BOARD DATE: 5 May 2016
DOCKET NUMBER: AR20160006667
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 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 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 determined by unanimous vote that there should be no change of the applicants disability and permanent retirement determination.
2. The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the MH condition during processing through the military Integrated Disability Evaluation System (IDES). The evidence of the available records show the diagnoses of post-traumatic stress disorder (PTSD), bipolar disorder in partial remission, panic disorder without agoraphobia, in partial remission, alcohol dependence in early remission, and Cluster B personality disorder with borderline features were rendered during processing through the IDES. A request for a diagnostic variance was made and the examiner agreed only with the diagnosis of PTSD, and also included alcohol dependence and personality disorder diagnoses. The SRP agreed there were no inappropriate changes in diagnoses 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.
3. The SRP agreed that physical evaluation board (PEB) adjudication of unfitting PTSD was well supported by the evidence. The applicant fully met
Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Edition, (DSM-IV TR), diagnostic criteria for PTSD, therefore, the diagnosis of PTSD was the appropriate diagnosis; however, there was insufficient evidence to support both panic disorder diagnosis and bipolar disorder. Regardless of diagnosis, the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.130 rated conditions based on symptoms, and therefore, all symptoms related to MH were considered in the rating scheme. The SRP also agreed that the application of the provisions of VASRD Section 4.129 was correct (Mental disorders due to traumatic stress) for application at Temporary Disability Retired List (TDRL) placement.
4. The SRP next considered if there was evidence for a VASRD Section 4.130 rating higher than 70percent at the time of placement. The higher rating of 100percent required evidence of total occupational and social impairment due to such symptoms as gross impairment in thought processes or communication, persistent delusions or hallucinations, grossly inappropriate behaviors, persistent danger, intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene), disorientation; not supported by the evidence. The SRP was unable to find any evidence supporting a rating higher than 70percent at TDRL placement.
5. The SRP next reviewed the evidence for rating at TDRL removal. The SRP noted the sole source available was the 2013 VA Compensation and Pension (C&P) examination and clinical notes. The C&P examination documented two inpatient hospitalizations in 2012 reported by the applicant; however, clinical note in January 2013 noted last hospitalization occurred in 2009. The applicant was not working; however, was taking online classes for an Associates degree in sociology. She was living with her third husband and their seven children. She had continued to participate in treatment and remained on medications. She reported good relationships with husband, mother and her father, and she described herself as a phone junky and a Facebook person. The C&P examiner continued the diagnosis of PTSD and noted the applicant had disturbance in motivation and mood, difficulty in establishing and maintaining effective work and social relationship. This opinion reflected the 50 percent level of disability. The evidence demonstrated that the applicants symptoms had stabilized sufficient enough for TDRL removal. She was not hospitalized, or treated in the emergency room for psychological issues in the 6 months prior to TDRL removal. She was a student and provided care to seven children, and maintained relationships via social media. The SRP considered the record in evidence did not support a rating higher than 50percent at the time of permanent medical retirement for the MH conditions.
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 for the applicants MH conditions at medical retirement.
7. The available evidence shows the SRPs assessment should be accepted.
________ ________ ________ GRANT FULL RELIEF
________ ________ ________ GRANT PARTIAL RELIEF
________ ________ ________ GRANT FORMAL HEARING
___X_____ __X______ ___X_ DENY APPLICATION
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.
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
ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS
ABCMR Record of Proceedings (cont) AR20160006667
ARMY BOARD FOR CORRECTION OF MILITARY RECORDS
RECORD OF PROCEEDINGS