RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-00774
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20060412

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E7, Strength Maintainer, medically separated from the Temporary Disability Retired List (TDRL) for “bipolar disorder” with a disability rating of 10%.

CI CONTENTION:  The VA gave him a 100% rating.  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 - 20060331	VARD – 20050111	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bipolar Disorder	9432	10%	Depressive Disorder, NOS	9423-9400	30%	20041012	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:  

Bipolar Disorder.  According to the service treatment record and MEB narrative summary (NARSUM), the CI was initially diagnosed with an anxiety disorder associated with panic attacks in November 2003.  His symptoms persisted despite treatment and he was placed on the TDRL effective 1 December 2004 with a disability rating of 30%, coded 9434 (major depressive disorder).  

The 10 February 2006 TDRL MEB NARSUM examination, 2 months prior to TDRL removal, was performed by the VA and was also a (C&P) evaluation.  The CI reported continued problems with anxiety and panic especially if his stressors increased.  He had just gotten back from a trip in which his truck had broken down (he was working as a long-haul truck driver) and also had stress from a broken furnace at home (and associated expense).  He reported that he enjoyed being a long haul driver since he was not around people much although he was depressed when away from his family (but not depressed when back home).  He had been fired from a previous job after a confrontation with a customer.  On examination, he was generally calm and cooperative although easily irritated and upset.  He denied hallucinations or delusions.  Cognition was intact.  He was thought to have a mixed type bipolar disorder with a mixed personality disorder.  The global assessment of function (GAF) was 75, indicative of transient symptoms or slight impairment.  The depression was thought to be in remission while the anxiety and panic persisted.  Continued treatment was recommended.  

The CI was seen in mental health on 7 November 2006, 7 months after TDRL removal.  He continued to work as a truck driver, but was off for the past 3 weeks for a Workman’s Comp injury.  He reported benefit with the medications and was advised to continue medications with the next follow up appointment 4 months later.  The GAF was 65, indicative of some mild symptoms or impairment.  The CI was not seen again until 6 March 2007; he had cancelled the previously scheduled appointment due to a conflict with work (out of town driving).  He reported that things were going well and his mood was neutral.  His affect was full range and appropriate.  The GAF remained 65.  On 29 May 2007, the CI reported that since the last appointment, he had purchased his own truck and was leasing it to the trucking agency.  He had doubled his salary, but was able to take more vacation.  His GAF was stable at 65.  It was noted that he remained married with children and no issues were recorded.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the mental health disorder 10%, coded 9432 (bipolar disorder), citing mild impact on his industrial and social capabilities.  The VA rated the mental health disorder 30%, coded 9434-9400, (major depressive disorder-generalized anxiety disorder), based on the C&P examination 2 months before TDRL placement, citing occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupation tasks due to such symptoms as depressed mood, anxiety, suspiciousness panic attacks, chronic sleep impairment and mild memory loss.  

The evidence indicates the CI was working full-time and making future plans.  No difficulties at home were noted.  Two months prior to TDRL removal, he was assigned a GAF of 75.  The criteria for a 30% rating include the intermittent inability to perform occupational tasks.  In fact, the CI was doing well in his occupation and had purchased his own truck in the months following TDRL removal.  His home environment also appeared to be stable (no issues were documented).  The record supported the 10% rating adjudicated by the PEB at TDRL removal.  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 mental health disorder.  

BOARD FINDINGS:  In the matter of the mental health 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 20170220, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180004901, 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