IN THE CASE OF:
BOARD DATE: 30 July 2014
DOCKET NUMBER: AR20140010919
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 applicants 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 applicants case, the SRP determined by unanimous vote that there should be no change of the applicants disability and separation determination.
2. The SRP considered the appropriateness of the changes in the MH diagnoses
and a disability rating recommendation in accordance with the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.130.
3. The SRP noted that at the entry into the Disability Evaluation System (DES) process, the applicant was determined to have an adjustment disorder, major depression, anxiety disorder, and a history of post-traumatic stress disorder (PTSD). The medical evaluation board (MEB) forwarded the MH diagnoses of mixed bipolar disorder (BPD), severe to the physical evaluation board (PEB) for adjudication. The PEB adjudicated the applicant for the diagnosis of BPD at Temporary Disability Retired List (TDRL) entry.
4. The SRP determined that the severity of the diagnosis increased during the DES process. The SRP also determined that no MH diagnoses were changed to the applicant's possible disadvantage in the disability evaluation process. Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project.
5. The SRP noted that the PEB did apply VASRD Section 4.129 and the applicant was on TDRL for more than the minimum 6 months directed by the Department of Defense (DoD) policy and Department of Defense Instruction (DoDI) 1332.38. The applicant also requested the addition of PTSD and attention deficit hyperactivity disorder (ADHD) to her PEB diagnoses and adjudication. The ADHD diagnosis was determined to be both medically acceptable and not unfitting. The PTSD diagnosis was changed to the more severe diagnosis of BPD during the DES process and was the working diagnosis of both the MEB and VA examiners. The evidence did not support a change in the diagnosis. Regardless of diagnosis used though, the disability rating assigned was based on the combined effect of all the unfitting MH conditions using VASRD Section 4.130 (rating mental disabilities) in accordance with (IAW) VASRD Section 4.14 (avoidance of pyramiding).
6. The SRP later considered the appropriate rating IAW VASRD Section 4.130 for TDRL entry. It noted that the PEB and VA adjudicated a rating of 70 percent for TDRL entry, coded 9432, bipolar disorder. A higher rating of 100 percent was indicated in cases of total occupation and social impairment. This was manifested by symptoms such as gross impairment of thought processes or communication, persistent delusions and/or hallucinations, persistent danger to ones self or others, grossly inappropriate behavior, poor hygiene, disorientation and significant memory impairment. Although there was previous suicidal ideation and attempts, this had resolved at the time of TDRL placement and the other symptoms had never risen to this level of severity. The SRP concluded that the criteria for a 100 percent rating were not met.
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 applicants MH conditions.
8. The available evidence shows the SRPs 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) AR20140010919
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