IN THE CASE OF: BOARD DATE: 6 March 2015 DOCKET NUMBER: AR20150002060 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 also states she is mentally ill after 9 years out of the Army and since has been hospitalized twice while on active duty for major depression which was incorrect. She further states none of the medication she is taking is working. 4. 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 applicant’s 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 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. The SRP recommends that the applicant’s prior determination be modified prior to the applicant’s medical retirement. 2. The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the mental health condition during processing through the Disability Evaluation System (DES). The evidence of the available records showed that diagnoses of major depressive disorder (MDD), dysthymia and “anxiety-depression” were rendered during processing through the DES. The SRP determined that a MH diagnosis was not changed to the applicant’s possible disadvantage in the disability evaluation. Therefore, the applicant did not meet the inclusion criteria in the Terms of Reference of the MH Review Project. 3. Application of Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) section 4.129 is considered by the SRP for all cases of service-connected psychiatric conditions resulting in separation, but all members agreed that the “highly stressful event” requisite for VASRD section 4.129 was not satisfied in this case. The SRP considered if there was evidence for a VASRD section 4.130 rating higher than 30 percent at the time of Temporary Disability Retired List (TDRL) entry. The 30 percent rating requires “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).” The next higher 50 percent rating is for “reduced reliability and productivity.” It was noted that there was one reported psychiatric hospitalization within a year of placement on TDRL. 4. The SRP also noted possibly one or two 50 percent threshold symptoms were present and GAF scores reflecting moderate symptoms or impairment. The SRP concluded that the available evidence was most accurately depicted by the 50 percent rating criteria (occupational and social impairment with reduced reliability and productivity). Regarding the permanent rating recommendation, it was noted that the re-evaluation examiner considered the condition to possibly be worse during the prior year. There were no reported psychiatric hospitalizations or emergency room visits, and no further suicidal thoughts. Although disturbance of motivation and mood (a 50 percent threshold symptom) was described by this examiner, the SRP noted no other 50 percent threshold symptoms. 5. The SRP concluded the evidence just elaborated is best described by the “occasional decrease in work efficiency” stipulation of the 30 percent rating. After due deliberation, considering all of the evidence and mindful of VASRD section 4.3 (reasonable doubt), the SRP recommends a TDRL rating of 50 percent and permanent disability rating after removal from TDRL of 30 percent for the MDD condition. 6. 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 the applicant’s record to reflect as follows, effective as of the date prior to the applicant’s medical retirement. UNFITTING CONDITION VASRD CODE TDRL RATING PERM RATING Major Depressive Disorder 9434 50% 30% Bilateral foot pain 5299 5280 20% Bilateral knee pain 5099-5003 20% Back pain 5299-5237 10% Neck pain 5299-5237 10% Asthma 6602 10% 10% COMBINED 60% 70% Note: The original Physical Evaluation Board (PEB) combined the knee, back, neck, and foot pain at 10 percent, coded as 5099-5003, with the final PEB unbundling the four conditions and coding them as identified by the permanent rating. __________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) AR20150002060 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1