BOARD DATE:	  11 June 2014

		DOCKET NUMBER:  AR20140007640 


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 a 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 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, the physical evaluation board (PEB) fitness determination, 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 noted the medical evaluation board (MEB) forwarded major depressive disorder (MDD), anxiety disorder not otherwise specified (NOS) and a parasomnia NOS to the PEB.  The PEB adjudicated the applicant for the diagnosis of MDD with associated anxiety requiring medication at the Temporary Disability retired List (TDRL) entry and at TDRL exit, MDD without psychotic features, requiring psychotropic medication and psychotherapy, unemployed. 

4.  The SRP determined that while the diagnosis changed during the Disability Evaluation System (DES) process, the changes were not to the applicant's disadvantage.  The PDRB psychiatrist noted that MDD represented a definitive diagnosis and the anxiety disorder, NOS diagnosis was within the spectrum of mood disorders; therefore, a separate anxiety diagnosis was not warranted.  The SRP determined that no MH diagnoses were changed to the applicant's possible disadvantage in the DES.  Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project. 

5.  The SRP considered if the provisions of VASRD Section 4.129 were applicable.  The SRP concluded that there was insufficient evidence to support a conclusion that a highly stressful event severe enough to bring about the veteran's release from active military service occurred and that the application of VASRD Section 4.129 was not appropriate in this case.  

6.  The SRP next considered the rating in accordance with VASRD Section 4.130 for both TDRL entry and exit.  The SRP noted that the applicant was not rated at 30 percent by both the PEB and the Department of Veterans Affairs at the time of TDRL entry and separation from active duty. 
7.  The SRP considered the provisions for a 50 percent rating and determined that these were not supported by the records in evidence.  Accordingly, no change in the PEB rating was recommended at TDRL entry.  The SRP later considered the rating at TDRL exit.  As noted above, the PEB cited the DOD Instruction (DODI) 1332.39 to reduce the rating to 10 percent.  This instruction was rescinded and was not utilized by the SRP in its rating recommendation.  The 70 percent rating required occupational and social impairment with deficiencies in most areas; this was not supported by the evidence.  The 50 percent rating required occupational and social impairment with reduced reliability and productivity which also was not supported by the evidence.  The SRP acknowledged the clinical findings at the TDRL exit examination; however, considered the preponderance of evidence to be inconsistent with that examination.

8.  The SRP noted that at the time of the TDRL exit examination the applicant was a full-time college student and maintained a 3.66 Grade Point Average.  In addition, the SRP also noted the applicant excelled academically in the absence of consistent MH treatment and use of psychotropic medication.  The evidence supported that the applicant successfully completed college in a timely fashion and his performance was sufficient to obtain admission to graduate school.  There was no evidence of emergency room visits, no psychiatric hospitalizations, no legal issues, no reported domestic violence, and no evidence of social impairment. 

9.  The SRP considered the descriptions of both the 30 percent occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal) and 10 percent ratings for occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication."  The SRP determined that the performance evidenced was best described by the 10 percent rating.  The SRP could not determine what rating the PEB had adjudicated prior to TDRL exit and what deduction, if any, was applied in accordance with DODI 1332.39.  Regardless of what route the PEB took to reach the 10 percent rating, the SRP determined that the 10 percent rating was appropriate for the level of disability in evidence. 

10.  After due deliberation in considering all of the evidence and mindful of VASRD Section 4.3 (reasonable doubt), the SRP concluded that there was insufficient cause to recommend a change in the PEB adjudication for the MH condition at either TDRL entry or exit.

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 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)                                  AR20140007640



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