IN THE CASE OF:
BOARD DATE: 29 September 2015
DOCKET NUMBER: AR20150014152
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 the applicants prior determination be modified to reflect bipolar disorder.
2. The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the MH condition during processing through the disability evaluation system (DES). Diagnoses of post-traumatic stress disorder (PTSD) and bipolar disorder (by the MEB) were rendered during the DES process. The diagnosis of PTSD was not forwarded by the MEB; however, this was not to the applicants disadvantage because the PTSD symptomatology was subsumed into the bipolar diagnosis and rated in accordance with the unified Department of Veterans Affairs Schedule for Rating Disabilities (VASRD).
3. In accordance with VASRD principles, MH diagnoses are rated together as one condition under the primary diagnosis due to overlapping symptoms and impairments. The SRP agreed there were no inappropriate changes in diagnosis and therefore determined that MH diagnoses were not changed to the applicants possible disadvantage in the disability evaluation. Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Diagnosis Review Project.
4. The SRP considered impairments attributed to the applicants PTSD in its overall VASRD section 4.130 rating recommendation for bipolar disorder. The SRP next considered whether the provisions of VASRD section 4.129 were applicable for the unfitting MH condition. Regardless of final Physical Evaluation Board (PEB) diagnosis, VASRD section 4.129 does not specify a diagnosis of PTSD, rather it states mental disorder due to a highly stressful event, and its application is not restricted to PTSD.
5. The SRP noted while the primary diagnosis was bipolar disorder, the evidence is clear that this condition had its onset after exposure to a series of traumatic events while in a combat zone. The SRP is obligated to recommend a minimum 50 percent for a mental disorder as a result of a highly stressful event for those MH cases in which the condition is secondary to a traumatic event. The SRP members agreed that the VASRD section 4.130 criteria for a Temporary Disability Retired List (TDRL) rating higher than 50 percent at the time of placement on TDRL were not met.
6. After due deliberation and consideration of all of the evidence, and mindful of the VASRD section 4.3, the SRP unanimously recommends a rating of 50 percent for the bipolar condition at TDRL placement. The SRP then considered the rating at TDRL removal. The SRP considered if there was evidence of a VASRD section 4.130 rating higher than 50 percent at time of TDRL removal.
7. The higher 70 percent rating is for Occupational and social impairment, with deficiencies in most areas. The SRP considered the record in evidence and determined that the evidence best supported the 70 percent disability rating. The SRP also noted that because total psychiatric impairment (regardless of co-existing MH diagnoses) is subsumed under a single rating, the presence of multiple MH diagnoses is irrelevant to rating.
8. The available evidence shows the SRP's assessment should be accepted.
BOARD VOTE:
________ ________ ________ GRANT FULL RELIEF
___x____ ___x____ ____x___ 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 partial relief. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by modifying the applicants record to show her prior separation as follows, effective as of the date of her medical separation.
UNFITTING CONDITION
VASRD CODE
TDRL RATINGgG
PERMANENT RATING
Bipolar Disorder
9432
50 percent
70 percent
COMBINED
50 percent
70 percent
2. The Board further determined that the evidence presented was insufficient to warrant a portion of the requested relief. As a result, the Board recommends no change to the applicants unfitting condition diagnosis.
__________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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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
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ABCMR Record of Proceedings (cont) AR20150014152
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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
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