IN THE CASE OF:  

		BOARD DATE:  12 May 2015	  

		DOCKET NUMBER:  AR20150005647 


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 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 recommended by unanimous vote that the Covered Individual's (CI’s) prior determination be modified as described in paragraph 6 below, effective as of the date of his prior medical retirement:

2.  The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the applicant's MH condition during processing through the Integrated Disability Evaluation System (IDES).  Diagnoses of post-traumatic stress disorder (PTSD) and depression, not otherwise specified (NOS) (medical evaluation board (MEB)) and PTSD (Department of Veterans Affairs (VA) were rendered during the IDES process.  The SRP agreed that there were no inappropriate changes in diagnosis to the applicant’s possible disadvantage while processing through the IDES.  Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project.

3.  The SRP noted that the physical evaluation board (PEB) assigned a disability rating of 50 percent without application of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 (Mental disorders due to traumatic stress).  The SRP agreed the provision was applicable in this case, and the SRP was therefore obligated to recommend a minimum 50 percent rating for a retroactive 6-month period on the Temporary Disability Retired List (TDRL). The SRP later determined the most appropriate fit with VASRD Section 4.130 criteria at the end of the constructional TDRL interval for its permanent rating recommendation.

4.  The SRP considered if a rating higher than 50 percent was warranted at the time of entry on the constructional TDRL period.  The next higher 70 percent rating required “Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.”  It was noted that neither  the narrative summary (NARSUM) or VA exams reported 70 percent threshold symptoms and the applicant did not require psychiatric emergency care or hospitalization.  Although social isolation and marital stress were reported and the applicant was unable to accomplish requirements of his Military Occupation Specialty (MOS), the commander’s statement noted relatively good social and occupational functioning, albeit in a low stress position.  Therefore, the SRP concluded that the 70 percent criteria were not approached and a rating higher than 50 percent was not supported.

5.  The SRP noted that in regards to a recommendation at the time of removal from the constructional TDRL period, the most proximate source of comprehensive evidence in this case was the VA Compensation and Pension  examination performed a month prior to placement on the constructional TDRL.  There was no relevant VA outpatient or civilian provider evidence providing psychiatric details during the six-month interval.  Therefore, the exam carried the preponderance of probative value in the SRP’s assessment of a fair permanent rating recommendation.  The VA examiner reported a Global Assessment of Functioning (GAF) suggesting moderate symptoms or impairment and described occupational and social functioning with 30 percent rating language (occasional decrease in work efficiency and intermittent ability to perform occupational tasks).  Although occupational details were not in evidence, the later VA exams (over 3 years after retirement) indicated the applicant was employed soon after discharge from the service.  The SRP therefore concluded that a permanent rating after removal from TDRL higher than 50 percent was not justified. 

6.  After due deliberation in consideration of the preponderance of the evidence, the SRP recommended, mindful of VASRD Section 4.3 (reasonable doubt), a TDRL rating of 50 percent and permanent disability rating after removal from TDRL of 50 percent for PTSD with comorbid depression condition.

7.  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 by modifying the Covered Individual’s prior determination, effective as of the date of his prior medical retirement:


UNFITTING CONDITION
VASRD CODE
RATING


TDRL
PERMANENT
PTSD with Comorbid Depression
9411
50%
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)                                  AR20150005647



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