RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01163
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20090820

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

CI CONTENTION:  The CI made no specific contention.  Her 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 condition(s) at the time of separation.  The panel 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 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 - 20090427	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
MDD	9434	10%	No VA Examination in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:  

MDD. According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s mental health condition began in 2005 following her pregnancy and due to increased marital conflict and occupational stressors.  She was begun on anti-depressant medications and entered into outpatient counseling.  The performance report which closed out in July 2005 noted she excelled and recommended promotion ahead of her peers.  Subsequent assessments in 2006 and 2007 noted average performance.  In June 2008 it was noted the CI was going through a divorce.  An October 2008 performance report noted she was found to meet overall standards but was easily distracted and failed to meet fitness standards.  She was overwhelmed by large projects, failed to prioritize tasks, and attention to detail was an issue.  The rater’s comments noted she needed “constant motivation and close supervision.”  The commander’ assessment, prepared on 28 January 2009, 8 months prior to separation, stated that her medical condition did not impede her ability to perform her duties at her home station, but she was not deployable.  The MEB psychiatric NARSUM examination, dated 18 February 2009, 6 months prior to separation, recorded that the CI reported improvement with medications, but had persistent problems with irritability, poor concentration and sleep, and decreased energy and interest in pleasurable activities.  She also reported her primary stressor was her occupation in the USAF.  She had been reprimanded for a poor attitude and work performance and tended to become overwhelmed and depressed with ordinary life stressors.  The examination, previously accomplished on 5 November 2008, noted she was in no acute distress.  Her mood was dysthymic and affect was appropriate.  Insight and judgement were slightly impaired.  The examination was otherwise unremarkable.  A 12 June 2009 primary care note, 2 months prior to separation, noted she always had secondary gain (avoidance of work).  A VA Compensation and Pension evaluation was not performed as the CI made no VA claim.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the MDD condition 10%, coded 9434 (MDD), citing mild social and industrial adaptability impairment.  The commander noted the CI was able to do her job in garrison, but was not deployable.  Her performance report indicated that except for fitness she met standards.  The NARSUM recorded she became overwhelmed with ordinary life stressors, but a primary care note also raised the concern of secondary gain.  The 10% rating adjudicated by the PEB is supported by her symptoms and the use of daily medications.  The criteria for a higher 30% rating include the inability to perform occupational tasks.  This was not recorded as the commander noted the opposite.  The panel also noted the CI was not hospitalized nor evaluated for a mental health condition in the emergency room.  

After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the MDD condition.  

BOARD FINDINGS:  In the matter of the MDD condition and IAW VASRD §4.130, the panel unanimously 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 there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150607, w/atchs
Exhibit B.  Service Treatment Record

SAF/MRB

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-01163.

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