RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-04487 BRANCH OF SERVICE:  NAVY	SEPARATION DATE: 20040312

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Surface Ship Nuclear Propulsion Plant Operator, medically separated for “major depressive disorder [MDD]” with a disability rating of 10%.

CI CONTENTION: He was medically separated but given 0% by VA. The complete submission is at Exhibit A.

SCOPE OF REVIEW: The panel’s scope of review is defined in Do DI 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 - 20040112	VARD - 20051118	
Condition	Code	Rating	Condition	Code	Rating	Exam	
MDD	9434	10%	Major Depressive and Anxiety Disorder	9434	0%	STR	
Anxiety Disorder	Cat II	No VA Placement	
Personality Disorder NOS [Not Otherwise Specified] with Schizoid and
Borderline Traits	Cat IV	No VA Placement	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 0%	

ANALYSIS SUMMARY:

MDD. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s mental health (MH) condition began around 10 January 2003, when he reported feeling sad and alone with difficulty sleeping, low interest and energy, poor appetite, tearfulness and alienation of others due to his mood. During an evaluation on 28 January 2003, he was found psychiatrically unfit for full duty due to his emotional instability and placed on limited duty

(LIMDU) and anti-depressant medication. He was seen by a psychologist and referred to the MH clinic for possible psychopharmacological treatment and further psychotherapy in February 2003. At that time, he complained of protracted feelings of sadness, difficulty sleeping, low interest, low energy, poor appetite, tearfulness and depressed mood. He had no psychiatric history prior to active duty entry in February 1999, but reported a long history of family abuse, especially from his father whom he described as physically and emotionally abusive and an alcoholic. The CI was treated with a sleep aid and anti-depressant, due to severe depression and anxiety, and placed on LIMDU for 8 months.

The 2 October 2003 MEB NARSUM examination, 5 months prior to separation, noted CI complaints of extreme mood swings and the inability to sleep more than 2-3 hours a night. He described feeling high at times and spending money recklessly, and at other times, feeling quite depressed. He also reported suicidal thoughts during the previous 8 months, but had not acted on these impulses. The examiner noted some decrease in symptoms with medication, but “not enough improvement to make him fit for duty.” The mental status examination (MSE) showed a somewhat flat presentation, depressed mood, and slightly blunted affect. The CI was irritable, reported difficulty concentrating, and admitted to aggressive feelings towards others, especially when stressed. He had past suicidal ideations, but denied a current suicidal plan. The examiner recorded a “guarded” prognosis, with “little improvement over the past eight months,” and rendered an Axis I diagnoses of MDD and anxiety disorder NOS; and an Axis II diagnosis of personality disorder NOS with schizoid and borderline traits. The commander noted the CI was currently working out of his specialty due to his medical condition. 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 MDD 10%, coded 9434 (MDD), and listed anxiety disorder as a related Category II condition (contributes to the primary unfitting condition but not separately ratable). Panel members agreed that the impairment from the anxiety disorder was properly subsumed under the overall rating for the MDD IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). The PEB also listed personality disorder NOS with schizoid and borderline traits as a Category IV condition (does not constitute a physical disability). The VA rated the MDD 0%, also coded 9434, based on the STR, citing the CI’s failure to attend a scheduled examination.

The panel first considered the provisions of VASRD §4.129 (mental disorders due to traumatic stress), and agreed there was no evidence of a traumatic event or stressor causing the unfitting MH condition, and that application of VASRD §4.129 was not appropriate in this case. The panel next considered the §4.130 rating at the time of separation, and noted that the NARSUM documented some improvement, but that the CI remained depressed with congruent affect and no suicidal/homicidal ideation. There was no documentation of legal problems, violence or hospitalizations, and the examiner noted the condition would require ongoing outpatient treatment. Panel members agreed the CI’s condition most closely met criteria for a 10% disability rating. 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 MDD.

Contended PEB Condition: Personality Disorder NOS with Paranoid and Schizoid Traits. The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting. The contended condition was not noted on LIMDU forms or implicated in the non-medical assessment, 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. 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 MDD and IAW VASRD §4.130, the panel recommends no change in the PEB adjudication. In the matter of the contended anxiety disorder, the panel agrees it cannot recommend it for additional disability rating. In the matter of the contended personality disorder with paranoid and schizoid traits, the panel recommends no change from the PEB determinations as not unfitting. 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 REFLY REFER TO:
1850
CORB: 003
10 Sep 20

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 ofno 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.