BOARD DATE: 3 December 2014
DOCKET NUMBER: AR20140018936
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 an 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 to the applicant's disability and retirement determination.
2. The SRP considered the appropriateness of changes in the MH diagnoses; 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. The VA compensation & pension (C&P) MH examiner diagnosed generalized anxiety disorder (GAD) and a second C&P examiner diagnosed opioid dependence and anxiety disorder. The psychiatric narrative summary (NARSUM) examiner listed an MH diagnosis of GAD and the Medical Evaluation Board (MEB) forwarded and the PEB adjudicated GAD. Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project.
3. The SRP noted that post-separation treatment notes by private providers referenced a diagnosis of Post-Traumatic Stress Disorder (PTSD) immediately following separation from the military. The applicant was not involved in combat and there was no highly stressful event meeting PTSD diagnostic criterion A noted in any records in evidence. There is no MH entry in the service treatment record or VA file documenting a psychiatric opinion in support of a diagnosis of PTSD. Based upon the evidence in record the SRP agreed that a diagnosis of PTSD were not satisfied.
4. The SRP noted that both the service and VA rendered the same MH diagnosis of GAD and agreed that there was not a preponderance of evidence to support an SRP recommendation for changing the MH diagnosis as adjudicated by the Service.
5. The SRP noted that at the pre-separation C&P examination for substance abuse the applicant was diagnosed with opioid dependence, not noted by the MEB examiners, MEB, or PEB. However, at the time of the C&P the applicant was in the process of being treated for opioid dependence and weaned off his narcotic pain medications for his non-MH condition as medically appropriate. Whether a diagnosis of active opioid dependence was warranted at the psychiatric NARSUM is not clear from the evidence in record, but the SRP agreed it is a moot issue because in accordance with DoDI 1332.38, Enclosure 5, uncomplicated substance abuse is not a physical disability and is not ratable.
6. The SRP noted that regardless of diagnostic considerations, the MH condition was determined to be not unfitting by the PEB. The SRP considered that the evidence in record supports that the applicant was able to successfully discharge the duties of his rank and MOS. The SRP considered the fact that over the course of all those assessments the applicant was being treated for MH symptoms and concluded that this strongly supports that the MH condition was not unfitting. There was no indication from the record that the MH condition significantly interfered with satisfactory duty performance. 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 fitness determination for the MH condition and, therefore, no disability ratings can be recommended.
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 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) AR20140018936
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