IN THE CASE OF:	  

		BOARD DATE:	  23 July 2014

		DOCKET NUMBER:  AR20140010492 


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 mental health diagnosis was changed during that process.

3.  The applicant submitted an application through the DOD Physical Disability Board of Review (PDBR) Mental Health 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 mental health condition during processing through the military disability system.  

2.  The Department of Defense memorandum, dated 27 February 2013, directed the Service Secretaries to conduct a review of mental health 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 be no change of the applicant’s disability and separation determination.

2.  The SRP considered the appropriateness of changes in the MH diagnoses, and the physical evaluation board (PEB) fitness determination.  The SRP concluded the MH diagnoses were made and appropriately changed according to the clinical presentation and then by chart review, during the disability evaluation process.  The applicant was first diagnosed with anxiety disorder.  The Department of Veterans Affairs (VA) psychologist examiner declared psychometric testing done at the VA which was negative for Post-Traumatic Stress Disorder (PTSD) as invalid and diagnosed PTSD by clinical impression, explaining that PTSD was an anxiety disorder, and that depression not otherwise specified (NOS) was the cause of the major symptomatology during that examination.  These diagnoses were changed back to anxiety disorder by a diagnostic variance memo. 

3.  The SRP noted the lack of treatment records due to the onset of the mild psychiatric symptoms 6 months prior to the medical evaluation board (MEB) and 10 months prior to Informal PEB (IPEB).  The applicant was promptly evaluated after the onset of symptoms (nightmares) and diagnosed accordingly, and differently, as is often the case especially by different providers with different levels of training and expertise.  To consider if this diagnostic variance represented a possible disadvantage to the applicant during the Integrated Disability Evaluation System (IDES) process, the SRP first considered if the preponderance of the evidence indicated unfitness to perform military duties.  The SRP determined that the diagnostic changes did not represent a disadvantage to the applicant during the IDES process.  Therefore, the applicant did not appear to meet the full inclusion criteria in the Terms of Reference of the MH Review Project

4.  The SRP deliberated and later turned to the consideration of whether the MH conditions, regardless of specific diagnosis, were unfitting for continued military service.  The SRP’s charge with respect to the MH conditions referred for review that were determined to be not unfitting by the PEB was an assessment of the appropriateness of the PEB’s fitness adjudication.  The SRP’s threshold for countering PEB not-unfit determinations required a preponderance of evidence. There were no profiled psychiatric limitations.  The commander’s statement on 5 December 2011, mentioned that there was satisfactory duty performance with little interference from any medical condition.  It stated the applicant was able to complete everyday tasks to standards, with occasional decrease in work efficiency and had effective work relationships with both supervisors and          co-workers.  

5.  The SRP noted the commander’s statement further elaborated that the applicant made reasonable decisions, including complex or unfamiliar ones.  There was no other evidence in the record such as prolonged absence from work, prolonged psychiatric hospitalizations or psychiatric urgent or emergent treatment, which would otherwise indicate unfitness.  The record was noticeably absent of a treatment history, since the applicant did not report any psychiatric symptoms until after entering the IDES process.  The record indicated treatment was improving his symptoms and his symptoms were not affecting the performance of his military duties per the psychiatrist memo and commander’s statement. 

6.  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 fitness determination for the MH condition and no disability rating was recommended.

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 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)                                  AR20140010492



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