AR20160000808

IN THE CASE OF:

BOARD DATE: 11 February 2016

DOCKET NUMBER: AR20160000808

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 applicants submissions and records for evidence of inappropriate changes in the diagnosis of a 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 11September 2001 and 30April 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 applicants case, the SRP determined that there should not be any change to the applicants disability and separation determination.

2. The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the MH condition during processing through the pilot Disability Evaluation System (DES). The evidence of the available records shows diagnoses of depressive disorder (Department of Veterans Affairs (VA)) and bipolar disorder (Medical Evaluation Board (MEB)) were rendered during processing through the DES. No diagnostic variance was in evidence but there was a reconciliation of apparent inconsistencies that addressed the differing diagnoses. The MEB forwarded the MH diagnosis of bipolar disorder to the Physical Evaluation Board (PEB) for adjudication. The PEB adjudicated the applicant for bipolar disorder, not otherwise specified (NOS) to include depressive disorder (also claimed as Post-Traumatic Stress Disorder (PTSD)) and mood disorder. The SRP determined that the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Diagnosis Review Project.

3. The SRP considered the MH diagnosis and determined that the preponderance of evidence supported a diagnosis of bipolar disorder at Temporary Disability Retired List (TDRL) placement. A memorandum from the psychiatric examiner who completed the narrative summary (NARSUM) examination noted that recent treatment notes focused on marital problems or management of bipolar symptoms, with no recent documentation of PTSD symptoms. Although the applicant had provided information to support traumatic exposures, there was no documentation to support Criteria B of a PTSD diagnosis. Since the applicants final Service adjudication was not effected, the SRPs sole charge in this case was assessing the fairness of the TDRL rating for the unfitting MH condition.

4. The SRP noted that because total psychiatric impairment (regardless of co-existing MH diagnoses) was subsumed under a single rating, the presence of multiple MH diagnoses is irrelevant to rating. The SRP noted that the provisions of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 (mental disorders due to traumatic stress) were appropriately applied by the PEB as directed by DoD policy (placement on TDRL with a minimum rating of 50percent for a period of 6 months before reevaluation and re-adjudication); but the SRP considered if there was evidence for a VASRD Section 4.130 rating higher than 50percent at the time of TDRL placement.

5. The next higher 70percent rating was for Occupational and social impairment, with deficiencies in most areas. At the NARSUM examination, the applicant reported that he was more content, more even keeled and not depressed most of the time. The SRP noted there were no psychiatric hospitalizations in the year leading up to TDRL entry, no emergency department visits for psychiatric reasons, and no 70percent threshold symptoms such as obsessional rituals, illogical speech, neglect of personal hygiene, or active suicidal ideation. The SRP concluded the record in evidence did not support a rating higher than 50percent at the time of TDRL placement.

6. After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that the application of VASRD Section 4.129 with a disability rating of 50 percent and placement on TDRL was appropriate in this case.

7. The available evidence shows the SRPs 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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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

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ABCMR Record of Proceedings (cont) AR20160000808

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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

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