BOARD DATE: 5 January 2016 DOCKET NUMBER: AR20150018336 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 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 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 DOD 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 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 recommended by unanimous vote that the applicant’s prior determination be modified effective the date of his prior medical separation. 2. The SRP reviewed the records for evidence of inappropriate changes in diagnosis of the mental health condition during processing through the military Disability Evaluation System (DES). The available records show a diagnosis of anxiety disorder was rendered during processing through the DES. The SRP agreed there were no inappropriate changes in diagnoses and therefore, determined the mental health diagnoses were 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 Mental Health Diagnosis Review Project. 3. The SRP agreed that the Physical Evaluation Board (PEB) adjudication of unfitting anxiety disorder was supported by the evidence. The applicant acknowledged a history of anxiety, anger, and mood symptoms that began during adolescence. Mental health treatment records showed at least one visit to Behavioral Health with a recommendation for anger management that predated his first deployment. There was also evidence of a visit to his Primary Care provider that predated his second deployment, resulting in treatment with an anti-anxiety, anti-depressant medication that he continued to take during deployment. The Psychiatry Addendum noted the applicant did not meet criteria A2 for a Diagnostic and Statistical Manual for Mental Disorders diagnosis of post-traumatic stress disorder; the SRP noted he also did not demonstrate evidence of criteria C (detachment, restricted affect, sense of foreshortened future). The SRP noted the PEB assigned a disability rating of 10 percent without application of the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Section 4.129 (mental disorders due to traumatic stress). The SRP noted the provision was not applicable in this case, given the pre-existing nature of his illness. 4. Regarding the rating at the time of placement on the Temporary Disability Retired List (TDRL), the SRP considered if there was evidence to support a rating higher than the 10 percent assigned by the PEB. The VASRD Section 4.130 criteria for the 10 percent rating specified “occupational and social impairment due to mild or transient symptoms which decrease work efficiency only during periods of significant stress, or; symptoms controlled by continuous medication.” The next higher 30 percent rating was for “occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks.” While the Psychiatry Addendum examiner scored the Global Assessment of Functioning as 75, he characterized the anxiety disorder as moderate to severe and noted there were four 30 percent threshold symptoms (depressed mood, insomnia, panic attacks, and anxiety). The SRP agreed that the Addendum’s assessment of mild social and industrial impairment and symptoms present since adolescence but significantly worsened due to the Soldier’s military service were not consistent with a 10 percent rating. The SRP concluded that the applicant met the criteria for a 30 percent disability rating. 5. Regarding the permanent rating recommendation, the SRP considered if a rating higher than the PEB’s 10 percent was warranted. The applicant reported continued symptoms of irritability, sleep disruption, unremitting rage, quick and uncontrolled mood swings, and blunted affect but had not received any further mental health treatment since he left the Army. The SRP noted the medication caused side effects that the applicant could not tolerate. He was working up to 15 hours per day in a fee for service position and felt he could not take time off for mental health appointments. The SRP concluded that the “occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks” stipulation of the 30 percent rating was met. The SRP concluded the applicant met the criteria for a 30 percent disability rating at TDRL removal. 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 prior determination as indicated below: UNFITTING CONDITION VASRD CODE TDRL RATING PERMANENT RATING Anxiety Disorder 9413 30% 30% COMBINED 30% 30% 11/17/2015 COMBINED 30% 30% _________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) AR20150018336 4 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1