RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00729
BRANCH OF SERVICE:  Coast Guard 	SEPARATION DATE:  20060424

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Machinery Technician, medically separated for “panic disorder and/or agoraphobia,” with a disability rating of 10%.

CI CONTENTION:  The CI contends for a higher rating.  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 upon a 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 - 20060227	VARD - 20110331	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Panic Disorder and/or Agoraphobia	9412	10%	Psychiatric Condition with Anxiety and Agoraphobia	9400	NSC	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NSC	

ANALYSIS SUMMARY:  

Panic Disorder and/or Agoraphobia.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s panic disorder condition began in approximately March 2005, soon after being assigned to the US Coast Guard Cutter Campbell.  The CI was removed from the cutter and assigned temporary duty on shore and his symptoms began to improve so he chose not to undergo treatments.  His condition did not allow the CI to perform all of the duties required of his rate and the MEB forwarded adjustment disorder with anxious and depressed mood and panic disorder with agoraphobia for PEB adjudication.  

At the primary care clinic visit 25 September 2005, 6 months prior to separation, the CI was brought to the clinic due to a shipmates observation of the CI “venting bottled up anger, mumbling about his girlfriend, and saying he hated this place, etc.”  In addition, the CI had been witnessed extinguishing cigarettes on the back of his hand.  The CI denied harming himself but did express disgust with the Coast Guard.  He was quoted as saying, “I’m doing a job I absolutely hate, got hurt doing a job I don’t like.  I hate being here, I’m not cut out for military life.  I just want out.”  Physical examination showed the CI to be somber and withdrawn during the interview.  He had four fresh burn marks on the back of his left hand and several smaller older wounds in various stages of healing.  

The MEB NARSUM psychiatric evaluation on 21 October 2005, 5 months prior to separation, noted the CI’s mood was improving since leaving the cutter and arriving in Boston.  The CI stated “60% of the time I’m alright.”  He denied problems with appetite and concentration as well as symptoms of mania.  He stated he was sleeping 5 hours per night and he took knaps during the day.  He described his energy level as “dragging.”  Physical examination showed normal appearance and grooming and the CI cooperated with the interview.  He appeared neither anxious nor depressed, though he did appear to be angry at times during the evaluation.  He denied thoughts of harming himself or others.  

The CI failed to report to his 31 March 2010 VA Compensation and Pension (C&P) evaluation.  STRs were used to evaluate the CI’s mental health condition by the VA.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the panic disorder and/or agoraphobia condition 10%, coded 9412 (panic disorder and/or agoraphobia).  The VA denied service connection for psychiatric condition with anxiety and agoraphobia, citing the CI failed to report for his scheduled 16 October 2010 VA C&P examination.  Members of the Board agreed the CI’s panic disorder condition caused mild or transient symptoms that decreased work efficiency and ability to perform occupational tasks only during periods of significant stress, justifying a 10% rating.  The evidence did not support intermittent periods of inability to perform occupational tasks, due to symptoms of depressed mood, anxiety, suspiciousness, weekly panic attacks, chronic sleep impairment or memory loss validating a higher 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 panic disorder condition.  

Contended PEB Conditions:  Adjustment Disorder with Anxious and Depressed Mood.  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The Board noted that adjustment disorder and panic disorder are rated using the same criteria in the VASRD and adjustment disorder is not associated with any findings that could be separately rated without violation of VASRD §4.14 (avoidance of pyramiding); thus, it was appropriately subsumed in the same rating recommendation as the primary condition.  After due deliberation, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.   

BOARD FINDINGS:  In the matter of the panic disorder condition and IAW VASRD §4.130, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the contended adjustment disorder with anxious and depressed mood condition, the Board unanimously agrees that it cannot recommend it for additional disability rating.  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 20150603, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

Dear XXXXXXXXXXXXXXXXXXX,

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-2015-00729) 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 XXXXXXXXXXXXXXXXXXX. 

	Sincerely,

	
Rear Admiral, U. S. Coast Guard
Assistant Commandant for Human Resources

2 Enclosures	

Copy:	CG Personnel Service Center (EPM-1)
DoD Physical Disability Board of Review
Department of Veterans Affairs