RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01368
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20040624  

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Aeromedical, medically separated for “bipolar II 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 (VA), 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 - 20040225	VARD - 20060308	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bipolar II Disorder	9432	10%	Bipolar Disorder with Panic Disorder	9412-9432	30%	20050518	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  70%	

ANALYSIS SUMMARY:  

Bipolar II Disorder.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI self-referred to Kadena Life Skills Support Center in January 2003 with mental health symptoms.  She described a history of “drastic” mood swings that occurred over days to weeks.  She reported “too happy” mood lasting 4 days and depressed or irritable mood lasting at least 2 weeks.  The CI was diagnosed with bipolar disorder and started on medication and psychotherapy.  

The 8 January 2004 MEB NARSUM examination, 5 months prior to separation, noted complaints of periods of depressed moods and irritability lasting 2 weeks.  The examiner noted that there was no history of psychotic symptoms.  There were no mental health hospitalizations.  The mental status examination showed good eye contact, regular rate speech, judgement fair, and adequate insight.  Her affect was restricted, dysphoric and non-labile.  Her mood was depressed.  There were no homicidal or suicidal ideations.  The examiner noted that the CI required intensive psychotherapy.  The commander’s statement noted “some days she is fully able to satisfy duty requirements, many days she is not.  She has been on a profile restricting her duties for several months out of the last year.”  

At the 17 May 2005 VA Compensation and Pension (C&P) evaluation, 11 months after separation, the CI reported mild symptoms of depressed mood, frequent crying spells, and decreased energy. She reported “not very good” attention, concentration or memory.  The CI denied suicidal and homicidal ideations and denied feelings of hopelessness and helplessness.  The CI reported decreased frequency of anxiety attacks on Celexa.  She denied psychiatric emergency department visits or hospitalizations.  The mental status examination showed good eye contact; logical, goal directed thoughts; and no impairment of abstract thinking.  Her mood was mildly depressed with appropriate affect.  

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the bipolar II disorder condition 10%, coded 9432 (bipolar disorder), citing mild social and industrial adaptability impairment. The VA rated the condition 30%, coded 9412-9432 (panic disorder-bipolar disorder); based on the C&P examination 11 months after separation, citing occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks.  The panel noted that the commander’s statement documented intermittent periods of inability to perform occupational tasks for a 30% rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 30% for the bipolar disorder condition, coded 9432.  

BOARD FINDINGS:  In the matter of the bipolar disorder condition, the panel majority recommends a disability rating of 30%, coded 9432 IAW VASRD §4.130.  The single voter for dissent recommended no re-characterization and did not elect to submit a minority opinion.  There were no other conditions within the panel’s scope of review for consideration.  

The panel recommends that 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 as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Bipolar II Disorder	9432	30%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160926, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

SAF/MRB

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-01368.

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 not appropriate under the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended your separation be re-characterized to reflect disability retirement, rather than separation with severance pay

I have carefully reviewed the evidence of record and the recommendation of the Board.    I concur with that finding, accept their recommendation and determined that your records should be corrected accordingly.  The office responsible for making the correction will inform you when your records have been changed.

As a result of the aforementioned correction, you are entitled by law to elect coverage under the Survivor Benefit Plan (SBP).  Upon receipt of this letter, you must contact the Air Force Personnel Center at XXXXXXXXXXXXXXXXXX to make arrangements to obtain an SBP briefing prior to rendering an election.  If a valid election is not received within 30 days from the date of this letter, you will not be enrolled in the SBP program unless at the time of your separation, you were married or had an eligible dependent child, in such a case, failure to render an election will result in automatic enrollment.

Sincerely,

Attachment:
Record of Proceedings