IN THE CASE OF:	  

		BOARD DATE:	  24 September 2014

		DOCKET NUMBER:  AR20140014492 


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 to the applicant's disability and retirement determination.

2.  The SRP considered the appropriateness of changes in the applicant's MH diagnoses; Physical Evaluation Board (PEB) fitness determination; and if unfitting, whether the provisions of 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 reviewed the records for evidence of inappropriate changes in a diagnosis of the MH condition during processing through the military Disability Evaluation System (DES).  Although the diagnosis was not changed at any time within the DES system, a service outpatient MH provider (apart from the DES system) changed the diagnosis from adjustment disorder to major depressive disorder (MDD). 

4.  The SRP determined that this did not represent a change to the applicant’s possible disadvantage in the disability evaluation, since major depression is a diagnostic clarification of mood disorder and is not a more serious condition.  Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project. 

5.  The SRP considered whether the provisions of VASRD section 4.129 were applicable for the unfitting MH conditions.  Regardless of final PEB diagnosis, VASRD section 4.129 does not specify a diagnosis of Post-Traumatic Stress Disorder (PTSD), rather it states “mental disorder due to a highly stressful event,” and its application is not restricted to PTSD.  The SRP concludes that there was not sufficient evidence to support a conclusion that a highly-stressful event severe enough to bring about the applicant’s release from active military service occurred and that the application of VASRD 4.129 is not appropriate in this case.

6.  The SRP considered if there was evidence for a VASRD section 4.130 rating higher than 50 percent at the time of medical retirement.  The SRP notes that the disability associated with all psychiatric conditions, regardless of the diagnosis, is subsumed under a single rating using the same criteria in accordance with VASRD section 4.130.  Therefore, the applicant’s disability rating assigned by the PEB, and the recommendation from the SRP, will be unaffected by the specific psychiatric diagnosis determined to be unfitting by the service.  The next higher 70 percent rating requires “occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood,” while the 100 percent rating is described by “total occupational and social impairment.”

7.  The SRP noted that there were no visits to the emergency room for MH treatment and no psychiatric hospitalizations.  The issue of unemployment after medical retirement was debated, but occupational functioning in an administrative capacity prior to retirement and some intact social relationships were also considered in the setting of no threshold symptoms of a 100 percent rating, such as persistent delusions or hallucinations, persistent danger of hurting self or others, or memory loss for names of close relatives, own occupation, or own name.  The SRP unanimously agreed that the evidence could not be reconciled with the 100 percent rating description, and deliberation settled on arguments for a 50 percent versus a 70 percent rating recommendation. 

8.  The SRP noted that the applicant was working full-time in an administrative capacity leading up to the time of medical retirement and debated the significance of some work-place conflict and frustration.  Ultimately, it was concluded that the evidence just described is most consistent with the “reduced reliability and productivity” stipulation of the 50 percent rating.  

9.  After due deliberation and the preponderance of evidence the SRP concluded that the evidence at the time of medical retirement is most accurately depicted by the 50 percent rating.

10.  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)                                  AR20140014492



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