RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04630
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060831

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Unit Supply Specialist, medically separated from the Temporary Disability Retired List (TDRL) for “schizoaffective disorder” with a disability rating of 10%. 

CI CONTENTION:  Review all conditions.  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 - 20060815	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Schizoaffective Disorder	9211	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Schizoaffective Disorder.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s mental health (MH) disorder began in June 2003 after reporting an auditory hallucination associated with a recently purchased doll and "seeing a ghost."  She was admitted for inpatient psychiatric evaluation and treatment, and diagnosed with a brief psychotic disorder, which was later changed to major depression with psychotic features.  The CI was separated and placed on TDRL on 25 February 2004.

At the 25 April 2006 TDRL NARSUM examination, 4 months prior to separation, she reported doing better overall, but complained of feeling down for 1 or 2 days, once or twice a month.  During these episodes, she felt depressed, sometimes had suicidal thoughts, and often had auditory hallucinations.  She worked a 40-hour work week, and about once a week, she would respond when she thought someone called her name, but coworkers would tell her nobody was asking for her.  The CI received no MH care since being placed on the TDRL, and had not been hospitalized.  She had some difficulty with maintaining sleep, but was able to fall back to sleep after 30 minutes.  Her energy was up and down, but she had no concentration issues most of the time.  She reported financial struggles and that she drank heavily with friends 4 days each week; she got along “okay” with her family.  Mental status examination recorded normal grooming, more spontaneous speech than at her previous visit, and affect that was fuller and appropriate.  The CI described her mood as “better,” and there was no evidence of a formal thought disorder or psychotic content.  Memory was not impaired and judgment was intact.  The examiner noted some improvement in mood since the last visit, with her condition characterized as “fairly stable;” prescriptions were written for an antidepressant and an antipsychotic medication during the appointment.  There was no VA examination proximate to TDRL removal in evidence. 

The panel directed attention to its rating recommendation based on the above evidence.  The CI was removed from TDRL with a permanent disability disposition of separation with severance pay at 10% for schizoaffective disorder citing mild industrial impairment.  Members first agreed that the provision 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 proceeded with the rating recommendation and considered the absence of MH treatment, emergency room visits or hospitalization since being placed on TDRL.  The NARSUM examiner indicated that the CI’s symptoms were fairly stable with no impairment or workplace issues. Therefore, members agreed that a 10% rating, but 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, or; symptoms controlled by continuous medication.”  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 schizoaffective disorder at the time of TDRL removal.

BOARD FINDINGS:  In the matter of the schizoaffective disorder and IAW VASRD §4.130, the panel recommends no change in the PEB adjudication at the time of TDRL removal.  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:

, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

      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.

Enclosure