IN THE CASE OF:
BOARD DATE: 23 September 2014
DOCKET NUMBER: AR20140014487
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 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 Department of Defense 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 to the applicants disability and separation determination.
2. The SRP reviewed the records for evidence of changes or elimination of a
diagnosis of the applicant's MH condition during processing through the Disability Evaluation System (DES) to the possible disadvantage of the applicant. The SRP also found that the DD Form 2808 listed Post-Traumatic Stress Disorder (PTSD) and adjustment disorder, and the psych narrative summary (NARSUM) examiner diagnosed adjustment disorder with mixed anxiety and depressed mood. The Variance memo recorded anxiety disorder not otherwise specified (NOS), and the medical evaluation board (MEB) forwarded anxiety disorder NOS, to the physical evaluation board (PEB). Therefore, the SRP agreed the applicants case did appear to meet the inclusion criteria in the Terms of Reference of the MH Review
Project.
3. The SRP noted the applicant's MH condition was determined to be not unfitting by the PEB. The SRPs charge with respect to MH conditions referred for review that were determined to be not unfitting by the PEB was an assessment of the appropriateness of the PEBs fitness adjudication. The SRPs threshold for countering PEB not-unfit determinations requires a preponderance of evidence. The MH condition was reviewed and considered by the SRP. The psychiatric profile was S-2 and the MH condition was not judged to fail retention standards by the MEB NARSUM psychiatrist and psychologist, the psychiatrist who authored the psychiatric diagnostic variance memo, or the MEB. The commanders statement noted mixed findings of being able to work effectively with people and make reasonable and complex decisions, but remaining alone, guarded, and easily agitated by others. However, no MH condition was specifically mentioned, whereas limitations due to physical problems were noted, as well as diminished performance due to pain.
4. The SRP noted the service treatment records (STR) indicated that the applicants treating psychiatrist had, at some point during treatment, indicated
the applicant did not meet retention standards due to a diagnosis of PTSD. However, in his note for the record following the MEB NARSUM, the treating psychiatrist indicated that the applicant had done quite well with treatment and he did not offer an opinion that the applicant failed retention standards at that time. There was no indication from the record that the MH condition significantly interfered with satisfactory duty performance.
5. The SRP also noted that at both Department of Veterans Affairs (VA) PTSD evaluations after separation, the examiners noted that there were potential issues of concern regarding symptom over-reporting or exaggeration, yet neither examiner confronted the applicant regarding numerous inconsistencies between the history and objective findings or the endorsement of all symptoms for all MH disorders. Yet both providers made MH diagnoses, with no explanation regarding their determination of which reported symptoms were essential or non-essential to diagnosis. The first VA examiner diagnosed PTSD and indicated there were no other MH diagnoses; and the second examiner, a month later, diagnosed PTSD and four additional Axis I MH conditions. Based on the post-separation VA evidence and the STR, the SRP was unable to conclude that there was either sufficient evidence to change the Service MH diagnosis or a preponderance of evidence to refute the PEBs fitness determination.
6. After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the applicant's MH condition and no disability rating was recommended.
7. 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
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ABCMR Record of Proceedings (cont) AR20140014487
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