AR20160002359

IN THE CASE OF:

BOARD DATE: 3 March 2016

DOCKET NUMBER: AR20160002359

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) Mental Health 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 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 applicants case, the SRP recommended by unanimous vote that the applicants prior determination be modified effective as the date of his prior medical separation.

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 shows the diagnoses of anxiety disorder and post-traumatic stress disorder (PTSD), listed as major depressive disorder (MDD) by the (Medical Evaluation Board (MEB)) was rendered during processing through the DES. The SRP agreed this applicant did not meet the inclusion criteria in the Terms of Reference of the MH Diagnosis Review Project.

3. The SRP noted that total psychiatric impairment (regardless of co-existing MH diagnoses) was subsumed under a single rating, the presence of multiple MH diagnoses was irrelevant to rating. At the time of placement on the temporary Disability Retired List (TDRL), the Physical Evaluation Board (PEB) assigned a 50percent rating for Occupational and social impairment, with reduced reliability and productivity. The SRP considered if there was evidence for a Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.130 rating higher than 50percent at the time of TDRL placement. The next higher rating of 70percent required occupational and social impairment, with deficiencies in most areas. The commander noted she demonstrated difficulty in adapting to stressful circumstances, an inability to establish and maintain effective relationships, near- continuous panic or depression affecting the ability to function independently, appropriately and effectively, and morbid ruminations. Due to the presence of several 70percent threshold symptoms, the SRP agreed that the applicant met criteria for the 70percent rating.

4. The SRP agreed at the time of permanent retirement that the record adequately demonstrated that the applicant did meet diagnostic criteria for anxiety disorder associated with MDD and non-combat related PTSD. Primary stressors appeared to be medical and familial. There was no evidence that PTSD signs and symptoms emanated from a combat stressor. The PEB executed a VASRD code change from 9413-9411 (anxiety disorder and PTSD listed as MDD and anxiety disorder) to 9413 (anxiety disorder associated with MDD and non-combat PTSD). Feelings of depression seemed to be dominant.

5. The SRP considered if there was evidence for a VASRD Section 4.130 rating higher than 50percent at the time of TDRL removal. Although the TDRL re-evaluation examiner stated that findings showed no measurable change in psychosocial function since her last rating exam, she was happily married, pregnant, and looking forward to the company of her in-laws. She enjoyed many activities and was physically active. Her Mental Status Exam (MSE) recorded no impairment in judgment, noted no evidence of psychosis, and no issues in orientation or hygiene. The symptoms had stabilized with no hospitalizations and no recorded visits to the emergency room for MH issues. There was no evidence of 70percent threshold symptoms. The record in evidence best supported the 50percent criteria at TDRL removal.

6. After due deliberation in consideration of the preponderance of the evidence, the SRP concluded that there was insufficient cause to recommend a change in the PEB adjudication of the applicants MH condition at the time of permanent retirement.

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 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 applicants prior determination as indicated below:

UNFITTING CONDITION
VASRD CODE
TDRL RATING
PERMANENT RATING
Anxiety Disorder
9413
70%
50%

COMBINED
70%
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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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

RECORD OF PROCEEDINGS

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ABCMR Record of Proceedings (cont) AR20160002359

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ARMY BOARD FOR CORRECTION OF MILITARY RECORDS

RECORD OF PROCEEDINGS

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