BOARD DATE: 17 September 2014
DOCKET NUMBER: AR20140014415
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 states that her anxiety, nightmares, and paranoia have worsened over the years.
4. 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 to the applicant's disability and retirement determination.
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). The evidence of the available records show the following diagnoses were rendered while processing through the DES -- cognitive disorder not otherwise specified (NOS), secondary to Traumatic Brain Injury; adjustment disorder with anxiety; and prolonged depressed mood and depression secondary to a general medical condition were rendered prior to Temporary Disability Retired List (TDRL) entry. Major Depressive Disorder (MDD); anxiety disorder, NOS; and Post-Traumatic Stress Disorder (PTSD) were rendered during the period of the TDRL.
3. The SRP noted that the available records show no changes to an MH diagnosis to the applicant's possible disadvantage during the DES process. Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project.
4. The SRP agreed with the Physical Evaluation Board (PEB) determination that symptoms of depression and anxiety were present. However, the major depression criteria were not met at the time of the applicant's entry onto the TDRL. The SRP agreed that the PEB adjudication of not unfitting adjustment disorder with anxiety and depressed mood were supported by the evidence and was an appropriate diagnosis.
5. The SRP also noted that no mental disorder diagnosis as a result of a highly stressful event rose to the level of unfitting and agreed that the provisions of the
Department of Veterans Affairs Schedule for Rating Disabilities section 4.129 were appropriately not applied at the applicant's TDRL entry.
6. The SRP agreed that the PEB TDRL exit diagnosis modification, 20 months after TDRL placement, of the adjustment disorder with anxiety and depressed mood to MDD and PTSD, not combat related, was supported by the evidence. The SRP noted depressive symptoms as evidenced by reports of psychomotor changes after discharge from the military. The available records reported a history of suicidal ideations after military discharge; however, there were no emergency room or unscheduled clinic visits nor psychiatric hospitalizations. The SRP noted evidence of progression of her anxiety symptoms as evidence by: reports of nightmares related to death, death of family members, and the applicant's head injury; avoidance of public places due to mistrust; elevated alertness; distressing intrusive thoughts; numb and impaired attachment; and increased irritability.
7. The SRP agreed that the PEB adjudication of the unfitting MDD and PTSD was supported by the evidence. The SRP considered if there was evidence for a rating higher than 50 percent at time of TDRL removal. The higher 70 percent rating is for "occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood." After due deliberation, the SRP concluded that there was insufficient cause to recommend a change in the PEB adjudication for the MH conditions at TDRL removal.
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 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) AR20140014415
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