RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03575
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070904

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Structural Journeyman, medically separated for “generalized anxiety disorder,” with a disability rating of 10%.

CI CONTENTION:  The applicant requests consideration of all conditions in his application.  The CI’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 based on 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 - 20070627	VARD - 20080422	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Generalized Anxiety Disorder	9400	10%	Panic Disorder and Adjustment Disorder with Anxiety	9412	10%	20080201	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Generalized Anxiety Disorder.  According to service treatment records, the CI initially presented to the Psychiatric center in November 2005 for evaluation of anxiety.  He reported shaking, irritability, and inability to eat.  He received a diagnosis of generalized anxiety disorder and was treated with counseling and medications.  He deployed to Iraq for several months.  While in theater he began to have panic attacks and sleep issues.  He described the panic attacks as shortness of breath and a feeling of suffocation with his heart pounding and lasting 15-30 minutes.  He sought mental health consultation to find out how to deal with his wife’s mental health problems.  He denied combat exposures.  He received medication for anxiety and redeployed in October 2007.  He had issues with gastroenteritis and panic attacks and lost 40 pounds.  The narrative summary noted no prior psychiatric history.  Mental status exam (MSE) was essentially normal.  He displayed good insight and judgment.  Psychological testing in May 2007 revealed no evidence of a personality or mood disorder or malingering.  A diagnosis of generalized anxiety disorder was rendered with a Global Assessment of Functioning (GAF) score of 75 (mild symptoms, impairment.)  The examiner noted he was taking multiple doses daily of an anti-anxiety medicine which could be sedating and affect his ability to function in a job.  He had difficulty functioning when under increased social stressors.  

At the February 2008 VA Compensation and Pension (C&P) exam performed 5 months after separation, the CI reported he last had a panic attack a few weeks previously and estimated he had 10 panic attacks since discharge.  They were less frequent than when he returned from Iraq. He had been employed since discharge.  He does not socialize much but enjoys work, working out and riding his motorcycle.  He had been married for 4 years and had a good relationship with his family.  MSE was unremarkable.  A diagnosis of panic disorder without agoraphobia, mild and adjustment disorder with anxiety were rendered with a GAF of 70 (mild symptoms, impairment.)  The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a disability rating of 10% under code 9400 (generalized anxiety disorder) based on mild social and industrial adaptability.  The VA assigned a 10% rating under code 9412 (panic disorder) due to mild social impairment.  Disability associated with any psychiatric condition, regardless of the diagnosis or multiple diagnoses, is subsumed under a single rating using the same criteria IAW VASRD §4.130 general rating formula for MH conditions.  Board members agreed that the provisions of VASRD §4.129 were not applicable in this case.  The Board then considered if there was evidence for a §4.130 rating higher than 10%.  The §4.130 criteria for a 10% rating is “symptoms controlled by continuous medication,” for a 30% rating is “occupational and social impairment with occasional decrease in work efficiency and intermittent inability to perform occupational tasks.”  The CI reported he had not had symptoms for weeks and symptoms were declining since his return from Iraq.  Board members agreed he did not meet criteria for a 30% rating.  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 generalized anxiety disorder condition.  

BOARD FINDINGS:  In the matter of the generalized anxiety 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.  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 20140707, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MR
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

Dear XXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2014-03575.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

Attachment:
Record of Proceedings