RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXX	CASE:  PD-2014-01793
BRANCH OF SERVICE:  Army	BOARD DATE:  20150127
SEPARATION DATE:  20030618

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4 (M1 Armor Crewmember) medically separated for bipolar II disorder.  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty.  He was issued a permanent S3 profile and referred for a Medical Evaluation Board (MEB).  The behavioral health condition, characterized as “biopolar (sic) II disorder, most recent episode hypomanic,” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other conditions were submitted by the MEB.  The Informal PEB adjudicated bipolar disorder, as unfitting, rated 10% with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.

CI CONTENTION:  The CI elaborated no specific contention in his application.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military/Naval Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation. 

RATING COMPARISON:

Service  IPEB – Dated 20020415	VA – 6 years post-separation	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bipolar II Disorder	9432	10%	No VA Entry	
Other x 0 (Not In Scope)	Other x 2	
Combined:  10%	Combined:  10%	
Derived from VA Rating Decision (VARD) dated 20080724 (most proximate to date of separation [DOS]).
*There is no C&P exam for behavioral health; however, there are C&P exams for Joints and Feet, dated 20080630.

ANALYSIS SUMMARY:

Bipolar II Disorder.  According to the MEB narrative summary (NARSUM) the CI sought care in March 2002 for depressive symptoms in the context of occupational and marital problems and was subsequently diagnosed with bipolar II disorder in April 2002.  Symptoms included irritability, anxiety, mood swings and pressured speech.  He was treated as an outpatient with medication requiring dose adjustments.  By mid-October 2002 his symptoms stabilized with no evidence of recurrent symptoms.  At the time of the MEB NARSUM on 10 March 2003, he remained on medication without evidence of recurrent symptoms.  At the time of MEB NARSUM examination, the CI reported feeling wired but the remainder of the examination was normal.  The CI was well groomed and appropriately dressed in uniform, cooperative and interactive with the examiner.  His speech was normal, with normal rate, rhythm, tone and volume.  Thought processes were normal (linear, logical, goal directed) and without evidence of suicidal or homicidal thoughts, delusions, hallucinations, or paranoia.  There was no evidence of ongoing manic behavior.  Cognitive functioning was considered intact.  The examiner assessed the civilian social and industrial impairment as mild and assigned a Global Assessment of Functioning of 65, denoting some mild symptoms or some difficulty in occupational functioning but generally functioning pretty well.  There are no VA examinations close to the time of separation.  The CI first filed a claim with the VA for disability compensation in 2008 but not for his mental health condition.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the bipolar II disorder 10% (9432-bipolar disorder), mild.  There is no service-connected VA rating for a mental health condition within 5 years of separation.  The evidence of the MEB NARSUM indicated that symptoms were controlled with medication and that social and occupational functioning was mildly impaired.  The Board did not find sufficient evidence to support the next higher rating (30%).  The condition did not require any emergency room visits or hospitalizations and at the time of the MEB NARSUM examination there were no symptoms present that would imply a level of impairment at the 30% level (such as depressed mood, anxiety, suspiciousness, panic attacks, memory loss, or sleep impairment.  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 bipolar II disorder condition.

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  In the matter of the bipolar II disorder condition and IAW VASRD §4.130, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.

RECOMMENDATION:  The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140425, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

			XXXXXXXXXXXXXXX
				President
DoD Physical Disability Board of Review

SAMR-RB									

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXX, AR20150009532 (PD201401793)

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a,   I accept the Board’s recommendation and hereby deny the individual’s application.  This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

 BY ORDER OF THE SECRETARY OF THE ARMY:

Encl		     XXXXXXXXXXXXXXX
			     Deputy Assistant Secretary of the Army
			          (Review Boards)
						         
CF: 
(  ) DoD PDBR
(  ) DVA