IN THE CASE OF:	  

		BOARD DATE:	  22 October 2014

		DOCKET NUMBER:  AR20140016107 


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 of the applicant’s disability and separation 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 the diagnosis of chronic adjustment disorder with anxiety and Post-Traumatic Stress Disorder (PTSD) were rendered during processing through the DES; therefore, an MH diagnosis was changed to the applicant’s possible disadvantage during that process.  Therefore, the applicant case did appear to meet the inclusion criteria in the Terms of Reference of the Mental Health Review Project.

3.  The SRP noted the PTSD diagnosis was listed on the physical examination for the medical evaluation board (MEB) (DD Form 2808) without recorded PTSD symptoms.  The SRP acknowledged the Compensation and Pension (C&P) examiner’s assessment and diagnosis of PTSD; however, there was insufficient clinical evidence to support that the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria were met since there was no clear evidence in the service treatment record to support that the applicant met criterion C or F for a PTSD diagnosis.  The SRP noted the psychiatrist’s initial evaluation of the applicant, two months prior to the psychiatry MEB and the diagnosis of PTSD.  The records recorded no other visits with the psychiatrist; the applicant cancelled the follow-up visit.  The SRP agreed the preponderance of evidence at the time of separation did not support a PTSD diagnosis. 

4.  The SRP noted the applicant denied PTSD-associated symptoms in the Post-Deployment Health Assessment (PDHA) and stated in a sworn statement that he could not physically conduct his duties to the best of his ability because of his knees.  In that statement, he noted he took psychotropic medications for sleep; no MH condition was implicated in his statement.  Although the applicant endorsed more symptoms at the Department of Veterans Affairs (VA) than recorded in the military record, available treatment records were consistent with 

an adjustment disorder.  The applicant’s initial presentation to MH on                   3 December 2009 documented the report of sleep, anger, and depression; all PTSD-associated symptoms were denied.  Three months later, he described PTSD symptoms; however, not sufficient to meet full diagnostic criteria.  The SRP concluded the diagnosis of chronic adjustment disorder with anxiety was the appropriate diagnosis at the time of separation. 

5.  The SRP also considered whether any mental condition, regardless of specific diagnosis, was unfitting for continued military service.  The adjustment disorder was not a physical disability and was not ratable in accordance with Department of Defense Instruction (DoDI) 1332.38.  The SRP agreed that the evidence of the record reflected minimal MH-related symptoms.  The applicant did not seek care prior to the initiation of the MEB and had a total of three visits prior to separation.  Although medications were prescribed, the applicant reported he did not take them daily as prescribed and often did not need the medications.  The commander’s statement did not implicate an MH issue and recommended retaining him.  Although there was an S2 on the profile for anxiety, there was no clear clinical documentation for the profile and no indication that an MH professional requested the profile. 

6.  After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that there was insufficient evidence that any MH condition rose to the level of being unfitting at the time of separation and none were subject to service disability rating.

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 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)                                  AR20140016107



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