IN THE CASE OF:	  

		BOARD DATE:	  15 October 2014

		DOCKET NUMBER:  AR20140015969 


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).  He states, in effect, that he was separated from the US Army for circumstances leading to his Post-Traumatic Stress Disorder (PTSD).  He was unable to function in his unit due to anger and anxiety issues.  After several “blow-ups” and the lack of concentration to his job, he was medically retired and currently has issues with PTSD.  He is currently under care with the Department of Veterans Affairs (VA) and to his knowledge does not know of any error in the disability board’s decision to retire him.

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 determined by unanimous vote that there should be no change of the applicant’s disability and retirement determination.

2.  The SRP considered the appropriateness of changes in the applicant's MH diagnoses and a disability rating recommendation in accordance with the VA Schedule for Rating Disabilities (VASRD) Section 4.130.  The SRP determined that no mental health diagnoses were changed in the disability evaluation process (DES).  Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project.

3.  The SRP noted that the provisions of VASRD Section 4.129 (mental disorders due to traumatic stress) were applied by the physical evaluation board (PEB) as directed by Department of Defense (DoD) policy (placement on Temporary Disability Retired List (TDRL) with a minimum rating of 50 percent for a period of 6 months before reevaluation and re-adjudication).  In addition, the SRP considered if there was evidence for a VASRD Section 4.130 rating higher than 50 percent at the time of the applicant placement on the TDRL.  The 50 percent rating was characterized by “occupational and social impairment with reduced reliability and productivity,” while the next higher 70 percent rating required “occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.” 

4.  The SRP noted that the narrative summary (NARSUM) examiner’s characterization of the condition prior to entry on TDRL reflected the “deficiencies in most areas” stipulation of the 70 percent rating; however the SRP noted that only one or possibly two 70 percent threshold symptoms were present.  It was considered that other threshold symptoms such as suicidal ideation, obsessional rituals, illogical speech, or neglect of personal appearance or hygiene were not evident, and there was no history of psychiatric hospitalization.   
At the time of the VA exam, 4 months after TDRL entry, there were no 70 percent or even 50 percent threshold symptoms, and full-time college attendance and part-time employment were reflected in a Global Assessment of Functioning (GAF) score indicative of mild symptoms or impairment.  The SRP concluded that the evidence could not be reconciled with the “deficiencies in most areas” stipulation of the 70 percent rating, and therefore a rating higher than 50 percent at the time of TDRL entry was not supported.  

5.  The SRP noted that a review of the permanent rating recommendation indicated that significant symptoms were still evident at the time of removal from TDRL, which reflected in the PTSD checklist and depression inventory scores; and a GAF score connoting moderate symptoms or impairment.  Although 50 percent rating language was used to describe the condition’s impact, the TDRL re-evaluation examiner acknowledged that only one 50 percent threshold symptom was present.  The 30 percent rating required “occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal).” 

6.  The SRP noted that the applicant was still in school and worked part-time, although allowances were sometimes made by professors and a supervisor for his MH condition.  Despite the feeling of emotional detachment, the applicant engaged in significant social contact.  The SRP agreed the evidence was best described by the “occasional decrease in work efficiency” stipulation of the 30 percent rating.

7.  After due deliberation, considering all of the evidence and mindful of VASRD Section 4.3 (reasonable doubt), the SRP concluded that there was insufficient cause to recommend a change in the PEB adjudication for the PTSD condition.

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)                                  AR20140015969



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