RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXX	CASE: PD-2017-03981
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20050801

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Infantryman, medically separated for “posttraumatic stress disorder [PTSD]” with a disability rating of 10%.

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 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 - 20050801	VARD – 20060525	
Condition	Code	Rating	Condition	Code	Rating	Exam	
PTSD	9411	10%	PTSD	9411	50%	STR	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 50%	

ANALYSIS SUMMARY:

PTSD. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI was medically evacuated for a medical problem unrelated to PTSD, but was subsequently seen in the psychiatry clinic in December 2004 for complaints of feeling “constantly depressed and anxious.” The 3 May 2005 MEB NARSUM examination, 3 months prior to separation, noted complaints of anxiety, nightmares, hyper-vigilance, startle reflex, poor sleep and frequent episodes of disorientation. The CI reported being frequently exposed to combat while in Iraq and was a “nervous wreck” on a daily basis. He had problems with sleep and tension in his marriage. The mental status examination was unremarkable with the exception of anxious and depressed mood and affect, and was frequently tearful. There was no report of problems with memory or panic attacks, and no history of suicidal or homicidal ideation, visits to the emergency room for mental health (MH) symptoms, or psychiatric hospitalizations. 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 PTSD 10%, coded 9411 (PTSD) citing the requirement for psychotropic medication and outpatient treatment with normal duty performance. The VA rated the PTSD 50%, coded

9411, based on the STR, citing VASRD § 4.130 criteria. In accordance with the DoD requirement directing the application of VASRD section §4.129 to all unfitting PTSD determinations, panel members recommended a retroactive 6-month period of constructive TDRL. The panel next proceeded with its rating recommendation under VARSD §4.130 based on the evidence at constructive TDRL placement and agreed the record in evidence did not support a rating higher than the minimum 50% rating at TDRL placement. There was no evidence of impaired judgment, and suicidal ideation was not present at any time during service. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 50% at TDRL placement.

Panel members next considered whether the evidence at the time of TDRL removal and permanent disability disposition supported a rating higher than the 10% rating adjudicated by the PEB. There were no treatment records during the constructive TDRL period and no C&P examination. There was no mention of mood symptoms at work or problems with co-workers or supervisors, and no report of domestic or workplace violence, psychiatric hospitalizations or ER visits. The CI had no history of panic or anxiety attacks, and no significant occupational impairment due to a MH disorder as he maintained full-time employment during the 2 years after separation. He had no MH follow-up treatment since separation. The panel considered the record in totality, and concluded the evidence demonstrated the CI’s condition was most consistent with the 10% level of disability 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, or; symptoms controlled by continuous medication.” After due deliberation, considering the totality of 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% (IAW VASRD §4.129), and a permanent rating of 10% for the PTSD.

BOARD FINDINGS: In the matter of the PTSD, the panel recommends an initial TDRL rating of 50% 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	
Post-Traumatic Stress Disorder	9411	50%	10%	

PD-2017-03981

AR20200000296, XXXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXX

	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.

	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. 

	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), XXXXXXXXXXXXXXXXXXXXXXXXX.

	A copy of this decision has also been provided to the Department of Veterans Affairs

PD-2017-03981