IN THE CASE OF:
BOARD DATE: 15 October 2014
DOCKET NUMBER: AR20140015782
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 applicants 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 applicants case, the SRP determined by unanimous vote that there should be no change of the applicants disability and retirement determination.
2. The SRP reviewed the records for evidence of inappropriate changes in the diagnosis of the MH condition during processing through the Disability Evaluation System (DES). The evidence of the available records showed diagnoses of Post-Traumatic Stress Disorder (PTSD) and panic disorder with agoraphobia, rendered during processing through the DES. The SRP determined that no MH diagnoses were changed to the applicants possible disadvantage in the disability evaluation. 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 physical evaluation board (PEB)
adjudication of unfitting PTSD and panic disorder. The applicant appeared to have met the Diagnostic and Statistical Manual for Mental Disorder, Fourth Edition, Text Revision (DSM-IV TR) diagnostic criteria for PTSD; therefore, the diagnosis of PTSD was the appropriate diagnosis and application of the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 was correct (Mental disorders due to traumatic stress) for application at Temporary Disability Retired List (TDRL) entry.
4. The SRP considered if there was evidence for a VASRD Section 4.130 rating higher than 50 percent at the time of placement on the TDRL. The higher rating of 70 percent required demonstration of impairment in most areas, which was not supported by the record; she had not been hospitalized, there were no recorded suicidal ideations, and although the narrative summary (NARSUM) examiner stated her panic disorder was severe there were no recorded visits to the emergency room, no legal issues, and no evidence of impairment in thinking or judgment.
5. The SRP considered the record in evidence did not support a rating higher than 50 percent rating for TDRL entry and there was insufficient reasonable doubt (in accordance with (IAW) VASRD Section 4.3) for recommending a 70 percent TDRL entry rating. The SRP agreed at the time of permanent retirement that the record adequately demonstrated that although the applicants symptoms had not significantly improved since initiation of TDRL they appeared to have stabilized in the 24 months prior to permanent retirement. The applicant was hospitalized twice in 2011. The hospital record in 2011 noted the applicant reported prior hospitalizations that were not recorded at the time of the NARSUM or the VA Compensation and Pension (C&P) examination in February 2009. The C&P examiner in 2011 indicated the applicant had delusions or hallucinations; however, he provided no descriptions of psychotic symptoms, and psychosis was not noted in her hospital records in 2011.
6. The SRP noted that there was no evidence in the record of a primary psychotic disorder. (The hospital discharge summary stated history of psychosis not otherwise specified (NOS), in her June 2011 discharge). There was no evidence of any hospitalizations in the 24 months prior to permanent retirement and no recorded visits to the emergency room for panic attacks or suicidal ideations. Her symptoms reflected the criteria for the 50 percent disability rating. The 2-year remote-from-separation VA C&P evaluation was adjudged post-separation worsening and not indicative of the applicants condition at the time of exit from TDRL.
7. 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 adjudication for the applicants MH conditions at TDRL entry or permanent retirement.
8. 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
RECORD OF PROCEEDINGS
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ABCMR Record of Proceedings (cont) AR20140015782
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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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