IN THE CASE OF:  	  

		BOARD DATE:  25 November 2014	  

		DOCKET NUMBER:  AR20140018417 


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

2.  The SRP considered the appropriateness of changes in the applicant's MH diagnoses during processing through the Disability Evaluation System (DES), physical evaluation board (PEB) fitness determination; and if unfitting, whether the provisions of 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. 

3.  The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the applicant's MH condition.  The applicant was diagnosed with an adjustment disorder by the service and with anxiety disorder not otherwise specified (NOS) by the pre-separation Department of Veterans Affairs (VA) Compensation and Pension (C&P) examiner.  The Diagnostic Variance Memorandum (DVM) provided an MH diagnosis of an adjustment disorder with anxiety and alcohol dependence in partial remission and the medical evaluation board (MEB) forwarded both diagnoses as meeting retention standards.  The PEB adjudicated the MEB-referred MH conditions as not ratable as previously elaborated.  Therefore, the applicant’s case did not appear to meet the inclusion criteria in the Terms of Reference of the MH Review Project. 

4.  The SRP noted that the DVM indicated that, according to the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision (DSM IV-TR) criteria, adjustment disorder was the appropriate MH diagnosis and the VA agreed with this diagnosis for rating in both the proposed rating and in the original VA Rating Decision.  The SRP also considered that the applicant was referred to a Post-Traumatic Stress Disorder (PTSD) treatment program by the Veterans Center within 6 months after separation and was diagnosed by a VA psychologist with PTSD in December 2013, approximately 20 months after separation.  The SRP noted that the PTSD diagnosis was outside the 12-month interval defined by Department of Defense Instruction (DoDI) 6040.44 for special consideration to VA post-separation evidence in its recommendations. 

5.  The SRP, under the Terms of Reference of the MH Review Project, considered the elimination or change in a diagnosis of PTSD applying criteria of the DSM IV-TR: the evidence for the stressor (criterion A), re-experiencing of the event (criterion B), persistent avoidance of stimuli associated with the trauma (criterion C), hyperarousal (criterion D), duration and onset (criterion E), and presence of significant distress or impairment in social, occupational or other important area of functioning (criterion F).  However, there was no MH entry in the service treatment records (STR) or VA file within 12 months of separation documenting an MH opinion in support of a diagnosis of PTSD.  The SRP agreed that DSM IV-TR Criteria A – F for a diagnosis of PTSD were not satisfied by a preponderance of evidence proximate to the date of separation. 

6.  The SRP also deliberated whether the evidence supported that any MH condition, regardless of specific diagnosis, was unfitting for continued military service.  The SRP considered that the psychiatric profile was S1 throughout service time and there was no evidence in the STR documenting adverse performance due to MH issues.  The commander’s performance statement addressed only physical limitations and noted the applicant established effective work relationships and was able to accomplish tasks within his company role, but limitations might impair effective performance in other support positions.  Therefore, regardless of diagnostic considerations, the SRP concluded there was insufficient cause to recommend any MH condition as unfitting at the time of separation. 

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 of the MH condition and no disability ratings was recommended.

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)                                  AR20140018417



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