IN THE CASE OF:	  

		BOARD DATE:	  30 July 2014

		DOCKET NUMBER:  AR20140011250 


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 responded to the advisory opinion and provided 3 exhibits with his rebuttal as follows:

* Page 2 of his Advisory Opinion

* Several copies of his Standard Form 600 (Chronological Record of Medical Care) 

* Letter from the Department of Veterans Affairs (VA), dated 28 December 2013

5.  In his rebuttal, the applicant states:

	a.  The majority of his mental health records were missing; however, he has enough to show the seriousness of his Post-Traumatic Stress Disorder (PTSD).  There were also a lot of discrepancies that show a lack of documentation which is why there was a problem with his PTSD being properly recorded in his records.  He listed several incidents and discrepancies.

   1.  On page 2 of his MH Disability Review, it stated “he felt useless and would be better off dead.”  That was documented as suicidal ideation.  On the same page, it stated he had been through “eye movement desensitization and reprocessing.”   He had never been through that and he also never to his knowledge received an S2 profile for mental health as stated on that page.  This seemed to be a clerical error or a mix-up of records.
   
   2.  He stated to the psychologist in group therapy, on numerous occasions, that he wished he was dead.  He made a number of statements that showed suicidal and homicidal ideation.  None of his statements made it into the “blanket statement” that he used for everyone in group therapy.  He included some of these blanket statements to show how generalized they were.
   
   3.  While deployed to Iraq in May or June 2008, he was suicidal.  He was escorted by a noncommissioned officer (NCO) to see the chaplain and later escorted to the Aid Station.  During this time, the bolt was removed from his weapon by the NCO to ensure the safety of himself and others.  He was placed on suicide watch.  He did not a have a current phone number but was able to be 

contacted through Facebook.  He created a short video which was posted on YouTube by the supply specialist to show the events of what he went through right before his suicidal incident.
   
   4.  Homicide:  an act of a human killing another human.  He brought this up to show the lack of questioning by the psychiatrist.  At no time did the psychiatrist ever ask him any questions pertaining to combat, suicide, homicide, or even violent behaviors.  The psychiatrist only asked questions pertaining to sleep, mood, and the effects of medication.  The psychiatrist statements show “no history of committing homicide.”  He was a first responder when an NCO was shot in the head on April 4, 2004 (also called Black Sunday).  The fight that ensued was more than he would talk about, even 10 years later.  There were also a number of other incidents besides that where he was forced to take a life.
   
	5.  His chronological care records show repeated depression, insomnia, anxiety, adjustment disorder, and nightmares which continued for a long time before PTSD was actually added to the list and which occurred after he began his medical evaluation board (MED).

   6. The VA, after treating him for PTSD, determined he was unemployable because of the severity of his symptoms.  This was with no changes to the symptoms that he was exhibiting in the Army.  The only difference was that he was being treated by a professional who listened to what he had to say.

   7.  The last point he would like to discuss was about when he returned to service in 2006.  Nothing was mentioned about PTSD because at that point, he had no idea what it was.  He did not learn about PTSD until 2007, when he was having marital problems.  The Chaplain explained to his wife and himself what PTSD was and pointed out to him some of his symptoms.  He concluded that after his first deployment he began to drink heavily, had problems with crowds, fireworks, and numerous other things which show he had issues adjusting.  He repeatedly asked for assistance and was denied.
   
8.  In summary, he hopes that mentioning some of these discrepancies and lack of documentation, along with other facts, would assist in the SRP’s decision.  He has attached and highlighted some various records pertaining to the above.

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 separation determination.

2.  The SRP 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.

3.  The SRP noted the Disability Evaluation System (DES) and the Department of Veterans Affairs (VA) were consistent in the diagnosis of PTSD.  The physical evaluation board (PEB) adjudged the applicant’s PTSD to be “not unfitting” after the MEB identified it as meeting medical retention standards.  The well established principle for fitness determinations was that they were performance-based and the SRP’s threshold for countering PEB not-unfit determinations required a preponderance of evidence.

4.  The SRP noted the applicant sought care for his MH condition for over 21 months prior to separation; there was no documentation to suggest the condition interfered with his duty performance.  The evidence supported that the applicant did benefit from the treatment provided by his behavioral health providers as evidenced by his improved mental status exam and Global Assessment of Functioning (GAF) score in the six-month period between the Compensation and Pension (C&P) exam and psychiatric narrative summary (NARSUM).

5.  The applicant was profiled at the “S2” level for his PTSD and the commander’s statement did not directly implicate PTSD as limiting his duty performance, although it did note diminished attention or performance related to insomnia.  The SRP was unable to determine if the insomnia was due to the PTSD or the non-MH conditions.  The evidence also contained personal statements from his platoon leader and a medic from his Battalion Aid Station and neither mentioned any signs or symptoms of an MH condition.  The applicant submitted a request for an independent medical evaluation that did not include a MH condition.  Additionally, on his DD Form 2807 (MEB History), the applicant did not mention PTSD, only noting that he was being treated by Behavioral Health and he was unsure if they made a diagnosis.  There were no psychiatric hospitalizations for an MH condition.

6.  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’s fitness determination for the applicant’s PTSD condition.

7.  After careful consideration of the available evidence and the applicant’s response to the advisory opinion, 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)                                  AR20140011250



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