IN THE CASE OF:
BOARD DATE: 21 May 2014
DOCKET NUMBER: AR20140006639
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 to the applicant's disability and separation determination.
2. The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the MH condition during processing through the Integrated Disability Evaluation System (IDES). The available evidence of record shows the diagnosis of anxiety disorder was proposed by the Department of Veterans Affairs (VA) as post-traumatic stress disorder (PTSD) within the IDES. Subsequently, the Service Department physical evaluation board (PEB) maintained the original diagnosis of anxiety disorder and adjudicated this condition. Therefore, the applicant did not appear to meet the inclusion criteria in the MH review project terms of reference.
3. The SRP devoted careful attention to the issue of diagnostic disparity between the service and VA with implications for the Board's rating recommendation in its deliberations. The first significant issue confronted in this case was the MH diagnostic identification of the applicant near the time of her date of separation. The evaluations of concern identified diagnoses of anxiety disorder, PTSD, and/or obsessive-compulsive disorder. The SRP deliberated the probative value of these conflicting evaluations and carefully reviewed the entire file for corroborating evidence from the period preceding separation. In regard to assessing probative value judgments in relation to the examinations as well as acknowledging recorded inconsistencies, the SRP took into consideration the following issues:
a. Although the VA examination was more in-depth as to historical content in comparison to the Service examination, it contained inconsistent notations concerning the applicant's exposure to wounded personnel (contradicted by the Post-Deployment Health Reassessment), as well as her onset of fearful symptoms while deployed or upon re-deployment.
b. Considering the three diagnoses in question, the only physician-level (psychiatrist) evaluation and diagnosis was the Service provider.
4. The SRP, in consideration of the above, agreed that both examinations were considered relevant and a higher probative value was placed on the Service psychiatrist's documentation. Both examinations contained detailed MH examinations. Anxiousness was only found with the VA; however, both noted long-term anxiety treatment within the VA. The problem behavior of "extreme anxiety" found in the VA examination, coupled with the applicant's frequent reporting of VA treatments for anxiety up to and including 6 days prior to her VA Compensation and Pension examination (24 August versus 30 August 2010), was indicative of a disorder overwhelmingly manifested by anxiety.
5. The SRP noted the service psychiatrist diagnosed the applicant with anxiety disorder (not otherwise specified) near her date of separation. The SRP then considered if the anxiety disorder could be found unfit by the preponderance of the evidence. The SRP agreed that despite the presence of a variety of anxiety symptoms, the evidence of record reflected minimal adverse symptoms and good duty performance (as related to mental functioning) in the period of time leading to entry in the IDES. The condition was never profiled and the commander's statement specifically indicated "yes" to the applicant's performance of her duties in her military occupation specialty.
6. After due deliberation in consideration of the preponderance of the evidence, the SRP concluded the MH condition of anxiety disorder was not unfitting at the time of separation and not subject to a disability rating.
7. 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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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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ABCMR Record of Proceedings (cont) AR20140006639
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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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