IN THE CASE OF:	 

		BOARD DATE:	  6 August 2014

		DOCKET NUMBER:  AR20140011598 


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 a 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 should be no change in the physical evaluation board (PEB’s) Temporary Disability Retired List (TDRL) and the applicant's permanent separation adjudication.

2.  The SRP reviewed the records for evidence of inappropriate changes in the diagnosis of the applicant's MH condition during processing through the military Disability Evaluation System (DES), pilot program.  The available evidence shows the diagnosis of Post-Traumatic Stress Disorder (PTSD) as the only MH diagnosis rendered during processing through the DES.  The SRP agreed there were no inappropriate changes in the diagnosis; therefore, it was determined that the applicant did not appear to meet the inclusion criteria in the Terms of Reference of the MH Review Project. 

3.  The SRP agreed that the PEB adjudication of unfitting PTSD was supported by the evidence, the diagnosis of PTSD was the appropriate diagnosis and application of the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 was correct (mental disorders due to traumatic stress) for application at TDRL entry.  

4.  The SRP considered whether there was evidence for a VASRD Section 4.130 rating higher than 70 percent at time of placement on the TDRL.  The higher 100 percent rating was for “Total Occupational and social impairment.”  Available treatment records at the time leading up to TDRL entry recorded no history of suicidal ideation, no visits to the emergency room for panic attacks or other psychiatric symptoms and no MH hospitalization.  There was no evidence of impairment in judgment or thinking and no evidence of impairment in family relations, but the applicant had impairment in social relations outside the home and impairment in short term memory.  The SRP concluded the record did not support a rating higher than 70 percent for TDRL entry and there was insufficient reasonable doubt (in accordance with (IAW) VASRD Section 4.3) to recommend a 100 percent TDRL entry rating.




5.  The SRP noted at the TDRL exit examination on 6 January 2012 (approximately 9 months into the TDRL), the applicant indicated he was not hospitalized for a MH condition, had continued on medication but had discontinued group therapy for PTSD.  He reported decreased frequency of nightmares and a small overall improvement in his symptoms.  He continued to avoid participation in events that might increase anxiety or irritability.  The applicant reported anxiety and mood symptoms, social discomfort, fear of driving, flashbacks, disrupted sleep, social detachment, and other symptoms of PTSD.  He occasionally accompanied his 15-year-old son to Reserve Officers’ Training Corp (ROTC) and maintained his interest in target shooting, hunting and fishing.  He was unemployed.  His mental status examination noted a dysphoric mood and affect, normal thought processes, good judgment, no evidence of psychosis, no suicidal or homicidal ideation, and cognitive processes were grossly intact. The applicant continued to meet criteria for PTSD and a Global Assessment of Functioning of 55 (moderate) was recorded.  The physician indicated the best description of occupational and social functioning was “reduced reliability and productivity” due to his symptoms, but his condition was noted as stable and chronic.  

6.  The SRP considered whether there was evidence for a VASRD Section 4.130 rating higher than 50 percent at time of medical retirement.  The SRP agreed at the time of medical retirement, the applicant’s condition demonstrated some improvement in overall functioning and was stabilized.

7.  The SRP noted the applicant was not working in the 8 or 9 months after TDRL entry and there was no evidence of impairment in thinking or judgment.  The applicant reported avoidance of activities considered by him to be anxiety provoking, but socially he maintained interest in outdoors sports and occasionally accompanied his son to ROTC activities.  The applicant was never hospitalized psychiatrically or treated in the emergency room for psychiatric symptoms, and he had no legal issues.  The SRP concluded the available record most closely approximates the criteria for a 50 percent rating and there was insufficient reasonable doubt (IAW VASRD Section 4.3) for recommending a higher rating.

8.  After due deliberation in consideration of the preponderance of the evidence, the SRP concluded there was insufficient cause to recommend a change in the adjudication of the applicant’s MH condition at medical 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 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



3


ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

 RECORD OF PROCEEDINGS


1

ABCMR Record of Proceedings (cont)                                  AR20140011598



2


ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

 RECORD OF PROCEEDINGS


1