RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2018-00527 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20080815

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E3, Basic Marine, medically separated for “major depression, recurrent, in partial remission,” and “generalized anxiety disorder, mild” with a disability rating of 0%.

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 - 20080616	VARD - 20090807	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Major Depression	Overall Effect	0%	Major Depression and Generalized Anxiety Disorder/Dysthymic Disorder	9434-9400	50%	STR	
Generalized Anxiety Disorder							
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 70%	

ANALYSIS SUMMARY:

Major Depression/Generalized Anxiety Disorder. The PEB combined the major depression and generalized anxiety disorder, under a single disability rating for “overall effect.” This is permitted by DoDI 1332.38 (E3.P3.4.4) when the combination of multiple conditions reflects the PEB’s determination that each condition was not separately unfit, but the functional impairment resulting from the conditions when considered together was unfitting. However, mental health (MH) conditions, regardless of one or multiple diagnoses, are given a single rating based on social and occupational impairment IAW VASRD 4.130. Therefore, the panel is obliged to determine the degree of impairment from both diagnosed conditions and assign one rating. The evidence for both mental disorders is presented together. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI was diagnosed with major depression in October 2007, and later developed anxiety. He had a good response with Celexa (anti-depressant) and buspirone (anti-anxiety agent), and did not require emergency room (ER) care or hospitalization. The 21 February 2008 MEB NARSUM examination, 6 months prior to separation, noted complaints of mild symptoms of restlessness, feeling on edge, irritability, trouble falling and

staying asleep, difficulty concentrating, and muscle tension. While his symptoms had improved significantly with medications, he experienced fatigue as a side effect, and had to be removed from training, which contributed to anxiety issues. The mental status examination (MSE) was unremarkable. The examiner noted that despite the fatigue from his medications, the CI needed to continue taking them to controlled depressive symptoms and passive suicidal ideation. The 19 March 2008 non-medical assessment recommended retaining the CI.

At the 21 October 2009 VA Compensation and Pension (C&P) examination, 14 months after separation, the CI reported difficulties with sleep and focusing, and felt worried most of the time. He also reported depressive symptoms and that he stopped taking his medication after separation. He had worked at one job for 8 months before leaving for another job in security, which lasted for 6 months until he got “tired of getting yelled at” by the public and his supervisors. He planned to stay at his current full-time night job, and was also in a good relationship and engaged to be married. The MSE was unremarkable, with the exception of depressed mood and flat affect; dysthymic disorder was diagnosed.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the overall effect of the mental health (MH) conditions 0%, without coding, noting the major depression was in partial remission and generalized anxiety condition was “mild.” The VA rated the MH condition 50%, dual coded 9434-9400 (major depressive disorder-generalized anxiety disorder), based on the C&P examination. The panel 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. When considering the rating recommendation, panel members noted the absence of ER treatment, or hospitalization, and the apparent stability of symptoms for several months prior to separation. The NARSUM recorded a normal MSE, and the absence of chronic insomnia, panic attacks, problems with memory, and suicidal or homicidal thoughts. The NARSUM examiner indicated that were it not for the fatigue caused by the CI’s medication, he might have been able to perform his duties since anxiety and depression symptoms were well-controlled. Although the STR clearly indicated a need for continuous medication, the CI had minimal MH treatment, and there was no evidence of significant impairment in social or occupational functioning as a result of the condition. The C&P examination offered limited probative value since it was too remote from separation. Panel members agreed that a 10% rating, and no higher, was justified for symptoms controlled by continuous medication. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the MH conditions, coded 9434-9400.

BOARD FINDINGS: In the matter of the major depression and generalized anxiety disorder, the panel recommends a disability rating of 10%, coded 9434-9400 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	PERMANENT RATING	
Major Depression and Generalized Anxiety	9434-9400	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 12 Oct 20

From: To:

Subj:

Ref:

Director, Secretary of the Navy Council of Review Boards 
PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

(a) DoDI 6040.44
(b)	PDBR ltr of 1 Apr 20
(b)	

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy for appropriate action.

2.	On 7 October 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) took action in your case by accepting the recommendation of the PDBR. Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEE) from 0% to 10% without re-characterization of your discharge.

3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement to additional compensation.

4.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, has been forwarded to the office of the Deputy Commandant, Manpower and Reserve Affairs, for appropriate changes to your personnel records and notification to you upon completion.