BOARD DATE:	  6 August 2014

		DOCKET NUMBER:  AR20140011789 


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 unanimous vote that there should be no change in the applicant’s unfitting condition diagnosis, and that the applicant’s records should be corrected to reflect placement on the Temporary Disability Retired List (TDRL) for a period of 6 months.  The SRP recommends no change to the applicant’s permanent disability rating previously assigned.

2.  The SRP considered the appropriateness of changes in the MH diagnoses, whether the provisions 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 agreed there was a change in diagnosis at the time of the Medical Evaluation Board (MEB) psychiatry narrative summary (NARSUM), to the applicant’s possible disadvantage, in the disability evaluation since Post-Traumatic Stress Disorder (PTSD) is a more serious disorder than anxiety disorder.  The SRP concluded the applicant met the inclusion criteria in the Terms of Reference of the MH Review Project. 

4.  The SRP considered the change in diagnosis from PTSD to anxiety disorder, not otherwise specified (NOS) during the time the applicant was going through the Disability Evaluation System (DES).  The SRP agreed the evidence of the record supported the change in diagnosis to anxiety disorder at the time of the MEB and Physical Evaluation Board (PEB).  This change was considered clinically appropriate by the SRP, as the symptoms of PTSD varied, and were improved 10 months prior to the PEB.

5.  The SRP next deliberated if the VASRD section 4.129 applied in this case.  Although the applicant’s PTSD improved by the time of the psychology examination, such that his PTSD may not have met full criteria 10 months prior to separation; the SRP concluded that sufficient reasonable doubt supported that a highly stressful event severe enough to bring about the applicant’s release from active military service did occur and that the application of VASRD section 4.129 is appropriate in this case. 


6.  The SRP did not find evidence in the clinical treatment records that indicated the anxiety symptoms at the time of evaluation in the DES were due solely to non-combat stressors.  The diagnostic variance assessment noted PTSD spectrum symptoms as part of the anxiety disorder and cited combat as one of the associated stressors. Therefore, the SRP concluded that application of the provisions of VASRD section 4.129 was appropriate and recommends a retroactive constructive 6-month period on the TDRL with a minimum rating of   50 percent. 

7.  The SRP examined whether the evidence at the time of separation and entry on the constructive period of TDRL supported a higher rating under VASRD section 4.129. The SRP did not find evidence for a higher; therefore, the SRP concluded a 50 percent rating at TDRL entry was appropriate.

8.  The SRP then considered its permanent rating recommendation at the time of removal from the constructive 6-month period of TDRL.  The SRP did not conclude that the post-separation evidence supported a higher rating.  After due deliberation in consideration of the evidence, the SRP concluded that the diagnosis of anxiety disorder was appropriate at the time of initial DES evaluation and that the provisions of VASRD section 4.129 were appropriately applicable, providing a TDRL entry rating of 50 percent.  Furthermore, the SRP concluded that a permanent rating of 50 percent at the time of removal from constructive TDRL is appropriate.

9.  The available evidence shows the SRP's assessment should be accepted.

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF 

____X____  __X______  _X___  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

________  ________  ________  DENY APPLICATION








BOARD DETERMINATION/RECOMMENDATION:

1.  The Board determined that the evidence presented was sufficient to warrant a recommendation for partial relief.  As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected to reflect placement on the TDRL for a period of 6 months. 

2.  The Board further determined that the evidence presented was insufficient to warrant a portion of the requested relief.  As a result, the Board recommends denial of so much of the application that pertains to the applicant’s unfitting condition diagnosis and no change to the applicant’s permanent disability rating previously assigned. 




      _________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)                                  AR20140011789



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