IN THE CASE OF:	  

		BOARD DATE:	  17 September 2014

		DOCKET NUMBER:  AR20140013436 


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 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 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 be no change of the applicant’s disability and separation determination.

2.  The SRP considered the appropriateness of changes in the applicant's MH diagnoses; the physical evaluation (PEB) fitness determination; and if unfitting, whether the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 were applicable; and whether a disability rating recommendation in accordance with VASRD Section 4.130 was made.  

3.  The SRP noted that the evidence of the available record shows diagnoses of Post-Traumatic Stress Disorder (PTSD), major depression disorder (MDD) and alcohol abuse (in early remission) were rendered, and the diagnosis of PTSD was eliminated during processing through the Integrated Disability Evaluation System (IDES).  The SRP agreed that the service psychiatrist's evaluation and examination documented diagnostic information was more current than the Compensation and Pension (C & P) exam and specified reasons for the inaccuracy of the PTSD diagnosis and appropriately reflected a diagnosis of MDD.  The VA, based on the mental status examination psychiatrist's addendum, likewise concluded that the PTSD diagnosis rendered by the C&P examiner was incorrect, and consequently only rated MDD.  Therefore, the applicant did appear to meet the inclusion criteria in the Terms of Reference of the MH Review Project. 

4.  The SRP determined that an MH diagnosis was eliminated in the disability evaluation system (DES) and that the diagnosis was appropriately eliminated.  Regardless of final PEB diagnosis, VASRD Section 4.129 did not specify a diagnosis of PTSD, rather it stated "mental disorder due to a highly stressful event," and its application was not restricted to PTSD.  The SRP agreed that there was not sufficient evidence to support a conclusion that a highly
stressful event severe enough to bring about the veteran's release from active military service occurred and that the application of VASRD Section 4.129 was not appropriate in this case.


5.  The SRP also considered a rating recommendation at the time of the applicant's medical retirement.  Regarding the diagnosis of alcohol abuse in early remission, the SRP noted that it was a condition not constituting a physical disability in accordance with the Department of Defense Instruction (DoDI 1332.38) and was therefore not ratable.  Under the 9434 code (MDD) the PEB adopted the VA's recommended 30 percent rating, which stipulated "occupational and social impairment with occasional decrease in work efficiency and intermittent inability to perform occupational tasks." 

6.  The SRP noted the next higher 50 percent rating required "occupational and social impairment with reduced reliability and productivity."  In deliberating a rating recommendation, the SRP noted that the applicant was hospitalized for suicidal thinking, which could support a 70 percent rating; however, this transpired over a year prior to medical retirement and there was no evidence the symptom subsequently recurred.  The medical evaluation board psychiatrist used 50 percent rating language in describing the condition's impact on occupational functioning.  While there were three and possibly four threshold symptoms for a 30 percent rating, there were no 50 percent threshold symptoms (such as flattened affect, panic attacks more than once per week, or impaired judgment).  Meanwhile, the commander used 30 percent rating language in describing occupational functioning, and noted that work relationships were intact.  Global Assessment Functioning scores indicated moderate impairment.  The SRP concluded that the evidence just described was most accurately described by the "occasional decrease in work efficiency and intermittent inability to perform occupational tasks" stipulation of the 30 percent rating. 

7.  After due deliberation in consideration of the preponderance of the evidence, and mindful of VASRD Section 4.3 (reasonable doubt), the SRP concluded that there was insufficient cause to recommend a change in the PEB adjudication for the MDD condition.

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)                                  AR20140013436



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