BOARD DATE:	  24 September 2014

		DOCKET NUMBER:  AR20140014534 


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 mental health diagnosis was changed during that process.

3.  The applicant submitted an application through the DOD Physical Disability Board of Review (PDBR) Mental Health 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 mental health 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 should be no change to the applicant’s disability and separation determination. 

2.  The SRP considers the appropriateness of changes (if any) in the MH
diagnoses, and provides remedial recommendations if it is judged that there were any elimination or unfavorable change in an MH diagnosis by the service.  The SRP further considered whether the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 were applicable to any unfitting MH condition (physical evaluation board (PEB) adjudicated or SRP recommended), and made rating recommendations in accordance with VASRD Section 4.130 (and Section 4.129 as appropriate).  Since the service acknowledged and rated the Post-Traumatic Stress Disorder (PTSD) condition, with application of VASRD Section 4.129, the applicant’s case did not appear to meet the inclusion criteria in the Terms of Reference of the MH Review Project.

3.  The SRP noted that since the applicant’s final service adjudication had not yet been effected at the time of SRP adjudication, the SRP’s sole charge in this case was assessing the fairness of the Temporary Disability Retired List (TDRL) entry rating for PTSD.  The PEB assigned the minimum 50 percent rating cited by VASRD Section 4.129, but the SRP must consider whether the VASRD Section 4.130 criteria for a 70 percent or 100 percent rating were reasonably satisfied by the evidence at TDRL placement.

4.  The SRP agreed that VASRD Section 4.130 criteria for a 100 percent rating
(total occupational impairment) were not met, and considered the 70 percent criteria, i.e., “occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood”; referencing typical symptoms of suicidal ideation, obsessional rituals, illogical speech, near continuous panic or depression, spatial disorientation, neglect of hygiene and inability to establish relationships.  The SRP noted that the first VA Rating Decision provided a 70 percent disability rating for the MH condition but opined that the evidence in the record supported that at TDRL entry the applicant was improved on psychotropic and sleep medications and was working successfully with reference to MH function in the Warrior in Transition Unit, as supported by the commander’s statement and performance evaluations. 
5.  The SRP noted that at both the pre-separation Compensation and Pension (C&P) examination and the MEB psychiatric narrative summary (NARSUM) examination, the applicant reported passive suicidal ideation (SI) and auditory and visual hallucinations.  However, the SRP considered that there was no evidence in the record of SI intent or attempts and reality testing was consistently normal.  The applicant did not appear to have any functional impairment related to the intermittently endorsed hallucinations; in fact, the applicant reported that the voice was “comforting.” At the post-separation the VA PTSD Disability Benefits Questionnaire (DBQ) neither SI nor hallucinations were endorsed.  The SRP considered that the applicant had a history of difficulty with intimate relationships that existed prior to his service-related MH diagnoses, but also noted that he reported he had a close friend and a good relationship with his children and extended family and a stable employment history.  The applicant was noted to be unemployed at the time of the VA PTSD DBQ because of the effects of physical limitations on his previous physical labor job, but had applied for a private sector job and was awaiting the outcome. 

6.  The SRP concluded that at the time of temporary retirement the applicant remained occupationally functional; there was no serious impairment in “most areas” as dictated by the 70 percent rating description and most of the exampled typical features were not present; therefore, the minimum 50 percent rating allowed by VASRD Section 4.129 was applicable.  

7.  After due deliberation in consideration of the preponderance of the evidence,
the SRP agreed, mindful of VASRD Section 4.3 (reasonable doubt), that there was insufficient cause to recommend a change in the PEB’s TDRL rating for PTSD.

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)                                  AR20140014534



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