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Decision Text

ARMY | BCMR | CY2014 | 20140011229
Original file (20140011229.txt) Auto-classification: Denied

	

		BOARD DATE:	  30 July 2014

		DOCKET NUMBER:  AR20140011229 


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.  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 applicant's MH diagnoses, the physical evaluation board (PEB) fitness determination; and if unfitting, 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.  

3.  The SRP considered the applicant was diagnosed with and being treated for Post-Traumatic Stress Disorder (PTSD) beginning at the time of entry into the Disability Evaluation System (DES) and that the diagnosis continued to be recorded during his processing through the medical evaluation board (MEB) and physical evaluation board (PEB).  The SRP concluded that the diagnosis was not changed and therefore, the applicant’s case did not meet the inclusion criteria of the Terms of Reference of the MH Review Project.

4.  The SRP noted that a disability associated with any psychiatric condition, regardless of the diagnosis or multiple diagnoses, was subsumed under a single rating using the same criteria in accordance with VASRD Section 4.130.  Therefore, the rating for PTSD included any social and occupational impairment that was due to the PEB’s associated major depressive disorder (MDD).  The SRP agreed that the provisions of VASRD Section 4.129 were applicable in this case, noting the association with combat experiences.

5.  The SRP also considered if there was evidence for a VASRD Section 4.130 rating higher than the PEB’s (VASRD Section 4.129 minimum mandated) 50 percent at time of the applicant's Temporary Disability Retired List (TDRL) entry.  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 due to such symptoms as …"  Although the MEB’s description of “incapable” for military duty and “questionable” for civilian employment would infer an impairment level of at least serious to near incapacitation, the examiner’s recorded Global Assessment of Functioning (GAF) of 60 and comment of “but generally functioning at a satisfactory level” indicated otherwise.  There was no current SI, obsessional rituals, illogic speech, near continuous panic attacks, abnormal impulse control, poor/neglect of personal hygiene, or depression to a degree of nonindependent function.  The SRP considered and agreed that the record in evidence best supported the 50 percent rating for TDRL entry and there was insufficient reasonable doubt for recommending a higher rating.

6.  After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that the diagnosis of PTSD with application of VASRD Section 4.129 minimum rating of 50 percent at TDRL entry was appropriate. 

7.  The SRP finally considered if there was evidence for a VASRD Section 4.130 rating higher than 30 percent at time of permanent retirement.  The SRP agreed that the "occasional decrease in work efficiency…" criteria as referenced by psychiatry, was best supported by the 30 percent rating criteria for permanent retirement.  There was insufficient evidence for recommending a 50 percent permanent rating.

8.  After due deliberation in consideration of VASRD Section 4.30 (reasonable doubt), the SRP concluded the diagnosis of PTSD associated with MDD with application of VASRD Section 4.130 rating of 30 percent at permanent retirement was appropriate.

9.  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)                                  AR20140011229



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