RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02708
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20071101

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Cavalry Scout, medically separated for “posttraumatic stress disorder” with a disability rating of 10%.  

CI CONTENTION:  “I believe the 10% rating was too low and due to 12 years of service, I feel my career was cut short due to my injuries sustained during OIF/OEF deployments.  I should have received medical retirement.”  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 - 20070914	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Posttraumatic Stress Disorder 	9411	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Posttraumatic Stress Disorder.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s mental health (MH) disorder began in April 2004 after transporting wounded Soldiers from trucks to the triage area, placing bodies in body bags and in a “cooler.”  The CI reported other traumatic combat experiences up until he left Iraq in March 2005.  His first contact with MH providers was in December 2006.  His initial concern was sleep problems but he also reported nightmares, anger, easy agitation and other PTSD symptoms.  The CI was treated with medication, and group and individual therapy. 

The 8 August 2007 MEB NARSUM examination, 3 months prior to separation, noted complaints of feeling on guard, being on edge and jumpy with easy agitation and nightmares.  Medications included Klonopin (anxiety) as needed, Seroquel (mood stabilizer, sleep) and Celexa (depression).  He reported his spouse had not noticed significant improvements.  He remained in therapy, but had not been to a firing range since returning from Iraq.  His work was administrative in nature.  His main support system was his spouse and a buddy from Iraq.  The mental status examination (MSE) showed mild to moderate psychomotor agitation related to the subject matter (worsened as he discussed his experiences in Iraq).  He described his mood as “distant” with a congruent affect.  Diagnoses of PTSD and major depressive disorder were rendered with a Global Assessment of Functioning score of 65 (mild impairment).  The examiner opined the CI was managing his home adequately and had a supportive spouse.  There was no VA examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the MH disorder 10%, coded 9411 (PTSD), citing  symptoms arising from verified combat experiences in Iraq, ameliorated with treatment and mild social and occupational impairment.  Panel members considered the provisions of VASRD §4.129 (mental disorders due to traumatic stress), and determined that the CI’s MH disorder was due to a “highly stressful event,” and that application of §4.129 was appropriate in this case.  Therefore, a minimum 50% rating for a retroactive 6‐month period on the Temporary Disability Retired List (TDRL) is recommended.  

Members agreed there was no evidence to support a rating higher than 50% at the time of TDRL placement.  The panel then turned to its permanent rating recommendation at the time of TDRL removal.  The most proximate source of comprehensive evidence on which to base the permanent rating recommendation in this case was the NARSUM examination.  The CI reported symptoms of easy agitation, anxiety and nightmares.  However, he was taking medication, performing administrative work, had the support of his wife and a friend, was adequately managing home life and his symptoms were rated as mild.  The CI had no hospitalizations, legal problems or emergency room visits documented.  Panel members concluded that his symptoms most closely approximated the criteria for mild disability.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a retroactive 6-month period of TDRL with a rating of 50% (in accordance with §4.129), and a permanent rating of 10% for the MH disorder, coded 9411.

BOARD FINDINGS:  In the matter of the MH disorder, the panel recommends an initial TDRL rating of 50%, coded 9411 in retroactive compliance with VASRD §4.129 as DoD directed; and a 10% permanent rating at 6 months IAW VASRD §4.130.  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, effective the date of medical separation:  

CONDITION	VASRD CODE	RATING	
		TDRL	PERMANENT	
Posttraumatic Stress Disorder	9411	50%	10%	

The following documentary evidence was considered:  

Exhibit A.  DD Form 294, dated 20170321, w/atchs  
Exhibit B.  Service Treatment Record  
Exhibit C.  Department of Veterans Affairs Record  

AR20190009142, 

Dear XXXXXXXXXXXXXXXXXX:

	I accept the recommendation of the Department of Defense Physical Disability Board of Review (DoD PDBR) to constructively place you on the Temporary Disability Retired List (TDRL) at 50% disability for six months effective the date of your original medical separation for disability with severance pay and then following this six month period no re-characterization of your separation or modification of the permanent disability rating of 10%.  Enclosed is a copy of the Board’s recommendation and record of proceedings for your information.

	The constructive TDRL period will result in an adjustment to your pay providing you 50% retired pay for six months from the date of your original medical separation and then no re-characterization of your separation or modification of the permanent disability rating of 10% following the constructive six month TDRL period. 

	The accepted DoD PDBR recommendation has been forwarded to the 
Army Physical Disability Agency for required correction of records and then to the 
U.S. Defense Finance and Accounting Service to make the necessary adjustment to your pay and allowances.  These agencies will provide you with official notification by mail as soon as the directed corrections have been made.  Due to the large number of cases in process, please be advised that it may be several months before you receive notification that the corrections are completed and pay adjusted.  Inquiry concerning your correction of records should be addressed to the U.S. Army Physical Disability Agency, (AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557.

	A copy of this decision has also been provided to the Department of Veterans Affairs and to the counsel you listed on your application,  XXXXXXXXXXXX, Disable American Veterans (DAV), 5788 Eckhert Road, Room 2A112, San Antonio, TX 78240.