IN THE CASE OF:
BOARD DATE: 7 May 2014
DOCKET NUMBER: AR20140004960
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 applicants 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 applicants case, the SRP determined by unanimous vote that the applicants prior disability description should be modified to reflect the effective date of his prior medical separation.
2. The SRP considered the appropriateness of changes in the applicant's MH diagnoses, the physical evaluation board (PEB) fitness determination, and if unfitting, whether the provisions of the Department of Veterans Affairs 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 considered the criteria for diagnosis according to the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition Text Revision including the evidence for the stressor (criterion A), re-experiencing of the event (criterion B), persistent avoidance of stimuli associated with the trauma (criterion C), hyperarousal (criterion D), duration and onset (criterion E), presence of clinically significant distress or impairment in social, occupational or other important area of functioning (criterion F).
4. The SRP determined the diagnosis of Post-Traumatic Stress Disorder (PTSD) was changed and removed at the medical evaluation board (MEB) level to anxiety disorder, not otherwise specified (NOS) during the Disability Evaluation System process. Therefore, the applicant met the inclusion criteria of the Terms of Reference of the MH Review Project.
5. The SRP also determined that the informal PEB (IPEB) coded VASRD diagnostic code 9411 (PTSD), with the disability description of Anxiety Disorder NOS, diagnosed by the DOD and rated under code 9411 as PTSD by the Department of Veterans Affairs. The SRP also determined that code 9411 (PTSD) was appropriately used by the IPEB, and the description as both PTSD and anxiety disorder provided no rating disadvantage to the applicant since both 9411 (PTSD) and 9413 (anxiety disorder, NOS) are both rated using the same general rating formula for mental disorders using VASRD Section 4.130. The SRP additionally determined that code 9411 PTSD most accurately described the clinical history in the record, and VASRD Section 4.129, 50 percent TDRL recommendation was properly applied.
6. After due deliberation in consideration of the preponderance of the evidence, the SRP recommended to only remove the disability description "Anxiety disorder, NOS, diagnosed by the DOD and rated under code 9411" to comply with VASRD diagnostic terminology, diagnostic coding, and rating schedule (Section 4.13 effect of change of diagnosis, Section 4.20 Analogous ratings, and Section 4.21 application of rating schedule).
7. The available evidence shows the SRPs assessment should be accepted.
BOARD VOTE:
____x___ ____x___ ____x___ GRANT FULL RELIEF
________ ________ ________ GRANT PARTIAL RELIEF
________ ________ ________ GRANT FORMAL HEARING
________ ________ ________ DENY APPLICATION
BOARD DETERMINATION/RECOMMENDATION:
The Board determined that the evidence presented was sufficient to warrant a recommendation for relief. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by modifying the applicants prior disability description effective the date of his prior medical separation as follows:
UNFITTING CONDITION
VASRD CODE
TDRL
RATING
Post Traumatic Stress Disorder
9411
50 %
RATING
50%
___________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
3
ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
1
ABCMR Record of Proceedings (cont) AR20140004960
2
ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
1
ARMY | BCMR | CY2014 | 20140006646
There was not a preponderance of evidence in support for all of the DSM IV-TR criteria, and the medical evaluation board (MEB) psychiatrist's diagnosis of anxiety disorder, NOS was the only MH diagnosis underpinned by a comprehensive evaluation and sufficiently probative evidence. The analysis by the end-TDRL psychiatrist establishing a progression from anxiety disorder, NOS to PTSD is a reasonable assumption, and was accepted as the conclusion of the SRP majority. The SRP next addressed...
ARMY | BCMR | CY2014 | 20140015391
The applicant also states that his rating for Post-Traumatic Stress Disorder (PTSD) should have been higher and not rated with his other disabilities because they are different. 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.
ARMY | BCMR | CY2014 | 20140010890
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. The SRP considered the appropriateness of changes in the MH diagnoses, Physical Evaluation Board (PEB) fitness determination, whether the provisions of Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) section 4.129 were applicable, and whether a...
ARMY | BCMR | CY2014 | 20140002392
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. The SRP considered the appropriateness of changes in the mental health (MH) diagnoses, the physical evaluation board (PEB) fitness determination and, if unfitting, whether the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities...
ARMY | BCMR | CY2014 | 20140001346
The applicant requests a review of the military disability evaluation pertaining to a mental health (MH) condition. 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. The SRP noted the applicant's MH diagnosis was changed from PTSD to anxiety disorder because there was no verified DSM-IV PTSD criterion A stressor.
ARMY | BCMR | CY2014 | 20140008914
The applicant requests a review of the military disability evaluation pertaining to a mental health (MH) condition. The diagnosis of anxiety disorder was the only established MH diagnosis in the service treatment records (STR), thus there was no unfavorable change of diagnosis. The SRP's charge was assessing the fairness of the service determination that criteria for the diagnosis of PTSD were not met, not whether an established diagnosis was eliminated.
ARMY | BCMR | CY2014 | 20140015409
The applicant requests a review of the military disability evaluation pertaining to a mental health (MH) condition. 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 rating at Temporary Disability Retired List (TDRL) entry. The SRP determined that an MH diagnoses was changed to the applicants possible disadvantage in the disability evaluation.
ARMY | BCMR | CY2014 | 20140009095
There was no evidence in the record of recurrent suicidal behaviors, no recorded visits to the emergency room for MH treatment, no recurrent psychiatric hospitalizations and no impairment in thinking or judgment at the time of separation. After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that the application of VASRD Section 4.129 was applicable in this case with a 50 percent disability rating. UNFITTING CONDITION VASRD CODE TDRL...
ARMY | BCMR | CY2014 | 20140011252
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. After a comprehensive review of the applicant's case, the SRP by majority vote recommends that the applicant's prior separation be modified to reflect a Temporary Disability Retired List (TDRL) rating of 50 percent, in accordance with of Department of Veterans Affairs (VA)...
ARMY | BCMR | CY2014 | 20140011252
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. After a comprehensive review of the applicant's case, the SRP by majority vote recommends that the applicant's prior separation be modified to reflect a Temporary Disability Retired List (TDRL) rating of 50 percent, in accordance with of Department of Veterans Affairs (VA)...