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ARMY | BCMR | CY2014 | 20140015295
Original file (20140015295.txt) Auto-classification: Approved

		IN THE CASE OF:	   

		BOARD DATE:	  1 October 2014

		DOCKET NUMBER:  AR20140015295 


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 applicant’s 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 applicant’s case, the SRP recommended by unanimous vote that the applicant’s unfitting anxiety disorder condition diagnosis should be changed to Post-Traumatic Stress Disorder (PTSD); that his records should be corrected to reflect he was placed on the Temporary Disability Retired List (TDRL) with a disability rating of 50 percent for the PTSD condition, with a combined disability rating of 80 percent; and he should receive a permanent disability rating of 50 percent for the PTSD condition, with a combined rating of 80 percent.

2.  The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the applicant's MH condition during processing through the Disability Evaluation System (DES).  The evidence of the available records shows a diagnosis of anxiety disorder was identified by the medical evaluation board (MEB) and adjudicated by the physical evaluation board (PEB).  The diagnosis of PTSD was exclusively used by the applicant’s treating providers for over 8 months prior to entry into the DES.  The narrative summary (NARSUM), DD Form 2808, and the commander’s statement also documented PTSD.  The SRP agreed that there was a change in diagnosis; therefore, the applicant’s case did appear to meet the inclusion criteria in the Terms of Reference of the MH Review Project. 

3.  The SRP considered the appropriateness of changes in the applicant's MH diagnoses; whether the provisions of the 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.  The SRP agreed that the applicant met all diagnostic criteria for PTSD as documented in the service treatment records, permanent profile, commander’s statement, and the MEB’s DD Form 2808.  In accordance with the Department of Defense (DoD) policy the SRP concluded that VASRD Section 4.129 applies to the rating of the applicant’s PTSD condition. 

4.  The SRP also reviewed the entire record for evidence that a rating greater that 50 percent should have been granted at TDRL entrance.  The SRP agreed that the applicant did not meet the rating criteria for the next higher 70 percent rating at TDRL entry based on no speech abnormalities, suicidal ideation, or 

panic attacks with normal memory, thought content, insight and judgment.  His Global Assessment of Functioning (GAF) was also consistent with moderate impairment.

5.  The SRP noted that the VA also granted a 50 percent evaluation based on the findings documented in the PTSD exam proximate to TDRL entrance.  The SRP next considered its recommendation based on VASRD Section 4.130 rating at TDRL removal.  The most proximate source of comprehensive evidence on which to base the permanent rating recommendation in this case was the TDRL evaluation psychiatric NARSUM performed 2 months prior to TDRL removal.  That exam documented continued PTSD symptoms with occupation and social impairment.  The applicant was unable to hold a job and was divorced from his wife.  He did have a couple of friends and talked to his mother frequently.  His GAF was essentially unchanged and the examining psychiatrist utilized the exact wording for the 50 percent rating. 

6.  After due deliberation in consideration of the preponderance of the evidence, the SRP agreed that the applicant met the VASRD Section 4.130 rating criteria for a 50 percent rating at TDRL removal.

7.  The available evidence shows the SRP’s assessment should be accepted.  

BOARD VOTE:

____x___  ___x____  ___x____  GRANT FULL RELIEF 

________  ________  ________  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

________  ________  ________  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

The Board determined that the evidence presented was sufficient to warrant a recommendation for relief.  As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by changing the applicant’s unfitting anxiety disorder condition diagnosis to PTSD; 
that his records be corrected to reflect he was placed on the TDRL with a 

disability rating of 50 percent for the PTSD condition, with a combined disability rating of 80 percent; and given a permanent disability rating of 50 percent for the PTSD condition, with a combined rating of 80 percent.



      _______ _   _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)                                  AR20140015295



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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

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