IN THE CASE OF:	  

		BOARD DATE:	  25 November 2014

		DOCKET NUMBER:  AR20140018421 


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 Department of Defense (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 DOD 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, 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 retirement determinations. 

2.  The SRP reviewed the records for evidence of inappropriate changes in the diagnosis of the applicant's MH condition during processing through the military Integrated Disability Evaluation System (IDES).  The evidence of the available records shows the diagnoses of Post-Traumatic Stress Disorder (PTSD), major depressive disorder (MDD), and cognitive disorder were rendered during processing through the DES.  The SRP determined that this applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project.

3.  The SRP agreed that PEB adjudication of unfitting PTSD was supported by the evidence.  The applicant fully met the Diagnostic and Statistical Manual for Mental Disorders, 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 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 also considered if there was evidence for a VASRD Section 4.130 rating higher than 50 percent at time of the applicant's placement on the TDRL.  The higher 70 percent rating was for “Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.”  Available treatment records at the time leading up to TDRL placement recorded no history of recurrent suicidal ideation, no psychiatric hospitalization, no visits to the emergency room and no evidence of impairment in judgment or thinking.  The applicant reported good response to treatment, was noted to work full-time at the time of the narrative summary (NARSUM), and had reported she had recently completed an Associates’ degree.  She was in couples’ therapy for marital problems in 2008 and reported, in family therapy in January 2011, that she was cooking meals for her husband every day and enjoying more time at home.  The applicant quit her job in 2011; however, she noted it was not related to her MH condition.  
5.  The SRP considered the record in evidence best supported the 50 percent rating for TDRL placement and there was insufficient reasonable doubt (in accordance with (IAW) VASRD Section 4.3 or Section 4.7) for recommending a 70 percent TDRL placement rating.  The SRP next considered if there was evidence for a VASRD Section 4.130 rating higher than 50 percent at time of permanent retirement. 

6.  The SRP noted that the applicant was unemployed, but pursuing a degree in child care development, continued to have a fair marital relationship, continued with individual and couple’s counseling, and had a supportive family (sister) environment.  The SRP also noted the TDRL removal examiner’s determination that the applicant would be able to function effectively in a low to moderate stress work environment, but that her symptoms impacted her functioning in many social settings.  Available treatment records at the time leading up to TDRL removal recorded no history of recurrent suicidal ideation, no psychiatric hospitalizations, and no visits to the emergency room for mental health issues.  The SRP determined that based on the record in evidence there was insufficient reasonable doubt IAW VASRD Section 4.3 or Section 4.7 for recommending a 70 percent rating and that the record of evidence best supported the 50 percent rating at the time of permanent retirement.

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 applicant’s MH condition at the time of TDRL entry and permanent retirement.

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)                                  AR20140018421



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