BOARD DATE: 20 June 2017 DOCKET NUMBER: AR20170008182 BOARD VOTE: _________ _______ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING _____x___ ____x____ ____x____ DENY APPLICATION 2 Enclosures 1. Board Determination/Recommendation 2. Evidence and Consideration BOARD DATE: 20 June 2017 DOCKET NUMBER: AR20170008182 BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. ______________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. BOARD DATE: 20 June 2017 DOCKET NUMBER: AR20170008182 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 service 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) 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 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 during 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: 1. After a comprehensive review of the applicant's case, the SRP recommended by unanimous vote that there be no change in the applicant's disability and retirement determination. 2. The SRP reviewed the records for evidence of inappropriate changes in diagnoses of the MH conditions during processing through the military Disability Evaluation System (DES). The available records show the diagnoses of recurrent major depressive disorder (MDD) and anxiety disorder (not otherwise were rendered during processing through the DES. The SRP agreed there were no inappropriate changes in diagnoses and determined the MH 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 MH Diagnosis Review Project. 3. The SRP agreed the physical evaluation board adjudication of unfitting anxiety disorder and MDD was supported by the evidence. The SRP found there was insufficient evidence to support that the MDD condition existed prior to service (EPTS); however, since the condition was included in the rating based on service aggravation, the EPTS classification did not adversely affect the rating. The SRP noted there was no specific, highly stressful service-related event to invoke section 4.129 for a mental disorder due to traumatic stress. 4. The SRP noted that regardless of diagnosis, the Department of Veterans Affairs (VA) Schedule for Rating Disabilities (VARSD), section 4.130, rated conditions based on symptoms and, therefore, all symptoms related to MH were considered in the rating scheme. The 50-percent disability level under section 4.130 required evidence of "occupational and social impairment with reduced reliability and productivity due to MH symptoms such as impaired judgment, impaired abstract thinking, impairment in memory, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships." 5. The SRP considered the narrative summary (NARSUM), the commander's statement, and the clinical records in the 6 months before separation. The NARSUM examination 8 months before medical retirement recorded a normal mental status evaluation (MSE) with the exception of depressed mood and anxious, reactive affect. The applicant's judgment was not impaired, but she continued to have difficulties with her mood and sleep. She also reported chronic suicidal ideation, which was present 1 week prior to the NARSUM. The commander stated that 8 months prior to retirement, "She could complete administrative duties, but only for short periods of time and in certain work environments that were not stressful and not around multiple Soldiers." She was unable to complete an 8-hour duty day, unable to perform duties/tasks without errors, and had intermittent periods of being unable to perform occupational tasks. It was also noted that she was unable to establish and or did not maintain effective work relationships with supervisors or co-workers. 6. The service treatment records going forward demonstrated relative stability of symptoms. She had no hospitalizations in the 11 months prior to separation and had a total of three visits to the emergency room (ER) for suicidal ideation without the need for hospitalization. Her last ER presentation occurred 7 months prior to retirement. Treatment records indicated she was stable in the 6 months prior to retirement and, although the applicant expressed suicidal ideation chronically, there were no recorded attempts. 7. The VA Compensation and Pension Examination recorded an essentially normal MSE and noted the applicant was a college student. She had continued her treatment and her condition had remained stable in the 2 years prior to retirement. 8. The SRP agreed the applicant's condition did not justify the higher rating of 70 percent at the time of retirement since her condition was stable, she had not required hospitalizations or visits to the ER in the 6 months prior to separation, and evidence of impairment in judgment or thinking was absent. 9. After due deliberation in consideration of the preponderance of the evidence, the SRP concluded there was no route to a higher rating based on the evidence. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20170008182 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20170008182 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2