IN THE CASE OF:	

		BOARD DATE:	 16 April 2014 

		DOCKET NUMBER:  AR20140004337 


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 applicant’s 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 applicant’s case, the SRP determined by unanimous vote that there be no change to the applicant’s disability and retirement determination. 

2.  The SRP reviewed the records for evidence of inappropriate changes in
diagnosis of the MH condition during processing through the military Disability Evaluation System (DES).  The evidence of the available records shows diagnoses of depression and Post-Traumatic Stress Disorder (PTSD) were rendered during the applicant's processing through the DES.  The PTSD diagnosis was recorded in the medical evaluation board (MEB) narrative summary but not among any other documents during processing through the DES.  The SRP panel noted this entry was made in error and therefore, not forwarded to the MEB or the physical evaluation board (PEB). 

3.  The SRP noted that the available service treatment record did not reflect a PTSD diagnosis; the psychiatric MEB did not record any trauma related symptoms, and there is no evidence to support a PTSD diagnosis.  The SRP agreed there were no inappropriate changes in diagnoses and the MH diagnoses were 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 also noted the diagnosis of major depressive disorder (MDD) forwarded to the MEB and subsequently to the PEB as MDD in accordance with (IAW) AR 40-501, Chapter 3-33, is not the appropriate reference for a mood disorder, as Chapter 3-33 corresponds to anxiety disorders.

5.  The SRP acknowledged the Department of Veterans Affairs (VA) Compensation and Pension (C&P) examination, rendering the diagnosis of PTSD; however, there was no evidence the applicant fully met the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition Text Revision diagnostic criteria for PTSD since Criterion C and F were not clearly met.  The SRP also considered whether a MH condition, regardless of specific diagnosis, was unfitting for continued military service. 

6.  The SRP acknowledged the S3 profile for depression, assigned approximately a week after the psychiatric MEB; however, noted the profiling psychiatrist specifically stated, the condition was being profiled for "Definitive medical care (psychiatry)" with no limitations in duty related to a mental health condition.  The commander's statement (CS) noted the applicant was not working in her military occupation specialty (MOS) due to her physical limitations; the entire statement related to physical conditions.  No MH condition was implicated or mentioned in the CS.  All of the mental status examinations in the record in evidence including the C&P exam were essentially normal.  There was no evidence of acute symptom exacerbation with visits to the emergency room and no hospitalizations; symptoms were stable at the time of the applicant’s Temporary Disability Retirement List (TDRL) entry.

7.  The SRP agreed that evidence of the record reflected continued MH related symptoms that were moderately responsive to treatment but whose genesis was reported to be the result of physical limitations caused by the Fibromyalgia (FM) condition.  The PEB adjudicated the applicant's depressive symptoms as associated with the FM condition.  Therefore, the Board unanimously agreed the depression condition was an integral, comorbid component of the FM condition and could not be rated as single unfitting conditions lAW the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.14. (avoidance of pyramiding).

8.  The SRP concluded that the preponderance of evidence did not support an unfit determination for any mental health condition at the time of evaluation in the DES or prior to separation. 

9.  After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that there was insufficient cause to recommend that a mental health condition be added as an unfitting condition and so no additional disability rating is recommended.

10.  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)                                  AR20140004337



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