RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX	CASE:  PD-2017-03769
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20080122

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Power Generator Equipment Repairer, medically separated from the Temporary Disability Retired List (TDRL) for “bipolar disorder” with a disability rating of 0%.   

CI CONTENTION:  No specific contention was made.  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 - 20071217	VARD - 20041012	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bipolar Disorder	9432	0%	Bipolar Disorder	9431	10%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10% 	

ANALYSIS SUMMARY:  

Bipolar Disorder.  According to the service treatment record and MEB narrative summary (NARSUM), the CI was initially seen in outpatient psychiatry in January 2004 with a euphoric mood, rapid speech, high energy, hyperactivity, romantic delusions about a male service member, and auditory hallucinations.  She was placed on TDRL in March 2004 with a diagnosis of bipolar disorder, manic, with psychotic features.  At the time of the TDRL placement, the CI had continued to experience mania with psychosis, and had just been discharged from the inpatient psychiatry unit related to acute onset of manic symptoms with psychosis. 

During the 3 August 2005 TDRL examination, the CI reported that since separation in 2004, she had been mostly stable until April 2005 when she had an acute manic episode while at work.  She spent 2.5 weeks in the hospital.  This was the only hospitalization since separation.  The CI had been working full-time as a sales associate in electronics at a major department store.  She was in treatment with a psychiatrist and was taking antipsychotic medication.  The CI was single, never married and not dating.  She attended church regularly and engaged in recreational activities with her mother.  The mental status examination (MSE) was unremarkable with the exception of psychomotor slowness.  The examiner noted that the CI was doing fairly well but constant monitoring and daily medication were necessary to maintain stability.

At the 30 October 2007 MEB TDRL re-evaluation, 3 months prior to separation, the CI reported she had not had any medication or mental health (MH) treatment for 2 years and had been employed full-time.  She continued to attend church regularly and live with her mother and was not dating. It was noted that the CI had a low stress lifestyle, but was able to handle the stress of hurricane Rita without decompensating.  The MSE was completely normal.  The examiner opined that the CI’s bipolar condition was in full remission.  There was no VA examination in evidence proximate to removal from the TDRL.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bipolar disorder 0%, coded 9432 (bipolar disorder), citing a mental condition that was diagnosed but the symptoms were not severe enough to interfere with occupational and social functioning or to require continuous medication.  The 2004 VA Rating Decision for the bipolar disorder was 10%, coded 9431 (cyclothymic disorder), based on the STR, citing occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress; or symptoms controlled by continuous medication.  

The panel members first agreed that the provisions of VASRD§ 4.129 for a “mental disorder that develops in service as a result of a highly stressful event” were not applicable.  The panel next considered the absence of emergency room treatment, or hospitalization, and the apparent stability of symptoms during the 24 months prior to TDRL removal.  Despite no medication or MH treatment, the CI was able to maintain full-time employment during the 2 years prior to separation.  She demonstrated the ability to manage stressful situations without decompensating, and she remained asymptomatic for 2 years.  There was no indication of occupational impairment due to symptoms.  The TDRL examiner documented that the condition was in full remission.  Panel members then agreed there was insufficient evidence to support a compensable rating for the CI’s condition at the time of separation.  After due deliberation, considering all 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 bipolar disorder.  

BOARD FINDINGS:  In the matter of the bipolar 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:
PD-2017-03769

AR20190011825, XXXXXXXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXX

	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.

	

	PD-2017-03769