IN THE CASE OF

		BOARD DATE:	    30 July 2014

		DOCKET NUMBER:  AR20140011247 


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 should be no change of the applicant’s disability and retirement determination 

2.  The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the MH condition during processing through the Integrated Disability Evaluation System (IDES).  The evidence of the available records shows the diagnoses of episodic mood disorder, Post-Traumatic Stress Disorder (PTSD), and alcohol dependence were rendered during processing through the IDES.  Episodic mood disorder was referred in to the IDES and remained unchanged at the physical evaluation board (PEB).  Therefore, the applicant did not appear to meet the inclusion criteria in the Terms of Reference of the MH Review Project. 

3.  The diagnosis of PTSD by the IDES Department of Veterans Affairs (VA) Compensation and Pension (C&P) examiner was considered by the medical evaluation board (MEB) psychologist who concluded that the applicant did not meet the diagnostic criteria for PTSD.  The SRP noted the applicant’s treatment records leading to the time of separation did not record a treatment diagnosis of PTSD.  The Post-Deployment Health Assessment (PDHA) recorded the applicant’s own denial of trauma exposure, denial of ever feeling a fear of losing his life, and denial of all symptoms suggestive of PTSD. 

4.  The SRP acknowledged the VA C&P evaluation, 13 months prior to separation, that the applicant reported symptoms that met the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision (DSM IV TR) diagnostic criteria for PTSD; however, clinical documentation throughout the clinical record recorded minimal symptoms of PTSD and no indication that PTSD diagnostic criteria were ever met.  The applicant continued to report mood symptoms a year after separation.  At the VA C&P evaluation, 6 months after separation, the SRP noted the diagnosis of PTSD was eliminated; bipolar disorder was the only diagnosis evidenced in that examination.  The SRP concluded the diagnosis of episodic mood disorder was the appropriate diagnosis at the time of separation, and the diagnosis of PTSD was not supported.

5.  The SRP noted the applicant fully met the DSM-IV TR diagnostic criteria for episodic mood disorder; therefore, the diagnosis of episodic mood disorder was the appropriate diagnosis.  The SRP considered whether the provision of the VA Schedule for Rating Disabilities (VASRD) Section 4.129 were applicable.  Although the applicant reported traumatic stressors at the VA C&P examination that would support application of VASRD Section 4.129, review of service treatment records did not support a conclusion that the mental disorder was due to a highly stressful or traumatic event warranting application of VASRD Section 4.129.  

6.  The SRP later considered if there was evidence for a VASRD Section 4.130 rating higher than 50 percent at time of medical retirement.  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 separation recorded the absence of suicidal ideation, no visits to the emergency room and no psychiatric hospitalizations in the 15 months prior to separation, and no report of panic attacks or mood instability.  There was no evidence of impairment in judgment or thinking, no gross abnormality recorded in any of the mental status examinations  and no evidence of impairment in family relations.  The commander statement in July 2010, 6 months prior to separation, noted the applicant’s squad leader was still recommending automatic promotion and that the applicant exhibited mild symptoms.  The SRP considered the record in evidence did not support a rating higher than 50 percent and the preponderance of evidence did not support consideration of a higher rating.

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 applicant’s MH conditions at medical retirement.

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)                                  AR20140011247



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