IN THE CASE OF:	  

		BOARD DATE:	  12 May 2015

		DOCKET NUMBER:  AR20150005736 


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 also states that his diagnosis of post-traumatic stress disorder (PTSD) was not properly rated.  He states the Board fail to realize that his PTSD did not come about as a result of injury and should have been rated and treated separately.

4.  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 reviewed the records for evidence of inappropriate changes in diagnosis of the applicant's MH condition during processing through the Disability Evaluation System (DES).  The evidence of the available records showed the diagnoses of mood disorder secondary to traumatic brain injury (TBI), cognitive disorder not otherwise specified (NOS) and depression, atypical psychosis and chronic PTSD were rendered during processing through the DES.  The chronic PTSD diagnosis was not recorded at the time of Temporary Disability Retired List (TDRL) placement; however, was addressed at TDRL exit.  All other conditions were addressed by the PEB at TDRL entry.  Therefore, no MH diagnosis was eliminated or changed during that process.  Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project.

3.  The SRP noted the PEB determined that the condition of depression, atypical psychosis, recorded on the general narrative summary (NARSUM), should not have been adjudicated since it was not included on the psychiatry NARSUM and the cognitive disorder NOS was secondary to the TBI.  The SRP agreed that although the applicant had depressive symptoms the preponderance of evidence at the time of TDRL entry did not support a separate depression diagnosis.  The applicant underwent two mental evaluations, neuropsychological and psychiatric, and major depressive disorder was not diagnosed.

4.  The SRP noted there were no recorded PTSD related symptoms prior to the Department of Veterans Affairs (VA) compensation & pension examination and members acknowledged the applicant reported significantly more and incongruent symptoms than recorded in all other treatment records.  The applicant account of the details of the motor vehicle accident and other trauma exposure were inconsistent with the evidence.

5.  The SRP concluded there was insufficient evidence to support a PTSD diagnosis.  At the time of separation, the VA also noted there was insufficient evidence to support the PTSD diagnosis and therefore, agreed with the diagnosis of mood disorder due to TBI.  The SRP noted the MH condition adjudicated by the Physical Evaluation Board (PEB) was recorded as post-concussions syndrome (PCS) manifested by mood disorder and cognitive disorder NOS.  All Panel members agreed this was an adequate representation of the diagnosed condition of mood disorder secondary to TBI, since PCS (TBI) is manifested clinically by mood and cognitive symptoms.

6.  The SRP concluded based on the evidence at the time of TDRL entry, the diagnosis of mood disorder due to TBI was supported by the evidence.  The SRP next considered the cognitive disorder NOS diagnosis and concluded the condition was an integral component of the TBI condition and therefore, is not compensable.  The SRP next considered if the provisions of Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) section 4.129 were applicable in this case.  The SRP agreed the provisions of VASRD section 4.129 was correctly not applied at TDRL entry since the mood disorder was due to his general medical condition of TBI and not due to an identifiable traumatic stressor. 

7.  The SRP next considered the evidence for a VASRD section 4.130 rating higher than 10 percent at time of placement on the TDRL.  The SRP deliberated the higher rating of 30 percent and agreed the evidence did not support the 30 percent rating at the time of TDRL placement.  The SRP concluded the evidence did not support a rating higher than the 10 percent disability level.  The SRP then considered the rating for TDRL exit.  There was no evidence of emergency room visits, suicidal or homicidal behaviors, or any mood symptoms causing significant impairment to his occupational functioning.  There was no evidence of impairment in thinking.  The applicant mood symptoms secondary to TBI remained stable.  The SRP determined that there was insufficient evidence to support a rating higher than the 10 percent rating.  

8.  After due deliberation in consideration of the preponderance of the evidence and mindful of VASRD section 4.3, the SRP concluded that there was insufficient cause to recommend a change in the PEB adjudication for the MH condition at either TDRL entry or exit. 

9. 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)                                  AR20150005736



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