RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-03850 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20050630

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Data Network Specialist, medically separated for “panic disorder with agoraphobia” with a disability rating of 10%.

CI CONTENTION: “…significant bouts of depression and occasional suicidal thought related to the events that occurred during my enlistment.” 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 - 20050422	VARD - 20060315	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Panic Disorder with Agoraphobia	9412	10%	Panic Disorder	9412	10%	20060104	
Major Depressive Disorder	Cat III	No VA Placement	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Panic Disorder with Agoraphobia. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s panic disorder symptoms began sometime during boot camp or shortly thereafter. She was first referred to mental health (MH) in October 2003 with the report of stomach pain that seemed to be related to stress, depression and anxiety. On 1 September 2004, she presented to MH for evaluation of depressive symptoms without suicidal ideation. At the time, she had legal actions pending for driving while intoxicated, and the following week, was admitted for psychiatric treatment after expressing suicidal thoughts. She was discharged with

medication after 6 days with a diagnosis of major depression. There were no additional hospitalizations or visits to the emergency room (ER) related to MH symptoms in evidence.

In the 11 February 2005 non-medical assessment (NMA), 4 months prior to separation, the commanding officer noted the CI was able to complete all assigned tasks in her primary administrative/office duties, and stated that unless medical authorities determined she was “a danger to herself or others” she was “fully capable to continue to perform her duties as a database administrator and complete her obligation to the Marine Corps.”

During the 18 February 2005 MEB NARSUM examination, 4 months prior to separation, the CI reported 4-5 panic attacks per week during good weeks and up to two attacks per day during the worst weeks. She also suffered from generalized anxiety and symptoms of depression, which included problems with sleep, loss of interest and motivation, decreased appetite and intermittent suicidal ideation. The mental status examination (MSE) revealed depressed mood and blunted affect. Thought process was slightly slowed and cognition showed some distractibility and decrease in concentration, but memory, insight and judgement were intact.

The 12 April 2005 psychiatric addendum, 2 months before separation, noted the CI had recently lost her security clearance as a result of ongoing MH difficulties and was unable to perform any of her military specialty tasks. It was noted the medical board had found her fit for duty and that she felt distraught over the determination. The CI complained that being idle was much more stressful for her than being gainfully employed. She complained of continued panic attacks with a predominately depressed mood. The examiner noted that the panic attacks were intermittent. The Global Assessment of Functioning (GAF) score was in the moderate range.

At the 4 January 2006 mental disorder VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported a history of depression, anxiety and sleeping problems. She felt moderately depressed at times, but was not receiving any psychiatric care, and stated that her symptoms had not interfered with her successful level of functioning at work or school. She had a boyfriend, but did not see him often due to work and school schedules. She denied ever being subjected to any severe trauma while in the Service, and noted that her panic attacks were less frequent and severe since discharge, with her last attack occurring several weeks before. She was sleeping well, no longer took prescription medication, and had not been hospitalized in the last 18 months. The MSE was unremarkable with the exception of a mildly depressed and slightly anxious mood. The examiner assessed panic disorder without agoraphobia, and rendered a GAF score of 80 for minimal symptoms/impairment.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the panic disorder with agoraphobia 10%, coded 9412 (panic disorder and or agoraphobia). The VA also rated the panic disorder 10%, coded 9412, based on the C&P examination, citing occupational and social impairment due to mild or transient symptoms which decreased work efficiency and ability to perform occupational task only during periods of significant stress; r symptoms controlled by continuous medication. 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. Regardless of the diagnosis, §4.130 rating is based on symptoms independent of diagnosis, therefore, all mental health symptoms are considered in the rating, and reflected in the panel’s recommendation.

The panel next proceeded with the rating recommendation, and considered the absence of ER treatment or hospitalization and the apparent stability of symptoms during the 9 months prior to separation and the 6 months after separation. The NARSUM addendum suggested that the CI’s condition was chronic but stable, despite marginal response to medication. Her panic attacks occurred intermittently, with no reports of chronic sleep impairment or problems with memory. The commanding officer indicated she was fully capable of performing her duties. The C&P

examiner noted her symptoms were mild and transient with no need for medication, and that she was functioning well at work and school with no sleep difficulties. Thus, panel members agreed that the 10% rating and no higher was justified for “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.”

Contended PEB Condition: Major Depressive Disorder. The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting. Although the contended condition was noted on limited duty forms, it was not specifically implicated in the NMA, and did not fail retention standards. There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation. Additionally, the condition was considered in the rating for the panic disorder IAW VASRD 4.130, and could not be recommended for additional rating IAW VASRD 4.14 (avoidance of pyramiding). After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.

BOARD FINDINGS: In the matter of the panic disorder with agoraphobia and IAW VASRD §4.130, the panel recommends no change in the PEB adjudication. In the matter of the contended major depressive disorder, the panel agrees it cannot recommend it for additional disability rating. 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:

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO,
1850
CORB: 003
10 Sep20

From: Director, Secretary of the Navy Council of Review Boards To:	 

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.