RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00384
BRANCH OF SERVICE:  AIR FORCE 	SEPARATION DATE:  20050517

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

CI CONTENTION:  “Review all conditions.”  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the Panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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 conditions at the time of separation.  The panel has neither the role nor the authority to compensate for progression or complications of service connected conditions after separation.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The panel 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 - 20050331	No VA Claim in Evidence	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Delusional Disorder, Paranoid Type	9410	10%		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:  

Delusional Disorder, Paranoid Type.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s mental health condition began in June 2004 after increased stress.  At the time, the CI expressed the belief that her house was bugged, and her fiancé was “talking in code.”  She also stated that she felt as if personnel in her shop were trying to hurt her.  She indicated that she believed that several co-workers, including supervisors, were against her since the time she filed an IG complaint 2 years prior.  Her condition did not require psychotropic medications or hospitalization.  Although her symptoms had resolved, due to the nature of her condition, she was referred to the MEB.  The 15 October 2004 MEB NARSUM examination, 7 months prior to separation, noted that the CI no longer experienced problems with sleep, anxiety, irritability, concentration or appetite.  
She no longer felt her co-workers were trying to hurt her, or that her fiancé was talking in code or that her home was bugged.  However, she continued to believe that the previous incidents had happened and had simply resolved after she presented to mental health.  She was scheduled for a follow-up visit 2 weeks after the initial evaluation but failed to keep the appointment.  By late July 2004, all of her symptoms had resolved. 

Mental status examination (MSE) was unremarkable with the exception of “slight” increase in psychomotor activity and mild apprehension.  The psychiatrist recorded the diagnosis of delusional disorder, paranoid type, and indicated that the condition had minimal impact on functioning and was not accompanied by obviously bizarre or odd behaviors.

The MEB NARSUM addendum on 19 January 2005, 4 months prior to separation, noted the CI was without symptoms, and had not exhibited any signs or symptoms of social or occupational dysfunction.  There was no VA claim in evidence.  

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the mental health condition 10%, coded 9410 (other and unspecified neurosis), noting that the condition was mild.  The higher rating of 30% is justified when there is evidence of “Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks occasional or intermittent impairment.”  The record clearly documented the CI’s condition had resolved within a couple of months.  Panel members agreed, there was insufficient evidence supporting the higher rating.  Therefore, the 30% rating was not justified.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the delusional disorder, paranoid type condition.  

BOARD FINDINGS:  In the matter of the delusional disorder, paranoid type condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, 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 20150602, with attachments
Exhibit B.  Service Treatment Record

SAF/MRB
XXXXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-00384.

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,

XXXXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings