RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-02915
BRANCH OF SERVICE:  cOAST gUARD 	SEPARATION DATE:  20091029

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Seaman, medically separated for major depressive disorder; with a disability rating of 0%.  

CI CONTENTION:  The CI has asked for consideration of all conditions.  The applicant’s complete submission is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (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 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 Veterans Affairs Schedule for Rating Disabilities (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 PEB - 20091029	VARD – N/A (NO CLAIM)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Major Depressive Disorder, Recurrent…	9434	0%	No VA Placement	
Pregnancy	Not Unfitting	No VA Placement	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  N/A (NO CLAIM)	

ANALYSIS SUMMARY:  

Major Depressive Disorder, Recurrent.  The narrative summary (NARSUM) noted that the CI’s history of emotional struggles began in early childhood.  The record noted that the CI was sent from her unit for evaluation of mood swings soon after her arrival there.  The psychiatric evaluation dated 1 February 2008 assessed the diagnosis of MDD, recurrent, currently in full remission.  Her Global Assessment of Functioning (GAF) score was 85 (indicative of absent or minimal symptoms).  The psychiatrist noted that given the CI had a history of episodic depressive symptoms, she needed to continue follow up with a local mental healthcare professional for continued monitoring and evaluation.  Treatment record demonstrated she was prescribed an antidepressant medication in June 2008 for the diagnosis of depressive disorder NOS.  Treatment entry 15 July 2008 noted that her condition was stable and that she had “appeared to have worked through” most of her depressive symptoms. At the NARSUM dated 2 September 2008, approximately a year before separation, the examiner noted that the CI had formally requested, via memo sent through chain of command, to be released from service due to life stressors.  She was pregnant with a due date of March 2009.  She had also stopped her antidepressant medication due to the pregnancy.  The examiner referenced an August 2008 clinic exam that noted a normal mental status exam (MSE) though her affect was flat.  An MSE was not conducted at the NARSUM (the CI was likely not present).  The diagnosis of depression, recurrent was recorded, and the physician noted that her condition could be characterized as long standing with waxing and waning course since childhood to the present.  It was noted that she received limited benefit from treatment; however, opined that she was not “disabled” in any way, “though it would be in her best interest to continue, as a civilian into the foreseeable future, in treatment for on-going depressive symptoms.”  It was also noted that she was adequately performing “deck force” duties at her station but was now performing only day work while awaiting disposition.  On 6 June 2009, consultation was requested after the CI had stated to her assigned counsel that she “is now fit for full duty/eligible for worldwide deployment with a desire to remain on active duty.”  On 16 June 2009, a fitness for duty evaluation was conducted.  At the evaluation, the CI reported that she has had no further episodes of clinically significant depression or mood instability since her last evaluation in January 2008.  The examiner noted that there had been no long periods of either depressed or unusually elevated moods.  It was noted that for at least the past 6 months, there had been absence of problems with sleep, appetite, concentration, energy, or interest in life.  She was not taking any medication.  The MSE was normal.  The diagnosis of MDD, recurrent, in full remission, full inter-episodic recovery was recorded, and a GAF of 85 was assessed.  The examiner recommended a S2 profile and noted that the profile reflected “the presence of a chronic condition, in full remission.”

The Board directed attention to its recommendations based on the above evidence.  The PEB rated the condition at 0%, citing condition “does not require continuous medication”, coded 9434 (MDD). As noted above, there was no evidence that a VA claim was made.

The Board first noted that the provision of VASRD §4.129 (“mental disorder that develops in service as a result of a highly stressful event”) were not applicable to this case.  The Board next reviewed the evidence in consideration of the higher rating of 10% and was unable to find any evidence to support the higher rating.  The commander’s statement (CS) was written more than a year before separation and therefore, was of limited probative value.  However, the CS indicated that she no longer performed the prescribed duties associated with her grade and rate but was performing duties in a limited capacity.  No statements were made in reference to MH symptoms interfering with performance. In the year before separation, the CI was pregnant, and was not taking any psychotropic medication, nor was she participating in regular counseling.  Her MSE 6 weeks before separation was normal and she was assessed with a GAF of 85.  Although she was noted to have episodic depressive symptoms, the record demonstrated she had been in full remission for 6 months before separation.   After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), and the application of §4.130, the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the major depressive disorder condition.  

Contended PEB Condition.  The MEB listed the pregnancy and noted that the CI was “unsuitable” for duty for reasons other than physical disability.  The CI was found unfit for her non-physical condition of major depression.  The Board reviewed all available records.  There were no residuals after the delivery and no complication during the pregnancy that would have rendered her unfit.  The pregnancy was profiled IAW military medical standards of ensuring proper care and attention to the mother and the child. The condition was not judged to fail retention standard. The condition was reviewed by the action officer and considered by the Board.  There was no performance based evidence from the record that this condition significantly interfered with satisfactory duty performance.  After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended conditions and so no additional disability rating is recommended.

BOARD FINDINGS:  In the matter of the major depressive disorder, recurrent 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.  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 20140612, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

Commandant
United States Coast Guard	Mail Stop 7907
2703 Martin Luther King Jr. Ave SE
Washington, DC 20593-7907
Staff Symbol: CG-1
Phone: (202) 475-5000

								   1850

Dear XXXXXXXXXX,
I am the Designated Decision Authority for the Coast Guard on applications submitted to the Department of Defense Physical Disability Board of Review (PDBR).  Under the authority of Title 10, United States Code, section 1554a, I accept the PDBR’s recommendation in your case (Case Number PD-2014-02915) and decline to modify your findings. 

Enclosed for your information are a copy of the PDBR’s recommendation and a copy of the record of proceedings. 

A copy of this decision has also been provided to Coast Guard Enlisted Personnel Management Branch, the PDBR, and the Department of Veterans Affairs. 

If you have any further questions, please contact the Coast Guard Personnel Service Center at (202)795-6645. 
	Sincerely,
2 Enclosures		
	
Copy:	CG Personnel Service Center (EPM-1)
DoD Physical Disability Board of Review
Department of Veterans Affairs