IN THE CASE OF:	  

		BOARD DATE:	  11 June 2015

		DOCKET NUMBER:  AR20150007336 


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 processing.

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 be no change of the applicant’s disability and retirement determination. 

2.  The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the MH condition during processing through the military Disability Evaluation System (DES) pilot program.  The evidence of the available records recorded the diagnoses of anxiety disorder, major depressive disorder (MDD), and post-traumatic stress disorder (PTSD) rendered during processing. Although the physical evaluation board (PEB) did not adjudicate the MH condition diagnosed at the Department of Veterans Affairs (VA) (PTSD and MDD) the diagnoses were acknowledged and a diagnostic variance was obtained.  Therefore the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project. 

3.  The SRP carefully reviewed the available records and noted the records demonstrated absence of symptoms to support a PTSD or MDD diagnosis.  The May 2009 Post-Deployment Health Assessment (PDHA) screen documented the denial of exposure to dead bodies and witnessing others wounded, and the applicant denied that she ever felt her life was in great danger.  All symptoms related to PTSD and depression were denied.  The September 2009 PDHA screen noted the applicant endorsed “No” responses to blast exposure, issues with family, friends, co-workers since returning from deployment; no nightmares; avoidance behaviors; hypervigilance; feeling numb or detached; easily startled.  She denied that she had experienced any event that was frightening or horrific.  

4.  The SRP noted when the applicant first presented to MH in March 2010 she denied PTSD symptoms endorsed at the Compensation and Pension (C&P) examination (intrusive thoughts, flashbacks, nightmares).  The SRP found insufficient evidence to support the diagnoses of PTSD and MDD at the time of Temporary Disability Retired List (TDRL) placement.  The SRP agreed that PEB
adjudication of unfitting anxiety disorder was supported by the evidence and the provisions of the VA Schedule for Rating Disabilities (VASRD) Section 4.129 were appropriately applied at TDRL placement. 

5.  The SRP considered if there was evidence for VASRD Section 4.130 rating higher than 50 percent at the time of TDRL placement.  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 suicidal ideation; there were no psychiatric hospitalizations, no aggressive behaviors, no visits to the emergency room for MH issues, and
no evidence of impairment in judgment or thinking.  Available treatment records documented good response to medication; however, the evidence was not sufficient to abort many of her symptoms.  The records demonstrated occasional visits to MH with all mental status examinations (MSE) being essentially normal up to the time of her last MH visit in May 2010.  Although profiled, no MH condition was implicated in the commander’s statement.  The SRP concluded there was insufficient reasonable doubt (in accordance with VASRD Section 4.3) for recommending a 70 percent TDRL placement rating. 

6.  The SRP later considered the rating at the time of medical retirement.  The higher rating of 70 percent required “Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood,” and the SRP agreed the evidence of record did not support the 70 percent rating.  The applicant reported minimal improvement in symptoms, although she had not been hospitalized, had no panic attacks, no visits to the emergency room and was attending college, but was not employed.  She worked volunteering at a hospital and animal shelter.  Her MSE was normal with a Global Assessment of Functioning (GAF) of 60.  There was no evidence of impaired judgment or thinking.  The SRP determined that the evidence did not support a rating higher than the 50 percent rating.

7.  After due deliberation in consideration of the preponderance of the evidence, and mindful of VASRD Section 4.3 (reasonable doubt), the SRP concluded that there was insufficient cause to recommend a change in the PEB adjudication for the MH condition at either TDRL placement or removal.

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)                                  AR20150007336



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