BOARD DATE:	  11 June 2014

		DOCKET NUMBER:  AR20140007892 


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, physical evaluation board (PEB) fitness determination, 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.  The psychiatry medical evaluation board (MEB) narrative summary (NARSUM) rendered a diagnosis of anxiety disorder not otherwise specified (NOS), while the Department of Veterans Affairs (VA) Compensation and Pension examination recorded a diagnosis of Post-Traumatic Stress Disorder (PTSD).  Due to the appearance of a change in diagnosis during the Disability Evaluation System process, this case appeared to meet the inclusion criteria in the Terms of Reference of the MH Review Project.  

3.  The SRP considered whether the diagnosis of PTSD was better supported than that of anxiety disorder NOS.  The SRP noted that, while the VA examiner's diagnosis was based on a single examination, the psychiatry MEB Narrative Summary examiner was knowledgeable of the applicant's entire treatment course and testing.  The SRP agreed that anxiety disorder NOS was appropriate and there was not a preponderance of evidence to overcome the MEB psychiatrist's diagnosis.  Regardless, the provisions of VASRD Section 4.129 were applied, and the applicant was awarded "10A/C" (DA Form 199, PEB proceedings, Section 10A and Section 10C) for a condition incurred as a direct result of armed conflict in Iraq. 

4.  The SRP noted that at the time of this advisory opinion, the applicant remained on the Temporary Disability retired List (TDRL) pending his final disability determination by the PEB.  The SRP deliberated if there was evidence for a VASRD Section 4.130 rating higher than 50 percent at the time of placement on the TDRL.  The disability associated with all psychiatric conditions, regardless of the diagnosis or multiple diagnoses, was subsumed under a single rating using the same rating criteria in accordance with VASRD Section 4.130. 

5.  The SRP noted that there were no visits to the emergency room for MH treatment, no psychiatric hospitalization, no legal issues or incidents of domestic violence and no impairment in thinking.  At the time of placement on TDRL, the military psychiatrist noted "no impairment of occupational function," adding that symptoms were controlled by continuous medication.  The applicant's commander noted that the applicant displayed "occasional decrease in work efficiency" but "had effective work relationships."  The VA psychiatrists had not noted any of the criteria for a higher rating than 30 percent, noting the absence of occupational and social impairment with reduced reliability and productivity and absence of specific symptoms and signs such as flattened affect, altered speech, panic attacks, impaired judgment, or memory, or difficulty in establishing and maintaining relationships.  

6.  The SRP also noted the absence of any symptoms suggestive of the next higher 70 percent rating; for example, recurrent suicidal ideation, spatial disorientation, obsessional rituals, and neglect of personal appearance and hygiene.  The SRP agreed that occupational and social impairment with deficiencies in most areas (such as work, school, family relations, judgment, thinking, or mood) was not reflected in the evidence; therefore, a rating higher than 50 percent was not supported. 

7.  After due deliberation in consideration of the preponderance of the evidence the SRP concluded that there was insufficient cause to recommend a change in the PEB adjudication for the applicant's MH condition at the time of separation.

8.  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)                                  AR20140007892



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