RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXX	CASE: PD-2017-03962
BRANCH OF SERVICE:  NAVY	SEPARATION DATE: 20060801

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

CI CONTENTION: “Respectfully request to be medically retired as the condition of my disability prevented me from reaching my goal of 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 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 – 20060516	VARD – 20070223	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Major Depressive Disorder	9434	10%	PTSD with Depression	9411	50%	20060221	
PTSD	Cat II					
COMBINED RATING: 105	COMBINED RATING OF ALL VA CONDITIONS: 50%	

ANALYSIS SUMMARY:

Major Depressive Disorder (MDD). According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s MDD began after his service in Iraq (February -May 2003) when he saw the devastation caused by the missiles he was in charge of firing. He thought he was handling the situation well until about 6 months after redeployment when his infant son nearly drowned while he was watching him at home. He stated the experiences in Iraq exacerbated his own feelings of guilt, hopelessness, anxiety and depression. In October 2005, he was found to have depressed mood with thoughts of suicide, and was admitted for inpatient psychiatric care.

The 24 March 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of ongoing symptoms. He was taking two anti-depressant medications and was compliant with both inpatient and outpatient treatment; he had been on limited duty since 15 November 2005. The mental status examination (MSE) showed a depressed mood with consistent affect and no suicidal ideation; the remainder of the examination was normal. Diagnoses of MDD and PTSD

were rendered with a Global Assessment of Functioning (GAF) score of 60-70 (borderline moderate to mild symptoms, impairment). The examiner noted the major stressor as “occupational,” and that continued significant depressive and anxiety symptoms impaired his ability to perform his job.

At the 21 December 2006 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI reported his depression and hospitalization, and that he had run out of medication a 1 month before due to affordability of care. He had difficulty falling asleep and nightmares of people screaming, and awoke feeling frightened and almost panicked. Certain songs or types of music brought back thoughts of the dead bodies in Iraq as well as seeing his son in situations that reminded him of the near drowning. He reported occasional flashbacks of incidents in Iraq and other symptoms of PTSD and depression, but stated he felt a little better with medication. He successfully completed two certification programs just prior to separation and obtained a job working as an electronics technician upon discharge. His relationships with his wife and mother were good, but he felt his relationship with his children “could be better.” The MSE showed a sad mood and blunted affect, and he described a few panic attacks while outside the examination room. Some suspicion was noted and thinking processes were slow. Diagnoses of MDD and PTSD were rendered with a GAF score of 50 (moderate bordering on severe symptoms and impairment). The examiner opined the CI was in need of intensive ongoing treatment and noted that when not working, he tended to isolate and withdraw from his family.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the MDD 10%, coded 9434 (major depressive disorder). The PEB also listed PTSD as a Category II (related to the primary unfitting condition, but not separately ratable). The VA rated PTSD with depression 50%, coded 9411 (PTSD), based on the C&P examination, citing the 50% rating criteria. The panel first considered the provisions of VASRD §4.129 (mental disorders due to traumatic stress), and determined that the MDD 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. The most proximate source of comprehensive evidence on which to base the permanent rating was the C&P examination performed 5 months after TDRL placement. Although the CI continued to be depressed and have symptoms of PTSD, he reported some improvement with medication, had been working since separation, and had good to fair family relationships. He had no further hospitalizations, legal problems or emergency room visits, and thus the panel majority determined the condition most closely met criteria for a 10% disability at TDRL removal. After due deliberation, 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 MDD, coded 9434.

BOARD FINDINGS: In the matter of the major depressive disorder, the panel majority recommends a TDRL rating of 50%, coded 9434 in retroactive compliance with VASRD §4.129 and a 10% permanent rating IAW VASRD §4.130. The single voter for dissent recommends modification to 30% at TDRL removal and did not elect to submit a minority opinion. There are no other conditions within the panel’s scope of review for consideration.

The panel majority recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	RATING	
		TDRL	PERMANENT	
Major Depressive Disorder	9434	50%	10%	

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:	XXXXXXXXXXXX

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.