RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX  	CASE:  PD-2017-04741
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20060628

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Information Management Specialist, medically separated for “generalized anxiety disorder” rated 50%, with a 40% deduction, for a total disability rating of 10%.  

CI CONTENTION:  Review requested of “continued depression and alcoholism.”  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 - 20060510	VARD - 20070327	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Generalized Anxiety Disorder…	9400	50%-40%=10%	Generalized Anxiety Disorder	9400	10%	20061030	
Alcohol Dependence	Cat III	No VA Placement	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Generalized Anxiety Disorder.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s mental health (MH) condition was initially documented in January 2006 after he was found cutting his wrist/forearm with a steak knife while intoxicated.  He was admitted to an inpatient psychiatry unit, and following hospitalization, he was enrolled in the partial hospital program for substance abuse, and subsequently went into full remission.  

During the 5 March 2006 MEB NARSUM examination, 4 months prior to separation, the CI reported a history of worry accompanied by restlessness, difficulty concentrating and irritability.  Since treatment with medication, the symptoms lessened and his alcohol dependence also improved.  The mental status examination was unremarkable except for anxious mood, but suicidal ideation was absent.  The examiner noted the principal diagnosis of alcohol dependence, in early full remission, and generalized anxiety disorder.  A Global Assessment of Functioning score (GAF) of 70 (mild symptoms) was recorded.  

At the 30 October 2006 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported no current MH symptoms while taking his medication.  The examiner noted no emergency room treatment for MH issues since the January 2006 hospitalization, and that he was studying for a real estate license.  The MSE was normal with a GAF score of 70.  

The panel directed attention to its rating recommendation based on the above evidence.    The PEB rated the anxiety disorder 50% and deducted 40% for aggravating/contributory factors for a final 10% rating, coded 9400 (generalized anxiety disorder), citing mild social and industrial adaptability impairment associated with alcohol dependence, but “considerable” overall social and industrial impairment.  The VA rated the anxiety disorder 10%, coded 9400, based on the C&P examination, citing VASRD §4.130 criteria.  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 in this case.  The panel next considered the §4.130 rating at the time of separation, and noted that the STR, NARSUM and the C&P examinations documented mild MH symptoms and GAF scores with alcohol dependence in remission at separation and beyond.  Although panel members were unable to justify a rating higher than 10%, the PEB specifically recorded the following remarks:  “The IPEB also notes your [CI] alcohol dependence, a non-ratable/non-compensable condition under disability law/policy, and opines it significantly affects the severity of your overall social and industrial adaptability impairment.  The Board opines were it not for the non-ratable/non-compensable condition, your social and industrial adaptability impairment rating would best be described as None to Mild with a 10% rating IAW Department of Defense/Veterans Administration Schedule for Rating Disabilities guidelines.”  In compliance with VASRD guidelines, which do not allow deductions in this case, a 40% deduction cannot be recommend although the evidence supports a 10% rating for mild social and industrial impairment.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 50% (no deduction) for the anxiety disorder, coded 9400.  Alcohol dependence is a condition that does not constitute a physical disability IAW DoDI 1332.38, enclosure 5.  The panel therefore has no basis for recommending the condition as unfitting.  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 generalized anxiety disorder, the panel recommends a disability rating of 50%, coded 9400 IAW VASRD §4.130.  In the matter of the contended alcohol dependence, 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.  

The panel recommends the CI’s prior determination be modified as follows; and, that the discharge with severance pay be re-characterized to reflect permanent disability retirement, effective the date of medical separation:  

	VASRD CODE	PERMANENT RATING	
Generalized Anxiety Disorder	9400	50%	

The following documentary evidence was considered:  

Dear XXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-04741.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was not in accordance with the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended your separation be re-characterized to reflect disability retirement, rather than separation with severance pay.

I have carefully reviewed the evidence of record and the recommendation of the Board.    I concur with that finding, accept the recommendation and determined that your records should be corrected accordingly.  The office responsible for making the correction will inform you when your records have been changed.

As a result of the aforementioned correction, you are entitled by law to elect coverage under the Survivor Benefit Plan (SBP).  Upon receipt of this letter, you must contact the Air Force Personnel Center at to make arrangements to obtain an SBP briefing prior to rendering an election.  If a valid election is not received within 90 days from the date of this letter, you will not be enrolled in the SBP program unless at the time of your separation, you were married, in such a case, failure to render an election will result in automatic enrollment by law.