Citation Nr: 18143284 Decision Date: 10/18/18 Archive Date: 10/18/18 DOCKET NO. 18-09 452 DATE: October 18, 2018 ORDER Entitlement to an initial disability rating in excess of 50 percent for posttraumatic stress disorder (PTSD) is denied. FINDING OF FACT The Veteran’s service-connected PTSD has resulted in no more than occupational and social impairment with reduced reliability and productivity. CONCLUSION OF LAW The criteria for a disability rating in excess of 50 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.10, 4.21, 4.125, 4.126, 4.130, Diagnostic Code (DC) 9411. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1985 to January 1986, from February 1987 to June 1992, and from February 2003 to June 2004. 1. Entitlement to a rating in excess of 50 percent for PTSD The Veteran contends that his PTSD meets the criteria for a rating higher than currently assigned. The Veteran’s PTSD is currently rated as 50 percent disabling from March 24, 2017. Disability ratings are determined by applying the criteria set forth in the VA’s Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10. In determining the severity of a disability, the Board is required to consider the potential application of various other provisions of the regulations governing VA benefits, whether or not they were raised by the Veteran, as well as the entire history of the Veteran’s disability. 38 C.F.R. §§ 4.1, 4.2; Schafrath v. Derwinski, 1 Vet. App. 589, 595 (1991). If the disability more closely approximates the criteria for the higher of two ratings, the higher rating will be assigned; otherwise, the lower rating is assigned. 38 C.F.R. § 4.7. It is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. In deciding this appeal, the Board has considered whether separate ratings for different periods of time are warranted, a practice of assigning ratings referred to as “staging the ratings.” See Fenderson v. West, 12 Vet. App. 119 (1999). The criteria for rating PTSD are found at 38 C.F.R. § 4.130, DC 9411. A 50 percent evaluation is warranted where there is occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short-and long-term memory; impaired judgment; impaired abstract thinking; disturbance of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. Id. A 70 percent evaluation is warranted where 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 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 and 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 work like setting); and inability to establish and maintain effective relationships. Id. A 100 percent evaluation requires 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; and memory loss for names of close relatives, own occupation, or own name. Id. Ratings are assigned according to the manifestation of particular symptoms. However, the use of the term “such as” in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). A veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage or others of similar severity, frequency, and duration. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013). Other language in Vazquez-Claudio indicates that the phrase “others of similar severity, frequency, and duration,” can be thought of as symptoms of like kind to those listed in the regulation for a given disability rating. Id. 116. If the evidence demonstrates that the claimant’s psychiatric disorder produces symptoms and resulting occupational and social impairment equivalent to that set forth in the criteria for a given rating in the General Rating Formula, then the appropriate, equivalent rating will be assigned. Mauerhan, 16 Vet. App. at 443. In this regard, the Board must consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran’s capacity for adjustment during periods of remission. 38 C.F.R. § 4.126. While VA considers the level of social impairment, it shall not assign an evaluation based solely on social impairment. Id. Private medical treatment records from May 2017 and June 2017 indicate that the Veteran denied any suicidal or homicidal thoughts. The Veteran denied any delusions or any auditory, visual, and tactile hallucinations. The Veteran reported problems with his memory and described it as “terrible.” He reported that the only person he trusts is his spouse of 25 years and that there have not been problems with coworkers or management because he works alone. The Veteran underwent a VA examination in August 2017. The report indicates that the Veteran exhibited occupational and social impairment with reduced reliability and productivity. The report indicates that the Veteran exhibited symptoms including depressed mood, anxiety, suspiciousness, panic attacks that occur weekly or less often, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships. The examiner stated that there was no evidence of hallucinations or delusions and that current impulse control, insight, and judgment appeared grossly intact. The Veteran denied suicidal ideation or intent but stated that “he will be glad when his life is over although he would never harm himself.” The Veteran was appropriately dressed and displayed good grooming and hygiene. Psychomotor activity was unremarkable. Eye contact was fair. Mood was anxious and affect was mood congruent. Thought processes were linear, logical and goal directed. There was no evidence of hallucinations or delusions. Current impulse control, insight, and judgment appeared grossly intact. The Veteran was engaged during the examination, but found it difficult to discuss deployment. Likewise, a September 2017 private treatment record from H.J., MD reflects that the Veteran was casually dressed, with normal speech tone and volume. Mood was ok. Affect was constricted but there was no pressured speech, no aphasia, and no dysarthria. There was no flight of ideas, no looseness of association. The Veteran denied auditory, visual and tactile hallucinations. He denied suicidal and homicidal ideation. The Veteran was alert and oriented, and there were no delusions. Based on the foregoing, the Board finds that the Veteran’s overall disability picture is manifested by symptoms which falls squarely within the criteria for the assignment of a 50 percent rating. Thus, the evidence is against granting a disability rating higher than 50 percent for the Veteran’s PTSD. The evidence does not show that the Veteran’s symptoms were of the type and degree contemplated by the criteria for a 70 percent disability rating. The evidence of record does not show that the Veteran has obsessional rituals, illogical speech, impaired impulse control, spatial disorientation, or an inability to establish and maintain effective relationships, nor does it show that the Veteran has reported suicidal or homicidal intent or ideation. Thus, the extent of his impairment has not been shown by the competent medical evidence of record to be that required for a 70 percent or higher rating at any time during the appeal period. In short, the Veteran’s overall disability picture is not manifested by deficiencies in most areas. Accordingly, the assignment of the next higher 70 percent rating is not warranted. (Continued on the next page)   As the preponderance of the evidence is against the claim for a rating in excess of 50 percent during the appeal period, the benefit-of-the-doubt doctrine is not applicable and the claim must be denied. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Labi, Associate Counsel