Citation Nr: 18141279 Decision Date: 10/10/18 Archive Date: 10/10/18 DOCKET NO. 13-20 277 DATE: October 10, 2018 ORDER Effective August 31, 2010, a 50 percent rating for anxiety disorder, not otherwise specified (psychiatric disability), is granted. FINDING OF FACT 1. The Veteran’s psychiatric disability is productive of panic attacks, impaired judgment and difficulty in establishing and maintaining effective work and social relationships. 2. The preponderance of the evidence shows that the Veteran’s psychiatric disability is not productive of occupational and social impairment with deficiencies in most areas. CONCLUSION OF LAW The criteria for an initial 50 percent rating, but no higher, for psychiatric disability have been met. 38 U.S.C. §§ 1154 (a), 1155, 5107 (b) (2012); 38 C.F.R. §§ 3.102, 4.130, Diagnostic Code (DC) 9400 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from November 1965 to July 1969. This matter came before the Board of Veterans’ Appeals (Board) on appeal from a March 2011 rating decision by the Department of Veterans’ Affairs (VA) Regional Office (RO). The Veteran contends that the manifestations of his psychiatric disability warrant a rating greater than 30 percent. The Veteran was rated at 30 percent under DC 9400 for his psychiatric disability. The Board evaluates the Veteran’s psychiatric disability under the General Rating Formula for Mental Disorders pursuant to 38 C.F.R. § 4.130, DC 9400. A 50 percent rating is warranted when there is occupational and social impairment with reduced reliability and productivity due to such symptoms such as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short-term and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 38 C.F.R. § 4.130, DC 9411. A 70 percent rating is warranted when there is occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms such as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately an effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 38 C.F.R. § 4.130, DC 9411. A 100 percent rating encompasses total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 38 C.F.R. § 4.130, DC 9411. The evidence considered in determining the level of impairment under 38 C.F.R. § 4.130 is not restricted to the symptoms provided in the code. Mauerhan v. Principi, 16 Vet. App. 436, 443 (2002). The Board must consider all symptoms of a claimant’s condition that affect the occupational and social impairment. Mauerhan v. Principi, 16 Vet. App. 436, 443 (2002). If the evidence demonstrates that a Veteran suffers symptoms or effects that cause occupational or social impairment equivalent to what would be caused by the symptoms listed in the DC, the appropriate, equivalent rating will be assigned. Mauerhan v. Principi, 16 Vet. App. 436, 443 (2002). After looking to the frequency, severity, and duration of the Veteran’s impairment to assess his disability picture, the Board finds that the preponderance of evidence demonstrates that disability due to the Veteran’s psychiatric disorder has approximated the schedular criteria for an initial rating of 50 percent, and no higher. See Vazquez–Claudio v. Shinseki, 713 F.3d 112, 117 (Fed. Cir. 2013). While the VA Examination Reports of record indicate that the Veteran has been able to maintain a sensible and supportive home and family life, in that he has been married for over thirty-five years to his spouse, and further indicates that he has a few friends in whom he keeps in contact with, the records overwhelmingly demonstrate that the Veteran’s psychiatric disability symptoms have reduced his reliability and productivity. See VA Examination Report, November 2010; see also VA Examination Report, June 2010. The Veteran has reported having nightmares and hallucinations since service in Vietnam. See VA Examination Report, November 2010. The Veteran’s spouse submitted lay statements corroborating the Veteran’s report of his symptoms that are most often experienced in the home. See Statement of Veteran’s Spouse, June 2018. According to the Veteran’s spouse, the Veteran’s anxiety has caused him to become irritable and angry ultimately resulting in outbursts of anger for no reason. See Statement of Veteran’s Spouse, June 2018. He has displayed a “flaring temper” when he gets angry and his hands begin to tremble as his anxiety increases. See Statement of Veteran’s Spouse, June 2018. Additionally, she also stated that he is a restless sleeper who often roams around the house displaying obsessive behaviors such as checking and rechecking the doors and windows to ensure they are locked, even after he witnessed them being locked and secured. See Statement of Veteran’s Spouse, June 2018. The Veteran’s spouse also stated that while interacting with family, he will either express his opinions or disassociate himself from his family if they are discussing a topic that he wishes not to discuss. See Statement of Veteran’s Spouse, June 2018. His spouse has also witnessed the Veteran having nightmares two to three times a week about death, destruction, rockets exploding and sirens going off in Vietnam. See Statement of Veteran’s Spouse, June 2018. She stated that the Veteran has difficulty socializing with his own friends and has difficulty meeting new people and that he often struggles with his memory at least once daily. See Statement of Veteran’s Spouse, June 2018. Although an August 2010 VA Examination demonstrates that the Veteran interacts with other Veterans while working and that he is able to hold conversations with these individuals, the Board finds that the credible and competent statement of the Veteran’s spouse is highly probative and far outweighs this finding from the August 2010 report. The Veteran’s spouse is competent to report the symptoms that she has observed in the current year while in the Veteran’s presence, and throughout her marriage to the Veteran for the last thirty-five years. Thus, the Board finds that her statements are an accurate depiction of the current impact on the Veteran’s occupational and social impairment. More specifically, the Board acknowledges that the Veteran’s spouse’s statements reflect that the Veteran has experienced disturbances of mood and motivation, difficulty in establishing and maintaining social relationships, impaired judgment, abstract thinking and short and long-term memory. See 38 C.F.R. § 4.130, DC 9411. The Board, however, finds that the preponderance of the evidence shows that the Veteran’s psychiatric disability is not of such severity as to more closely approximate occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking or mood, as required for a 70 percent rating. The fact that the Veteran has been able to socialize with other Veterans that he identifies with, indicates that he exercises social skills while at work. See Statement of Veteran’s Spouse, June 2018. The Veteran also indicated that he is able to go to restaurants, church and to the movies with his family and that he would be able to be in a country fair environment, if asked. See VA Examination, October 2010. The Veteran has shown his ability to maintain familial relationships as he has been married to his spouse for over thirty-five years and also indicated that his interests are “t.v. and [his] grandchildren.” See VA Examination, November 2010. This evidence strongly suggests that the Veteran’s overall occupational and social impairment is not deficient in most areas given his ability to maintain a social network and an interest in family relations. Likewise, the Board cannot conclude based on the symptomatology that the Veteran’s psychiatric disability is of such a severity as to produce total occupational and social impairment as required for a 100 percent rating. The evidence does not demonstrate that the Veteran experienced gross impairment in thought processes or communication; persistent hallucination; gross inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation, or own name. 38 C.F.R. § 4.130, DC 9400. Although the Veteran’s spouse stated in her August 2010 statement that the Veteran had episodes of nightmares and hallucinations, there is no evidence that the hallucinations continued or that they were persistent. Group records from August 2010 through August 2018 VA Examinations indicate that the Veteran posed no harm or danger to himself or to others and that he appeared well-dressed and well-groomed at his examination appointments. There is no indication from the Veteran’s spouse’s statement that she ever witnessed the Veteran to be disoriented as to time and place or that he could not remember the names of close relatives, his occupation or his own name. Therefore, a finding of total occupational and social impairment is unfounded, as the Veteran’s symptoms do not approximate the symptoms necessary for a 100 percent rating. In sum, resolving all reasonable doubt in the Veteran’s favor, the Board finds that the evidence supports an initial 50 percent disability rating, and no more, for his psychiatric disability. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Jones, Associate Counsel