 70-percent threshold symptoms, such as suicidal ideation, obsessional rituals, illogical speech, or neglect of personal appearance or hygiene, were not in evidence.  The NARSUM examiner's description of occupational and social impairment quoted the 
30-percent rating criteria, while the final service treatment notes and the VA psychiatrist's evaluation after TDRL entry were not consistent with the 70-percent criteria.  Therefore, the SRP concluded that a rating higher than 50 percent at the time of TDRL entry was not supported.

9.  The SRP reviewed a rating recommendation at the time of the applicant's removal from the TDRL.  The PEB assigned a 50-percent rating, quoting the VASRD, section 4.130, criteria of "occupational and social impairment with reduced reliability and productivity."  The SRP considered if a rating higher than 50 percent was justified, but noted school performance, the VA examiner's description of functioning in June 2011 that quoted 10-percent criteria, good family relationships, and the absence of 70-percent threshold criteria.

10.  After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that a rating higher than 50 percent at the time of removal from the TDRL was not supported.

11.  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 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)                                  AR20140003670



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