RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2014-02161 COUNSEL: NONE HEARING DESIRED: NO APPLICANT REQUESTS THAT: She receives a mental health diagnosis review. APPLICANT CONTENDS THAT: The applicant did not present any contentions. The applicant’s complete submission, with attachments, is at Exhibit A. STATEMENT OF FACTS: The applicant developed mental health symptoms diagnosed as depression in 2007. During the applicant’s initial Behavioral Outreach Program intake exam, she reported that she had a history of being seen for depression. 22 October 2009, the applicant was seen by a Medical Evaluation Board (MEB) and her case was referred to an Informal Physical Evaluation Board (IPEB) with a diagnosis of recurrent giant cell tumor of right distal radius. The applicant was seen a second time by an MEB on 25 August 2010 and her case was referred to an Informal Physical Evaluation Board (IPEB) with a diagnosis of recurrent giant cell tumor of right distal radius and dysthymic disorder with anxiety disorder. On 6 October 2010, the IPEB evaluated the applicant’s case, found her unfit because of physical disability, and recommended temporary retirement with compensable percentage for physical disability of 100 percent in accordance with (IAW) the Department of Defense and Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) guidelines. On 26 January 2011, the applicant was released from active duty with an honorable characterization of service and a narrative reason for separation of “Disability, Temporary.” She was credited with 6 years, 7 months and 12 days of active duty service. On 27 January 2011 the applicant was placed on the Temporary Disability Retired List (TDRL) with a combined compensable physical disability rating of 100 percent. On 26 June 2012, the IPEB reevaluated the applicant’s case and found that her medical condition had improved since being placed on the TDRL and appeared to have stabilized. They found her unfit for duty and recommended permanent retirement with a disability rating of 60 percent IAW VASRD guidelines. Special Order No. ACD-02993 reflects that on 8 August 2012, the applicant was removed from the TDRL and retired in the grade of staff sergeant with a compensable percentage of 60 percent for physical disability. The remaining relevant facts pertaining to this application are contained in the memorandum prepared by the Air Force office of primary responsibility (OPR), which is attached at Exhibit C. AIR FORCE EVALUATION: The Physical Disability Board of Review (PDBR) Special Review Panel (SRP) recommends that there be no change of the applicant’s disability and retirement determination. The SRP states they reviewed the records for evidence of inappropriate changes in diagnosis of the mental health condition during processing through the military Integrated Disability Evaluation System (DES). The evidence of the available records recorded no inappropriate changes in diagnoses to the applicant’s possible disadvantaged during the DES process. This applicant therefore did not meet the inclusion criteria in the Terms of Reference of the Mental Health Review Project. At the VA Compensation and Pension (C&P) evaluation performed on 16 March 2011, approximately 2 months after being placed on the TDRL, the applicant indicated the mental health issues dating back to 2005, after the death of her father. She continued with weekly therapy but was not taking psychotropic medications. The applicant reported a good response to talk therapy. Her sleep problem comes and goes and has not affected her duty performance. She continues to have anxiety symptoms but anxiety attacks are now uncommon. The applicant noted she is planning to marry in a few months; she has two children and reported psychosocial functioning is fine. The mental status evaluation (MSE) was completely normal. The examiner noted she does not meet diagnostic criteria for PTSD or major depression disorder (MDD) and diagnosed dysthymic disorder and anxiety disorder, NOS with a GAF of 62 (moderate); however, noted at the present time the symptoms are in the mild range. The SRP agreed that PEB adjudication of unfitting dysthymic disorder with anxiety disorder, NOS was supported by the evidence and application of the provisions of VASRD §4.129 were appropriately not applied at TDRL entry. The SRP considered if there was evidence for a §4.130 rating higher than 30 percent at time of placement on the TDRL. The 50 percent rating requires occupational and social impairment with reduced reliability and productivity which was not supported by the evidence. Available treatment records at the time leading up to TDRL entry recorded no history of recurrent suicidal ideation, no psychiatric hospitalization, no visits to the emergency room, and no evidence of impairment in judgment or thinking. The applicant reported good response to treatment and her GAF scores consistently recorded mild symptoms. The panel acknowledged the findings at the VA C&P examination; however, considered the examination to be inconsistent with the applicant’s report of functional status and with the preponderance of evidence. There was no indication from the record that the mental health condition was ever profiled and no mental health condition was implicated in the commander’s statement. At the VA C&P examination, the applicant noted she was no longer on psychotropic medications, was engaged to marry and noted no impairment in performance of duty. The SRP considered the record in evidence best supported the 30 percent rating for TDRL entry and there was insufficient reasonable doubt (IAW VASRD §4.3) for recommending a 50 percent TDRL entry rating. The panel then considered the rating for TDRL exit. It noted that the applicant diagnosis was changed by the PEB and rated at 10 percent. The PEB referenced a recent psychiatric evaluation that diagnosed major depression; however, that evaluation was not among the available treatment record in evidence. Information excerpted from that evaluation and recorded in the PEB adjudication noted the following. The applicant excelled academically in the absence of psychotropic medication use, in the setting of an accelerated academic program where she was a full-time student. She had remarried and reported good marital relationship. Additionally, there was no evidence of emergency room visits, no psychiatric hospitalizations, no legal issues and no evidence of social impairment. The panel considered the descriptions of both the 30 percent “occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal) and 10 percent ratings “occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication.” The panel determined that the performance evidenced was best described by the 10 percent rating. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the mental health condition at either TDRL entry or exit. A complete copy of the PDBR/SRP evaluation is at Exhibit C. APPLICANT'S REVIEW OF AIR FORCE EVALUATION: A copy of the Air Force evaluation was forwarded to the applicant on 10 November 2014 and 30 March 2015 for review and comment within 30 days (Exhibit D). As of this date, no response has been received by this office. THE BOARD CONCLUDES THAT: 1. The applicant has exhausted all remedies provided by existing law or regulations. 2. The application was not timely filed; however, it is in the interest of justice to excuse the failure to timely file. 3. Insufficient relevant evidence has been presented to demonstrate the existence of an error or injustice. We took notice of the applicant’s complete submission in judging the merits of the case; however, we agree with the opinion and recommendation of the Physical Disability Board of Review, Special Review Panel, and adopt its rationale as the basis for our conclusion that the applicant has not been the victim of an error of injustice. Therefore, in the absence of evidence to the contrary, we find no basis to recommend granting the requested relief. THE BOARD DETERMINES THAT: The applicant be notified the evidence presented did not demonstrate the existence of material error or injustice; the application was denied without a personal appearance; and the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application. The following members of the Board considered this application in Executive Session on 30 June 2015 under the provisions of AFI 36-2603: The following documentary evidence was considered: Exhibit A. DD Form 149, dated 12 April 2013, w/atchs. Exhibit B. Applicant’s Available Master Personnel Records. Exhibit B. Letter, PDBR/SRP, dated 27 May 2014. Exhibit C. Letter, SAF/MRBR, dated 10 November 2014 and 30 March 2015.