RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00727
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20040412

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

CI CONTENTION:  Change the rating for the mental health disorder.  He also requested several other conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) be reviewed.  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20040301	VARD - 20040624	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Major Depressive Disorder	9434	10%	Major Depressive Disorder	9434	10%	20040319	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Major Depressive Disorder.  According to the service treatment record and MEB narrative summary (NARSUM), the CI self-referred in September 2003 for symptoms of depression and suicidal thoughts.  The CI stated while on deployment he attempted suicide by placing the muzzle of his M16 into his mouth but could not pull the trigger.  He denied significant exposure to combat or other trauma.  Treatment consisted of multiple psychotropic medications and individual therapy over a 3-month period focused on depressive symptoms, suicidal thoughts, sleep problems and marital issues.  

At the 21 November 2003 MEB NARSUM examination, 5 months prior to separation, the CI reported daily suicidal thoughts, marital discord and feeling irritable and frustrated.  The examiner recorded depressed mood, thoughts of death and loss of interest and indicated the CI had severe impairment for military duty and mild impairment for social and industrial adaptability.  The mental status exam indicated a congruent moderately depressed affect.  

During the 27 January 2004 psychiatry clinic appointment, 2 months prior to separation, the CI completed a brief mood survey where he indicated it was only moderately true that he had suicidal thoughts and somewhat true that he felt sad, discouraged, worthless and had loss of pleasure in his life.  The examiner recorded the patient was not depressed or suicidal, had improved sleep and was stable.  

At the 9 March 2004 VA Compensation and Pension (C&P) evaluation, 1 month before separation, the CI reported occasional irritability and not liking social activities.  The examiner noted the CI denied suicidal or homicidal thoughts.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the major depressive disorder 10%, coded 9434 (major depressive disorder), citing requirement for medication management and outpatient psychiatric treatment.  The VA also rated the major depressive disorder 10%, coded 9434, based on the C&P examination, citing relatively mild recent symptoms with definite improvement with regular medication; no indication of ongoing anxiety, panic attacks, sleep disturbance, memory loss, or any significant difficulty with normal activities; and a Global Assessment of Function score indicative of mild and transient symptoms.  The panel agreed that at the time of separation, the salient features of the CI’s condition included chronic suicidal ideation, depressed mood, chronic sleep disturbance and marital discord, but the record is lacking in any evidence to indicate occasional or more frequent decrease in occupational functioning that would justify a rating greater than 10%.  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 major depressive disorder.  

BOARD FINDINGS:  In the matter of the major depressive disorder and IAW VASRD §4.130, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends 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 20170214, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180004792, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

	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