IN THE CASE OF:	  

		BOARD DATE:	 1 October 2014 

		DOCKET NUMBER:  AR20140015297 


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 (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 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 in the physical evaluation board (PEB) adjudication of the temporary disability and permanent retirement determination.

2.  The SRP reviewed the records for evidence of inappropriate changes in
diagnosis of the MH condition during processing through the military Disability Evaluation System (DES).  The evidence of the available records showed major depressive disorder (MDD) was the referred diagnosis during processing through the DES.  Although MDD was changed during that process, it was changed to a more severe diagnosis.  Therefore, the applicant did not appear to meet the inclusion criteria in the Terms of Reference of the MH Review Project.

3.  The SRP agreed that the evidence supported the PEB adjudication of unfitting MDD with psychotic features.  The PEB appropriately did not apply the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 at Temporary Disability Retired List (TDRL) entry.  The SRP considered if there was evidence for a VASRD Section 4.130 rating higher than 30 percent at time of placement on the TDRL.  Available treatment records at the time leading up to TDRL entry recorded two psychiatric hospitalizations due to suicidal and paranoid thoughts, no suicide attempts, no documented panic attacks, no history of violence or aggression, and no legal history. 

4.  The SRP noted the applicant achieved stability after hospitalization, but needed continued monitoring and treatment, and had no evidence of impairment in judgment or thinking in the four months prior to TDRL entry.  There was no indication that he behaved impulsively or irrationally.  The SRP considered the record in evidence best supported the 30 percent rating for TDRL entry and there was insufficient reasonable doubt (in accordance with (IAW) VASRD Section 4.3) for recommending a 50 percent TDRL entry rating.  The SRP agreed at the time of permanent retirement that the record adequately demonstrated that the applicant’s condition had worsened since TDRL entry.  He had the diagnosis of 
bipolar disorder I, which was consistent with the clinical documentation.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           The SRP agreed that the evidence supported PEB adjudication of unfitting bipolar disorder I condition at the time of permanent retirement.  

5.  The SRP considered if there was evidence for a rating higher than the 50 percent at TDRL removal.  The TDRL exit examination noted the applicant was unemployed, had not taken medications for months, was not in treatment, had not been hospitalized since prior to TDRL entry, and had no reported visits to the emergency room (ER).  The applicant noted he had a few friends he engaged socially, but had separated from his wife and had moved to another state.  He had completed several courses in college and had three more classes to complete for the degree.  Although the applicant exhibited symptoms of hypomania during the TDRL exit exam, there was insufficient evidence recorded in the examination to indicate that he was unstable and required immediate intervention.  The applicant was not taking medications and denied symptoms.  His mental status examination recorded no evidence of psychosis or suicidal/homicidal ideation.  There was no evidence of impairment in thinking or judgment. 

6.  After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that there was insufficient cause to recommend a disability rating higher than the 50 percent granted.

7.  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)                                  AR20140015297



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