IN THE CASE OF:	  

		BOARD DATE:	  23 July 2014

		DOCKET NUMBER:  AR20140010672 


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 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 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 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 be no change of the applicant’s Temporary Disability Retired List (TDRL) and permanent retirement disability determinations.

2.  The SRP reviewed the records for evidence of changes in diagnosis of the MH condition during the applicant's processing through the military Integrated Disability Evaluation System (IDES).  The evidence of the available records show diagnoses of Post-Traumatic Stress Disorder (PTSD), depressive disorder, not otherwise specified (NOS), major depressive disorder (MDD), obsessive compulsive disorder (OCD) and personality disorder, NOS were rendered during processing through the IDES.  The evidence of the available records recorded no inappropriate changes or elimination of diagnoses to the applicant’s possible disadvantaged during the IDES process.  Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project.

3.  The SRP agreed that the physical evaluation board (PEB) adjudication of unfitting PTSD and depressive disorder, NOS was supported by the evidence.  The applicant appeared to have met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM IV-TR), criteria for PTSD and depressive disorder due to PTSD; therefore, the diagnoses of PTSD and depressive disorder, NOS were the appropriate diagnoses and application of the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 was correct (mental disorders due to traumatic stress) for application at TDRL entry. 

4.  The SRP considered if there was evidence for a VASRD Section 4.130 rating higher than 50 percent at time of placement on the TDRL.  The higher 70 percent rating was for “Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.” Available treatment records at the time leading up to TDRL entry recorded a history of suicidal ideation without intent; however, there were no psychiatric hospitalizations in the 12 months prior to TDRL placement, no aggressive behaviors, no recorded visits to the emergency room, and no evidence of impairment in judgment or thinking.  The SRP considered the record in evidence best supported the 50 percent rating for TDRL entry and there was insufficient reasonable doubt (in accordance with (IAW) VASRD Section 4.3 or Section 4.7) for recommending a 70 percent TDRL entry rating. 

5.  The SRP noted that the VA rated PTSD with depression in strict accordance with the unified rating of psychiatric functional impairment regardless of diagnosis or number of diagnoses.  While the PEB rated PTSD and depressive disorder NOS as separately unfitting at 50 percent and 10 percent respectfully. Consequently, in this case, the SRP is unable to apply a single 50 percent PTSD (MH) rating and eliminate the 10 percent depressive disorder NOS rating because this action would lower the applicant’s combined PEB TDRL entry rating of 60 percent, which was prohibited by Department of Defense Instruction (DoDI) 6040.44 guidance.

6.  The SRP agreed that the PEB TDRL removal adjudication of unfitting PTSD with elements of major depression was supported by the evidence.  The SRP considered if there was evidence for a VASRD Section 4.130 rating higher than 50 percent at time of TDRL exit.  The higher 70 percent rating was for “Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.”  Available treatment records during TDRL recorded a history of suicidal ideation without intent; however, there were no psychiatric hospitalizations during TDRL, no recorded visits to the emergency room, and no evidence of impairment in judgment or thinking.  There were no legal issues and the applicant was working from home full-time. 

7.  After due deliberation in consideration of the preponderance of the evidence,
the SRP determined that there was insufficient reasonable doubt in accordance with VASRD Section 4.3 for recommending a 70 percent TDRL entry rating and that the record in evidence best supported the 50 percent rating for TDRL.

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)                                  AR20140010672



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