IN THE CASE OF:
BOARD DATE: 30 July 2014
DOCKET NUMBER: AR20140011245
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 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 majority vote that there should be no change to the applicant's disability and retirement determination.
2. The SRP considers the appropriateness of changes in the MH diagnoses, and provides remedial recommendations if it is judged that there were any elimination or unfavorable change in MH diagnosis by the service. The SRP further considers whether the provisions of Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) section 4.129 were applicable to any unfitting MH condition Physical Evaluation Board (PEB) adjudicated or SRP recommended, and makes rating recommendations in accordance with VASRD section 4.130 VASRD section 4.129
3. The SRP notes that, although Medical Evaluation Board (MEB) proceedings did not commence until 2011; the November 2009 profile suggests that Disability Evaluation System (DES) proceedings could have been initiated at a time when Post-Traumatic Stress Disorder (PTSD) was the primary MH diagnosis in effect, and not in remission.
4. The SRP notes that the Integrated DES VA psychiatrist recognized an established diagnosis of PTSD, opining that it was now in remission and the narrative summary (NARSUM) examiner concurred that the diagnosis of PTSD was present, but in remission since 2009. There is no evidence for the presence of a co-existing ratable MH condition other than PTSD in remission. Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project.
5. The SRP considered the recommendation for a diagnosis of PTSD. The SRP states that it must be noted that there is a paucity of probative pre-retirement MH evidence available other than the Integrated DES psychiatric evaluation by the VA. That examination, in addition to offering a specialty opinion that PTSD was in remission, did not provide evidentiary support for all of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria requisite to a diagnosis of PTSD at the time of retirement.
6. The SRP consensus was that there was not a preponderance of evidence on which the SRP could base a recommendation for diagnosis change to PTSD. The SRP noted that, even if a ratable MH diagnosis were conceded, the compelling NARSUM opinion that the MH condition did not prohibit continued military duty and that it met retention standards is a formidable challenge to concluding that there was unfitting psychiatric impairment for service rating.
7. The SRP, by a majority vote, agreed that there was not a preponderance of evidence to support an SRP recommendation for changing the MH diagnosis of adjustment disorder to PTSD or other ratable unfitting MH diagnosis. One member, however, supported a recommendation that "PTSD (in remission); not unfitting" be added as a service diagnosis. That member did not elect to submit a separate minority opinion.
8. The SRP unanimously agreed that there was not a preponderance of evidence that any MH condition, regardless of diagnosis, rose to the level of being unfitting at the time of retirement.
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 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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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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ABCMR Record of Proceedings (cont) AR20140011245
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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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