Citation Nr: 18159882 Decision Date: 12/20/18 Archive Date: 12/20/18 DOCKET NO. 15-40 334 DATE: December 20, 2018 ORDER A 100 percent disability rating for an anxiety disorder is granted. FINDING OF FACT Giving the Veteran the benefit of the doubt, for the entire appeal period, the Veteran’s anxiety disorder is manifested by total occupational and social impairment. CONCLUSION OF LAW The criteria for a maximum 100 percent disability rating for an anxiety disorder have been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.3, 4.7, 4.130, Diagnostic Code 9413 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1994 to August 1995. In an April 2015 rating decision, the RO granted a total disability rating based on individual unemployability (TDIU), which is effectively a 100 percent rating. 1. A disability rating higher than 70 percent for anxiety disorder. The Veteran contends that a 100 percent disability rating is warranted for his anxiety disorder, from his current 70 percent disability rating. The next higher, maximum 100 percent evaluation is warranted when there is evidence of 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, Diagnostic Code 9413. Giving the Veteran the benefit of the doubt, the Board finds that a 100 percent disability rating is warranted. The Board notes that in his November 2015 VA Form 9, following his last VA examination in June 2014, the Veteran reported that his condition had worsened. As the Board is fully granting the Veteran’s claim, a remand for a new VA examination is not necessary. The June 2014 VA examiner found occupational and social impairment with reduced reliability and productivity, indicative of a 50 percent disability rating. The examiner further noted that he had essentially severe anxiety problems, with significant functional limitations of routine activities of daily living. He rarely drives or leaves home and relies on his mother for shopping and cooking. He was capable of routine self-care. The Board finds, however, that VA medical records and credible lay statements support finding that his symptoms are worse than indicated by the VA examination. An August 2011 record documented social anxiety, difficulty being around other people, being unable to leave the house, and panic attacks resulting in him needing to leave a situation right away. Similarly, in an October 2014 record, he reported that he could not function out in the world and that the only places he went were to doctor appointments. In his November 2015 substantive appeal, he reported that he had gotten worse, could not get out of bed, never left the house, and was always nervous something bad to happen or hurt someone. A June 2016 VA medical record documented that the Veteran’s nephew reported that over the past 2 months the Veteran had grown out his hair and beard, spent all day in bed, and seemed like “he’s given up.” In a February 2017 letter, the Veteran’s VA medical provider reported that the Veteran was diagnosed with mood, psychotic, and substance use disorders and would benefit from a fiduciary to help manage finances as his mental health conditions can impair his judgment and ability to make sound financial decisions. In a May 2018 rating decision, the RO found that the Veteran was competent. Various March 2017 VA medical records document that the Veteran had been admitted for in-patient treatment for drug abuse. One March 2017 record documented that the Veteran endorsed chronic psychotic symptoms over the past 20 years of auditory hallucinations (undiscernible voices at night) and paranoid delusions (people out to get him on behalf of his ex-wife), and that such symptoms were exacerbated by his substance abuse. He further indicated that the paranoia was likely based on a valid concern for his wife seeking past retribution, but that his fears have likely magnified this beyond any real basis over time. In a March 17, 2017 VA medical record, the Veteran denied any suicidal or homicidal ideations, but reported that he came in due to having thoughts of hurting people, but no one person specifically. A September 2017 VA medical record documented that the Veteran had been admitted due to suicidal ideation in the context of drug and alcohol use. The Board finds that giving the Veteran the benefit of the doubt, his symptoms may be consistent with a maximum 100 percent disability rating, indicting total occupational and social impairment. A 100 percent disability rating is granted. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Lindio