RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXX		CASE: PD-2016-00857 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20061115

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Helicopter Airframe Mechanic, medically separated for “bipolar II disorder” with a disability rating of 10%.

CI CONTENTION:  Review all conditions.  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 Medical Evaluation Board (MEB), but determined by the PEB 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. The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate. The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.

RATING COMPARISON:

SERVICE PEB - 20060906	VARD - 20070329	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bipolar II Disorder	9432	10%	Bipolar Disorder II	9432	10%	20061128	
Gilbert’s Disease	Cat III	Gilbert’s Disease	7399-7345	0%	20060919	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Biplolar II Disorder. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s mental health (MH) condition began in March 2006 while deployed to Iraq with decreased concentration, anhedonia, insomnia, decreased energy and appetite, and thoughts of suicide. Despite treatment with medication, he began to display symptoms of hypomania to include irritable mood, increased energy, decreased need for sleep, and distractibility. He was medically evacuated, diagnosed with bipolar disorder in May 2006, and started on a mood stabilizing anti-depressant. The CI first joined the Marine Corps in 1997, served until 2002, and reenlisted in September 2005. He reported several episodes of depression

since high school and during his first period of service, and he also saw a psychologist in the past for anger issues. The STR did not indicate a previous finding of incompetency or incapacity.

The 7 June 2006 MEB NARSUM examination, 5 months prior to separation, noted no specific complaints. Mental status examination (MSE) showed essentially normal findings with the exception of an irritable mood and congruent affect. A diagnosis of bipolar II disorder, existing prior to service (EPTS) and service aggravated, was rendered with a Global Assessment of Functioning (GAF) score of 58 (moderate symptoms, impairment.) Social and industrial impairment was rated moderate. The October 2006 non-medical assessment, noted he was away from work an average of 7 hours per week.

At the 28 November 2006 VA Compensation and Pension (C&P) MH examination, 3 days after separation, the CI reported constant symptoms and treatment with two medications, but no previous psychiatric hospitalizations or emergency room visits. He had a disciplinary infraction in 1997 and formal counseling for assaulting another private, but had no legal problems after discharge. He was unemployed at the time of the evaluation. During the MSE, he reported obsessional rituals, checking locks several times and wanting everything in its place. He showed some mild forgetting of names, directions and recent events. There was no history of panic attacks but he did feel suspicious of everybody. A diagnosis of bipolar I disorder was rendered with a GAF score of 60 (moderate bordering on mild symptoms, impairment.)

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the bipolar II disorder 30%, coded 9432 (bipolar disorder), but then took a 20% EPTS deduction resulting in a 10% rating. The VA rated the bipolar II disorder 10%, also coded 9432, based on the C&P examination, citing the helpfulness of medications and a mostly normal MSE. Application of VASRD §4.129 is considered by the panel for all cases of service connected psychiatric conditions resulting in separation; but, all members agreed that the “highly stressful event” requisite for §4.129 was not satisfied in this case.

The panel next considered the EPTS deduction, and noted that service entry examinations did not record or render an MH condition. The CI served in the Marine Corps from 1997-2002 without evidence of mental impairment, and re-enlisted in 2005, again without record of an MH condition. While he reported some episodes of depression prior to enlistment and during his first tour of service, there was no documentation of a diagnosis of bipolar or evidence of treatment. The NARSUM examiner specifically noted no evidence of previous findings of incompetency or incapacity, and members agreed the EPTS determination was not supported.

The panel then considered the most appropriate §4.130 rating at separation. The criteria for a 10% rating requires “symptoms controlled by continuous medication.” A 30% rating stipulates “occupational and social impairment with occasional decrease in work efficiency and intermittent inability to perform occupational tasks” and a 50% requires “reduced reliability and productivity.” The NARSUM examiner opined that the CI’s condition was moderate, but the C&P examination, more proximal to separation, noted the presence of anxiety, suspiciousness, and mild forgetting of names which meet criteria for a 30% rating. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 30% for the bipolar disorder, coded 9432.

Contended PEB Condition: Gilbert’s Disease. The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting. The contended condition was not noted on limited duty forms or implicated in the non-medical assessment, and did not fail retention standards. There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation. After due deliberation, the panel concluded there was insufficient cause to recommend a change in the

PEB fitness determination for the contended condition, so no additional disability rating is recommended.

BOARD FINDINGS: In the matter of the bipolar II disorder, the panel recommends a disability rating of 30%, coded 9432 IAW VASRD §4.130. In the matter of the contended Gilbert’s condition, the panel agrees it cannot recommend it for additional disability rating. There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows; and, that the discharge with severance pay be re-characterized to reflect permanent disability retirement, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Bipolar II Disorder	9432	30%	

DEPARTMENT  OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD DC 20374-5023

IN REPLY REFER TO

1850
CORB:003
12 Feb 20

From: To:

Director, Secretary of the Navy Council of Review Boards 
PD-2016-00857 

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW  (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr of 6 Feb 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy for appropriate action.

2.	On 31 January 2020, the Assistant Secretary of the Navy took action in your case by accepting the correct recommendation of the PDBR.	Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Physical Evaluation Board from 10 to 30 percent with assignment to the Permanent Disability Retired List.

3.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, was sent to the office of the Deputy Commandant, Manpower and Reserve Affairs, for correction of your records as stated above.	You will be notified once those changes are complete.