IN THE CASE OF:	  

		BOARD DATE:	  6 March 2015

		DOCKET NUMBER:  AR20150001798 


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).

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 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 recommend by  unanimous vote a 50 percent disability rating at Temporary Disability Retired List (TDRL) entry and that there be no change in the physical evaluation board (PEB) adjudication of the permanent retirement determination. 

2.  The SRP reviewed the records for evidence of inappropriate changes in
diagnosis of the applicant's MH condition during processing through the military Disability Evaluation System (DES).  The evidence of the available records showed anxiety disorder, not otherwise specified (NOS) was the only diagnosis rendered during processing through the DES.  The SRP concluded no MH diagnosis was changed during that process.  Therefore, the applicant did not appear to meet the inclusion criteria in the Terms of Reference of the MH Review Project.

3.  The SRP agreed that the evidence supported the PEB adjudication of unfitting anxiety disorder NOS.  The PEB appropriately did not apply the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 at TDRL entry. 

4.  The SRP considered if there was evidence for a VASRD Section 4.130 rating higher than 30 percent at time of placement on the TDRL.  The available treatment records at the time leading up to TDRL entry recorded two psychiatric hospitalizations, the first due to anxiety symptoms and the second due to 
self-reported suicidal attempt by overdose.  The applicant had not achieved stability after hospitalizations and demonstrated impulsive behaviors and impaired judgment.  The narrative summary (NARSUM), approximately 8 weeks prior to TDRL entry, recorded a Global Assessment of Functioning (GAF) of 60 (moderate).  He was hospitalized involuntarily less than a month later and had a GAF of 25-30.  

5.  The SRP also considered if the record in evidence supported a rating higher than 30 percent.  The SRP deliberated on the 50 percent and 70 percent criteria, and concluded the applicant’s condition at the time of TDRL entry was best reflected in the description of the 50 percent criteria. The SRP recommended a disability rating of 50 percent at TDRL entry rating.

6.  The SRP agreed at the time of permanent retirement that the record adequately demonstrated that the applicant’s condition had changed since TDRL entry.  He had the diagnosis of bipolar disorder, which was consistent with the clinical documentation.  The SRP also agreed that the evidence supported PEB adjudication of unfitting bipolar disorder condition at the time of permanent retirement. 

7.  The SRP considered if there was evidence for a rating higher than the 50 percent at TDRL removal.  The TDRL removal examination made no comment in regard to employment status; however, the initial TDRL examination, 2 weeks prior to the removal examination recorded the applicant had worked part-time.  He was maintained on one single medication with good effect, had not been hospitalized in the 2 years prior to TDRL removal and
had no reported visits to the emergency room.  The applicant was in a stable three and a half year relationship.  His mental status examination (MSE) during the TDRL removal examination was unremarkable and he showed
no signs of mania or hypomania, suicidal or homicidal thoughts or psychosis. There was no evidence of impairment in thinking or judgment.

8.  After due deliberation in consideration of the preponderance of the evidence,
the SRP concluded that there was insufficient cause to recommend a disability rating higher than the 50 percent granted.

9.  The available evidence shows the SRP’s assessment should be accepted. 

BOARD VOTE:

___x____  ___x____  ___x____  GRANT FULL RELIEF 

________  ________  ________  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

________  ________  ________  DENY APPLICATION









BOARD DETERMINATION/RECOMMENDATION:

The Board determined that the evidence presented was sufficient to warrant a recommendation for relief.  As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected to reflect a 50 percent disability rating at TDRL entry without change to the PEB adjudication of the permanent retirement determination.


UNFITTING CONDITION
VASRD CODE
TDRL
RATING
PERMANENT
RATING
Anxiety Disorder NOS
9413
30/50%
---
Bipolar Disorder with Episodes of Panic Attacks
9432
----
50%

COMBINED
50%
50%



      __________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)                                  AR20150001798



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