Citation Nr: 18144572 Decision Date: 10/24/18 Archive Date: 10/24/18 DOCKET NO. 16-18 747 DATE: October 24, 2018 ORDER A rating in excess of 70 percent for posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. The Veteran had active service from March 1992 to March 1996. 2. For the entire period on appeal, the Veteran’s PTSD has been manifested by symptoms such as a desire to harm people when angry, hypervigilance, anxiety, and avoidance of thoughts and feelings associated with traumatic experiences, resulting in occupational and social impairment in work, judgment, and mood but less than total occupational and social impairment. CONCLUSION OF LAW The criteria for a rating in excess of 70 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.130, Diagnostic Code 9411 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSION Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Under DC 9411 and the General Rating Formula for Mental Disorders, a 70 percent rating 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. A 100 percent evaluation for a psychiatric disability is warranted for 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. Upon careful review of the evidence of record, the objective medical evidence and the lay statements regarding the Veteran’s symptomatology more nearly approximate symptoms associated with no more than a 70 percent rating for the entire period on appeal. Specifically, the Veteran has exhibited a variety of symptoms, including anxiety due to fear of the unknown, mild depression, desire to harm people when angry, recurrent nightmares, avoidance of thoughts, feelings, and people associated with traumatic experiences, feelings of detachment or estrangement from others, persistent arousal affecting sleep, hypervigilance, and anxious mood. He has also been noted as having social and work related functional impairments such as unprovoked irritability and difficulty adapting to stressful circumstances. Specifically, in 2010, he was fired from his job as a prison security guard for beating up an inmate and reported in his August 2014 VA examination that he suffered from continuing violent outbursts. However, despite these symptoms, the evidence does not indicate that PTSD symptoms have caused him to experience the level of social and occupational impairment required for a 100 percent. To that end, in the August 2014 examination, he reported that he maintains a good relationship with his two children and described his marriage as “fine.” He also stated that he had worked full time as a transportation manager for the last three years and described his work performance as “okay.” In addition, he reported his leisure activities as music and attending family events but stated a decreased interest in working out. However, despite this decreased interest, his ability to work full time and maintain good relationships with family members weighs against a finding of total occupational and social impairment. The medical evidence also coincides with the lay evidence. One factors listed in the 100 percent schedular rating is a persistent danger of hurting oneself or others. In a February 2014 suicide risk assessment, the examiner noted that the Veteran was at a low risk for suicide, further providing support that a 100 percent rating is not warranted. In March 2014, the Veteran underwent a mental status examination conducted by private psychologist. The Veteran was reported to be oriented to person, place, and time. His long and short-term memories fell within normal limits, as evidenced by his ability to correctly spell the word “world” forward and backward, as well as his recall of his previous evening meal and the location of his birthplace. His intelligence fell within average range but his concentration, judgment, and insight fell below normal limits. Further, the private clinician noted that the Veteran’s angry outbursts were likely to substantially negatively impact his employability. Based on the evidence above, an increased rating is not warranted. Although the Veteran was noted by the examiner to have impairment in thought processes or communication, there is no indication that this was a gross impairment, as his immediate, long-term, and short-term memories were intact and he was found to be of average intelligence. Also, other than the 2010 incident at his previous job, the evidence does not show that his angry outbursts have negatively impacted his employment, as he has been employed by the same company for three years and no other work-related incidents were mentioned in the record. Moreover, the examiner reported that the Veteran was oriented to all three spheres and did not note a history of persistent delusions or grossly inappropriate behavior that would support a 100 percent rating. Therefore, although he does exhibit a level of impairment, it does not appear to be gross impairment. The August 2014 examiner specifically described the Veteran’s impairment as occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. As he is able to manage his financial affairs and maintain a normal routine behavior and self-care, including working full time, the evidence supports no more than a 70 percent rating. The Board has also considered the Veteran’s lay statements that his disability is worse. While he is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, Layno v. Brown, 6 Vet. App. 465, 470 (1994), he is not competent to identify a specific level of disability PTSD according to the appropriate diagnostic codes. Such competent evidence concerning the nature and extent of the Veteran’s PTSD has been provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings (as provided in the examination reports and other clinical evidence) directly address the criteria under which PTSD is evaluated. Moreover, as the examiner has the requisite medical expertise to render a medical opinion regarding the degree of impairment caused by the disability and had sufficient facts and data on which to base the conclusion, the Board affords the medical opinion great probative value. As such, these records are more probative than the Veteran’s subjective complaints of increased symptomatology. In sum, after a careful review of the evidence of record, the benefit of the doubt rule is not applicable and the appeal is denied. As to the duty to assist, the Veteran contends that the Regional Office (RO) violated the Veterans’ Claims Assistance Act (VCAA) when it failed to address a March 2014 psychological evaluation made by his private clinician in its rating decision. However, this report was part of the evidence considered on the initial grant of service connection and initial rating. Therefore, the Board finds no due process violation. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not   required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Ragofsky, Legal Clerk