IN THE CASE OF:
BOARD DATE: 10 September 2014
DOCKET NUMBER: AR20140013480
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 applicants 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 applicants case, the SRP determined by unanimous vote that there should be no change of the applicants disability and separation determination.
2. The SRP considered the appropriateness of changes (if any) in MH diagnoses, the appropriateness of physical evaluation board (PEB) fitness determination for any MH condition; and, if unfitting, whether the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 were applicable.
3. The SRP further considered the fairness of disability ratings for MH conditions and made recommendations for said ratings in accordance with VASRD Section 4.130 (and VASRD Section 4.129 as appropriate). Although a diagnosis of post-traumatic stress disorder (PTSD) was contended in writing to the medical evaluation board (MEB) and noted on the DD Form 2808, thereby forwarded in the Disability Evaluation System documents, the only formal MH diagnosis forwarded for PEB adjudication was anxiety disorder. The SRP concluded the applicants case appeared to meet the inclusion criteria of the Terms of Reference of the MH Review Project.
4. The SRP considered whether a change of the diagnosis to PTSD was recommended. There was no documentation by any Service provider that the requisite the Diagnostic and Statistical manual for Mental Disorders, Fourth Edition, Text Revision (DSM IV-TR) criteria for a diagnosis of PTSD was endorsed. The evidence from the civilian psychologist was obtained late in the course of the MEB proceedings; the evidence from the Department of Veterans Affairs (VA) psychiatrist was obtained after retirement (although probative to same); and, neither of the latter evaluations were corroborated by the service treatment records evidence.
5. The SRP agreed that it was more likely that (non-criterion A) Service occupational stressors were the primary substrate for the MH symptoms, rather than the emergence of Gulf War stressors after many years of clinical silence. The SRP also agreed that there was not a preponderance of evidence in support of a recommendation to change the service diagnosis from anxiety disorder to PTSD.
6. The SRP later turned to its assessment of the fairness of the PEBs determination that the established MH condition was not unfitting. As with recommendations regarding a change of MH diagnosis, an SRP recommendation for a change in a fitness determination must be supported by a preponderance of evidence; not grounded in speculation or based on reasonable doubt.
7. The SRP noted the MEB psychiatrist conducted a comprehensive fitness evaluation, proceeded with further evaluation and repeated his evaluation before opining that the MH condition did not prohibit continuing service. The ensuing S2 profile was not commonly associated with unfitting psychiatric impairment and did not mandate MEB referral. The commanders statement was incriminating for continued performance within the applicants recruiter military occupational specialty (MOS); but, referred more to intrinsic personality issues (not service ratable) than to psychiatric impairment; and, the SRP must consider that the need for a change of MOS or duty assignment did not equate to a determination that the member was unfit for continued service.
8. After due deliberation in consideration of all the performance based evidence, the SRP concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the MH condition.
9. The available evidence shows the SRPs 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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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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ABCMR Record of Proceedings (cont) AR20140013480
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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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