IN THE CASE OF: BOARD DATE: 4 December 2013 DOCKET NUMBER: AR20130019770 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 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 mental health diagnosis was changed during that process. 3. The applicant submitted an application through the 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 applicant’s submissions and records for evidence of inappropriate changes in the diagnosis of a mental health condition during processing through the military disability system. 2. The Department of Defense memorandum, dated 27 February 2013, directed the Service Secretaries to conduct a review of mental health diagnoses for service members completing a disability evaluation process between 11 September 2001 and 30 April 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 applicant’s case, the SRP determined by unanimous vote that the applicant’s prior permanent retirement be modified to reflect that the applicant was placed on the Temporary Disability Retired List (TDRL) at 90 percent (50 percent mental health rating in accordance with Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) 4.129 for a period of 6 months) and then a change in diagnosis to Post-Traumatic Stress Disorder (PTSD) at 70 percent, with a permanent combined 90 percent disability retirement. 2. The SRP first considered whether the applicant’s diagnosis had been changed to the applicant’s disadvantage through the course of his processing through the Disability Evaluation System. It determined that no such change in diagnosis took place. Therefore, the applicant did not appear to meet the inclusion criteria in the Terms of Reference of the Mental Health Diagnosis Review Project. 3. Additionally, the SRP considered the possible contribution of the effects of traumatic brain injury (TBI) to the clinical picture. In reviewing the entirety of the record, an independent psychiatrist concurred with the formulation stated in the VA Compensation and Pension exam of May 2010 that a large portion of the applicant’s behavioral symptoms as well as other symptoms such as headache and tinnitus could be a result of TBI. 4. The SRP unanimously agreed that sufficient evidence supports that a highly stressful event severe enough to bring about the applicant’s release from active military service did occur and that the application of VASRD 4.129 is appropriate in this case. 5. The SRP unanimously agreed that equity favors giving this applicant the benefit of section VASRD 4.129 for re-rating following a constructive TDRL period (in addition to the PEB's 50 percent rating level application at his prior retirement date). 6. The SRP agreed that the record did not support a mental health rating higher than 50 percent at the time of the PEB or for entry into a TDRL period. However, the applicant had as an additional complication to this case the overlap between mental health symptoms and symptoms of TBI. 7. The SRP unanimously concluded that, based on the available data, a permanent disability diagnosis of PTSD with a rating of 70 percent at the end of the 6-month constructive period of TDRL, had it occurred, most closely fit the available data. Given the total disability picture, and TDRL and permanent disability rating schema, there was no benefit to re-evaluating any separate component of TBI at the time of permanent separation. 8. The available evidence shows the SRP’s assessment should be accepted. BOARD VOTE: ___X____ ___X____ ___X____ GRANT FULL RELIEF ________ ________ ________ 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 relief. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by modifying his prior determination to reflect that the applicant was placed on the TDRL at 90 percent (50 percent mental health rating in accordance with VASRD 4.129 for a period of 6 months) and then a change in diagnosis to PTSD at 70 percent, with a permanent combined 90 percent disability retirement. _______ _ 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 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20130019770 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1