IN THE CASE OF: 

		BOARD DATE:	  23 July 2014

		DOCKET NUMBER:  AR20140009137 


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 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.  The SRP recommends no change in the applicant’s unfitting condition diagnosis, and that the applicant’s prior separation be modified to reflect that the applicant was placed on the Temporary Disability Retired List (TDRL) at 50 percent for a period of 6 months in accordance with (IAW) the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) section 4.129 and then permanently separated by reason of physical disability with a final 80 percent rating.  

2.  The SRP considered the appropriateness of changes in the MH diagnoses, Physical Evaluation Board (PEB) fitness determination; and if unfitting, whether the provisions of VASRD section 4.129 were applicable, and a disability rating recommendation in accordance with VASRD section 4.130. 

3.  The SRP noted that the applicant entered the Disability Evaluation System (DES) with the MH diagnoses of cognitive disorder, secondary to Traumatic Brain Injury (TBI) and panic disorder, with agoraphobia from Medical Evaluation Board (MEB) and the first Informal Physical Evaluation Board (IPEB) adjudicated the same conditions.  Additionally, the reconsideration IPEB also adjudicated the same MH conditions.  The final IPEB adjudicated cognitive disorder secondary to TBI (unchanged), and Post-traumatic Stress Disorder (PTSD) (changed from panic disorder, with agoraphobia).

4.  The SRP agreed that the diagnoses were appropriately changed as the conditions were treated and evaluated from the acute injury to the 2-year follow-up and presented no possible disadvantage to the applicant in the DES process. 

5.  The SRP considered whether the provisions of VASRD section 4.129 were applicable for the unfitting MH conditions.  Regardless of final PEB diagnosis, VASRD section 4.129 does not specify a diagnosis of PTSD, rather it states “mental disorder due to a highly stressful event,” and its application is not restricted to PTSD.  The SRP concludes that sufficient evidence supports that a highly stressful event severe enough to bring about the Veteran’s release from active military service did occur and that the application of VASRD section 4.129 is appropriate in this case.

6.  The SRP considered if there was evidence for a VASRD section 4.130 higher rating than 50 percent at time of placement on the TDRL.  The SRP did not find any evidence in the clinical record for a TDRL entry rating higher than 50 percent rating for various MH conditions.

7.  The SRP noted the cognitive impairment from TBI in this case is inextricable from the VASRD section 4.130 rating for the coexisting unfitting MH condition; thus, the cognitive impairment from the neurologic injury was subsumed in the service disability rating of the psychiatric impairment associated with the latter.  Therefore, the SRP majority consensus was IAW VASRD section 4.14 no additional rating could be recommended above 50 percent.  

8.  The SRP then turned its attention to the final TDRL exit rating. The closest examination in the record is the PTSD compensation and pension examination 12 months prior to the IPEB for TDRL exit.  The SRP determined that the evidence most closely approximated the 50 percent rating.

9.  The SRP agreed that there was no evidence for a higher rating as previously discussed, or evidence of worsening of the condition.  Although the diagnosis was changed, from panic disorder with agoraphobia at the more acute stages of treatment and evaluations, both panic disorder and PTSD are rated using the VASRD general rating formula for mental disorders imparting no disadvantage to the applicant. 

10.  After due deliberation in consideration of the evidence in the record, the SRP agreed that the evidence in the record concluded that the TBI and PTSD symptoms were inextricable and subsumed under one rating.  The SRP majority consensus was that no additional rating could be recommended above 50 percent. 

11.  The available evidence shows the SRP's 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 applicant’s record to reflect no change in the applicant’s unfitting condition diagnosis, and that the applicant’s prior separation be modified to reflect that the applicant was placed on the TDRL at 50 percent for a period of 6 months (PTSD at minimum 50 percent in accordance with IAW VASRD section 4.129) and then permanently separated by reason of physical disability with a final 80 percent rating.  



      _______ _ 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)                                  AR20140009137



2


ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

 RECORD OF PROCEEDINGS


1