RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02256
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060819

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty Reserve O3, Human Resource Officer, medically separated for “major depressive disorder” with a disability rating of 10%.  

CI CONTENTION:  The CI made no specific contention.  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 - 20060725	VARD - 20060826	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Major Depressive Disorder	9434	10%	Major Depressive Disorder	9434	10%	20060609	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Major Depressive Disorder.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) mental health narrative summary (NARSUM), the CI reported that she first began having episodes of depression in high school that would last 5 or 6 months at a time but did not present for care until 2002.  Symptoms of depression, which included hypersomnia, anhedonia, crying spells, subjective sadness, increased appetite and weight gain occurred again in late October or early November 2005 while deployed to Iraq.  There was no history of traumatic stress while in service which may have caused her symptoms.  She was diagnosed with major depression, recurrent and started on medication in March 2006.  Due to worsening symptoms, including feeling suicidal and hopeless, she was evacuated from theater in April 2006.  Despite treatment with medication and psychotherapy, the CI’s depressive disorder condition did not improve sufficiently.  

The 9 June 2006 MEB NARSUM examination, 2 months prior to separation, noted complaints of early morning wakening.  She told the psychiatrist that she felt the Effexor (antidepressant) was helping but that she still had feelings of depression.  The CI reported that she did not feel comfortable being alone so she moved in with a family from her church.  Mental status examination showed a tired appearance with mild psychomotor retardation.  Her reported mood was empty, dysphoric and depressed.  Affect was somber and sad.  Her level of consciousness was normal, cognitive function, thought processes and thought content were all normal.  She denied suicidal ideation.  Speech was soft, eye contact was fair to poor and the CI appeared to be tearful at times.  

At the 9 June 2006 Pre-Discharge examination, performed 2 months before separation, mental status examination showed behavior was appropriate, responses to questions were coherent with no abnormal emotional reactions during the examination.  The VA requested a VA Compensation and Pension (C&P) evaluation which was scheduled; however, the CI contacted the VA and stated she did not intent to attend the scheduled examination.  

In an addendum to the commander’s impact statement dated 30 June 2006, 2 months prior to separation, the commander stated that the CI “does minimal duties due to her reaction to stress of any sort, especially military related duties.”  The commander detailed that the CI’s duties were limited to attending her appointments and other minor assignments such as attending meeting and taking notes which she handed over to the commander or first sergeant for further action.  The commander opined that the CI was “of no further use for this or any unit and it would best serve the Army to separate her.”  The final Officer Evaluation Report signed 5 July 2006 shows evidence of a highly effective officer with recommendations from both the rater and the senior rater to promote and to send to the next service school.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the major depressive disorder condition 10%, coded 9434 (major depressive disorder), citing mild social and industrial impairment.  The VA also rated the major depressive disorder 10% coded 9434, based on the STR, citing continuous medication for control of symptoms which decreased work efficiency and ability to perform occupational tasks only during periods of significant stress.  

The panel noted there was ample evidence of occupational and social impairment due to mild or transient symptoms and symptoms controlled by continuous medications to justify a 10% rating coded 9434.  The majority of members agreed that although there was evidence chronic sleep impairment and periods of inability to perform occupational tasks there was no evidence of anxiety, suspiciousness, panic attacks, or memory loss to justify the next higher rating of 30%.  

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 major depressive disorder condition.  

BOARD FINDINGS:  In the matter of the major depressive disorder condition and IAW VASRD §4.130, the panel majority recommends no change in the PEB adjudication.  

The single voter for dissent recommends modification to 30% with re-characterization and elected not to submit a minority opinion.  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 20150729, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170012861, XXXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,					      
						      					
Enclosure