RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02120
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070403

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

CI CONTENTION:  The CI submitted a lengthy contention for his mental health (MH) condition stating he still suffered from the condition and listing multiple life circumstance stressors.  The 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 - 20070216	VARD - 20071227	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Major Depressive Disorder	9434	10%	Depression	9434	NSC	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Major Depressive Disorder (MDD).  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s major depressive disorder began in late 2005.  The CI reported to his flight surgeon that he had been feeling depressed for “the last few months.”  After treatment with medication and group therapy the depression symptoms improved greatly; however, the CI’s military specialty was as an aviator and MEB was initiated to consider retraining.  

The CI was initially evaluated by a psychologist 4 April 2006.  He was then referred to a psychiatrist for a medication evaluation 6 April 2006.  At that visit, the CI appeared uncomfortable but fairly open.  His mood was reported as “down”, affect was initially very restricted and serious at first but warmed later and was found to be appropriate and non-labile.  The CI denied suicidal or homicidal ideation.  

At the 24 May 2006, 10 months prior to separation, psychiatry follow-up appointment the CI reported a dramatic improvement in mood, increased energy, concentration and more efficiency at work.  Mood was reported as “much better” affect was brighter and still no suicidal or homicidal ideation.  

The CI’s final Enlisted Performance Report covering a period ending 15 October 2006, approximately 11 months after the reported onset of symptoms, showed the CI was an exceptional performer and leader as well as a skilled communicator.  The rater noted that he “consistently completed all tasks with little supervision” and that he set an example for others in his flight.  In addition to exceptional duty performance, the CI also volunteered and constructed a home for Habitat for Humanity, donated 8 hours of his time to Feed the Children and completed 18 hours credit toward his Bachelor degree in business management.  

At the 20 December 2006 MEB NARSUM examination, 3 months prior to separation, the CI noted improvement in his depressive symptoms.  The CI reported he anticipated graduating with his Bachelor’s degree in February 2007.  A mental status examination was not recorded on that evaluation.  The assessment by the treating psychiatrist says that the CI’s MDD, single episode, moderate severity was “tremendously improved, though not yet in full remission on medication …” He opined that although the CI was, at that time, in partial remission he had a good eventual prognosis to achieve full remission.  The psychiatrist noted that the degree of impairment for civilian social and industrial adaptability was minimal.  The CI submitted an undated, lengthy “Letter of Exception” in which he did not dispute the facts of his MEB NARSUM other than to point out administrative inaccuracies.  He did detail his wife’s medical problems and the impact those problems have had on them as a family after the NARSUM was written.  There was no VA examination in evidence proximate to separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated “MDD, single episode” 10%, coded 9434 (MDD), citing moderate severity, social and industrial adaptability Impairment: mild, with application of DoDI 1332.39.  The VA did not service-connect the CI’s major depressive disorder, citing the CI failed to report for a scheduled VA examination without good cause, and there was no evidence to indicate a record of a diagnosed chronic condition incurred or aggravated by active military service.  

The panel noted that the CI’s symptoms were controlled with continuous medication satisfying the requirements for a 10% rating under the General Rating Formula for Mental Disorders.  Other than being disqualified from flying status there was no evidence of occupational or social impairment with intermittent periods of inability to perform occupational tasks due to such symptoms as depressed mood, anxiety, suspiciousness, panic attacks, chronic sleep impairment, or memory loss to justify the next higher rating of 30%.  There are no other applicable rating formulas.  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 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 that 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 20150803, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-02120.

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,

XXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings