Citation Nr: 18159985 Decision Date: 12/20/18 Archive Date: 12/20/18 DOCKET NO. 16-48 378 DATE: December 20, 2018 ORDER Entitlement to an initial disability rating in excess of 10 percent for lumbosacral (lumbar) strain is denied. Entitlement to an initial disability rating in excess of 30 percent for an acquired psychiatric disorder, to include post-traumatic stress disorder (PTSD), chronic adjustment disorder, depression, and anxiety (hereinafter referred to as PTSD), is denied. FINDINGS OF FACT 1. The Veteran’s lumbar strain is manifested by forward flexion functionally limited to no less than 90 degrees, and by a combined range of thoracolumbar spine motion functionally limited to no less than 230 degrees; but not by guarding or muscle spasm severe enough to result in an abnormal gait or abnormal spinal contour, by ankylosis, or by intervertebral disc syndrome. 2. The Veteran’s service-connected psychiatric disorder is manifested by occupational and social impairment with occasional decreases in work efficiency and intermittent periods of inability to perform occupational tasks, but not by total occupational and social impairment, by occupational and social impairment with deficiencies in most areas, or by occupational and social impairment with reduced reliability and productivity. CONCLUSIONS OF LAW 1. The criteria for a disability rating in excess of 10 percent for lumbar strain have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. Part 4, 38 C.F.R. §§ 4.2, 4.3, 4.7, 4.10, 4.21, 4.40, 4.71a, Diagnostic Code(s) 5237, 5243. 2. The criteria for a disability rating in excess of 30 percent for psychiatric disability have not been met. 38 U.S.C. §§ 1155, 5107, 5110; 38 C.F.R. Part 4, 38 C.F.R. §§ 3.400, 4.2, 4.3, 4.7, 4.21, 4.126, 4.130, Diagnostic Code 9411. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from December 2010 to January 2012 with additional active duty service from August 2009 to October 2009. The Veteran had additional service in the United States Army Reserve totaling six years, which began in February 2008 and ended in February 2014. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision of the Newark, New Jersey, Regional Office (RO) of the Department of Veterans Affairs (VA). Increased Ratings The Veteran appeals to the Board contending that her service connected disabilities are more severe than currently reflected by her assigned disability ratings. Disability evaluations are determined by comparing a Veteran’s present symptomatology with criteria set forth in VA’s Schedule for Rating Disabilities (Rating Schedule), which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. When a question arises as to which of two ratings apply under a particular diagnostic code, the higher evaluation is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. In both initial rating claims and normal increased rating claims, the Board must discuss whether “staged ratings” are warranted, and if not, why not. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). It is not expected, especially with the more fully described grades of disabilities, that all cases will show all the findings specified; findings sufficiently characteristic to identify the disease and the disability therefrom are sufficient; and above all, a coordination of rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21. It is the responsibility of the rating specialist to interpret reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of the present disability. 38 C.F.R. § 4.2. Consideration of factors wholly outside the rating criteria constitutes error as a matter of law. Massey v. Brown, 7 Vet. App. 204, 207-08. The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value. Masors v. Derwinski, 2 Vet. App. 181 (1992); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992); Hatlestad v. Derwinski, 1 Vet. App. 164 (1991). Where a claimant, or the record, raises the question of unemployability due to the disability for which an increased rating is sought, then part of the increased rating claim is an implied claim for TDIU. The Board has considered whether an inferred claim for a total disability rating based on individual unemployability has been raised. Rice v. Shinseki, 22 Vet. App. 447 (2009). However, because Rice does not suggest that a disagreement with a decision denying entitlement to an increased rating must be read to include a disagreement with the denial of TDIU, and as the record shows the Veteran is gainfully employed, the Board finds that an inferred claim for TDIU pursuant to Rice is not raised. It is the policy of VA to administer the law under a broad interpretation, consistent with the facts in each case with all reasonable doubt to be resolved in favor of the claimant. However, the reasonable doubt rule is not a means for reconciling actual conflict or a contradiction in the evidence. 38 C.F.R. § 3.102; 38 C.F.R. § 4.3. 1. Entitlement to a disability rating in excess of 10 percent for lumbar strain When rating a disability, the rating agency shall consider all the evidence of record and assign a rating based on the level of functional impairment. The basis of disability evaluations is the ability of the body as a whole, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. This imposes upon the medical examiner the responsibility of furnishing, in addition to the etiological, anatomical, pathological, laboratory and prognostic data required for ordinary medical classification, full description of the effects of disability upon the person’s ordinary activity. 38 C.F.R. § 4.10. The Veteran is currently rated as 10 percent disabled for lumbar strain. Under 38 C.F.R. § 4.71a, Diagnostic Code 5237: A 10 percent disability rating is assigned when a veteran’s forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent disability rating is assigned when a veteran’s forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 40 percent disability rating is assigned when a veteran has unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent disability rating is assigned when a veteran has unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent disability rating is assigned when a veteran has unfavorable ankylosis of the entire spine. When evidence is present, VA shall evaluate any objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code. Note (1) following the General Rating Formula for Diseases and Injuries of the Spine. Under 38 C.F.R. § 4.71a, Diagnostic Code 5243: A 10 percent disability rating is assigned when a veteran has incapacitating episodes having a total duration of at least one week but less than two weeks during the past 12 months. A 20 percent disability rating is assigned when a veteran has incapacitating episodes having a total duration of at least two weeks but less than four weeks during the past 12 months. A 40 percent disability rating is assigned when a veteran has incapacitating episodes having a total duration of at least four weeks but less than six weeks during the past 12 months. A 60 percent disability rating is assigned when a veteran has incapacitating episodes having a total duration of at least six weeks during the past 12 months. Analysis The Veteran contends that her lumbar strain is more severe than represented by her assigned disability rating. During the appellate period, an August 2015 VA examination noted that the Veteran’s lumbar strain began while on deployment to Afghanistan in 2012. The Veteran sustained an injury to her lower back while exercising. Since then, she has reported symptoms such as: extreme pain, weakness, radiating pain from the lumbosacral area into lower extremities, and being limited in certain movements. The VA examiner noted on the August 2015 examination report that the Veteran had no findings of radiculopathy at the time of the examination, explaining that radiculopathy typically improves or often resolves with time. Other pertinent findings contained within the August 2015 VA examination were as follows: the Veteran had no other neurologic abnormalities, such as bowel or bladder problems; the Veteran had not reported flare-ups; the Veteran did report having functional impairment regardless of repetitive use when running long distances, lifting heavy objects, sitting or standing for extended periods of time, and difficulty sleeping; the Veteran did not show evidence of pain with weight-bearing; the Veteran did not show evidence of guarding or muscle spasm with regard to her thoracolumbar spine; the Veteran did not show signs of radicular pain; the Veteran did not have ankylosis of her spine; the Veteran did not show signs of neurologic abnormalities; the Veteran did not have intervertebral disc syndrome (IVDS); and the Veteran did not have arthritis. With regard to functional loss, the VA examiner noted that the examination was neither medically consistent or inconsistent with the Veteran’s statements describing functional loss with repetitive use over time. The Veteran underwent muscle strength testing, reflex examination, and sensory examination; which all revealed normal findings. The VA examiner concluded that the Veteran’s service connected lumbar strain impacts her ability to work by limiting her ability to perform tasks such as, heavy lifting. “[F]unctional loss... may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion.” Range of motion (ROM) testing revealed: forward flexion to 90 degrees with no objective evidence of painful motion; extension to 20 degrees with no objective evidence of painful motion; right lateral flexion to 30 degrees with no objective evidence of painful motion; left lateral flexion to 30 degrees with no objective evidence of painful motion; right lateral rotation to 30 degrees with no objective evidence of painful motion; and left lateral rotation to 30 degrees with no objective evidence of painful motion; and a combined ROM of the thoracolumbar spine totaling 230 degrees. The VA examiner noted the Veteran’s subjective complaints of pain on examination associated with her extension ROM. However, the VA examiner also indicated that there was no objective evidence of localized tenderness or pain on palpitation of the joints or associated soft tissue of the thoracolumbar spine. According to a September 2014 private medical examination, the Veteran suffered from: displacement of the lumbar intervertebral disc at L5-S1 with narrowing of the right foramen, and a disc bulge at L4-L5 contacting the exiting right L4 nerve root; chronic lumbar strain/sprain; and somatic dysfunction of the thoracic, lumbar, sacrum, lower limb, and rib cage. The Veteran had an additional private medical examination on February 19, 2013, where she reported the following: progressively worsening pain; pain level graded at 8/10; stiffness and aching with intermittent stabbing bilateral leg pain; and aggravated pain levels when running or working out. The Veteran indicated to the private provider that physical therapy had helped her in the past and that she underwent an outpatient transforaminal lumbar epidural steroid injection procedure on February 11, 2013. The procedure was performed without any complications and the Veteran reported that the injection helped to improve her left-sided leg pain; however, her left-sided low back pain had gotten worse. Additionally, the Veteran had an MRI of her lumbar spine in January 2013, which revealed the following: normal lordosis, a disc bulge at L4-L5, and a right foraminal disc herniation at L5-S1. Also, the Veteran reported radiating pain into her lower extremities. Review of the record shows that on VA examination, the Veteran was able to forward flex her thoracolumbar spine to 90 degrees, and had a combined range of thoracolumbar motion exceeding 210 degrees. Notably, despite her complaints of pain and weakness associated with her lower back disorder, the Veteran did not evidence any painful motion or weakness, and the examiner otherwise was unable to identify any clinically evident functional loss affecting the thoracolumbar spine. Although she reported functional impairment at the extremes of activity, such as after running long distances or after lifting heavy objects, she did not report functional impairment with ordinary levels of activity, and in any event did not clinically demonstrate any functional impairment. She also denied any flare ups. Private medical reports do not describe her range of thoracolumbar motion, and only report functional loss complaints similar to those evaluated by the August 2015 examiner. The August 2015 examiner also noted the absence of any guarding or muscle spasm. Diagnostic studies, while showing evidence of degenerative changes, did not demonstrate any abnormal spinal contour; to the contrary, the Veteran’s lordosis was normal, and no spinal deformities were identified. A 20 percent evaluation requires forward flexion limited to at least 60 degrees, a combined range of motion limited to at least 120 degrees, or muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour. Here, the evidence shows that even when the Veteran’s account of pain and weakness are considered, her forward flexion is clearly not limited to less than 90 degrees, and the combined range of thoracolumbar motion is well in excess of 120 degrees. Moreover, examination has shown the absence of any muscle spasm, gait disturbance or guarding, and diagnostic studies show that the Veteran’s spinal contour is not abnormal. As noted previously, the August 2015 examiner noted that the Veteran denied any recent flare ups. Given the above, the Board finds that even when the Veteran’s complaints of functional loss are considered, she clearly does not have limitation of thoracolumbar spine motion that even remotely approximates the criteria for a 20 percent evaluation. Nor, in the absence of muscle spasm, guarding or an altered gait, is there a basis to otherwise assign an evaluation in excess of 10 percent. The Board notes that in the absence of any ankylosis, there is no basis for assignment of a 50 or 100 percent evaluation. Turning to the Veteran’s neurological complaints, the Board finds that the Veteran does not have a neurologic condition associated with the thoracolumbar spine disability that may be separately rated. In this regard, diagnostic studies show the Veteran has disc herniation at L5-S1 and a disc bulge at L4-L5. She also reports radiating left leg pain. Notably, however, she has not been diagnosed with radiculopathy or any other nerve impairment associated with the lower back disorder. The August 2015 examiner specifically noted that the Veteran’s leg pain was not radicular in nature. That examination also revealed the absence of any sensory or reflex abnormalities, and the examiner concluded the Veteran did not have any associated neurologic abnormalities. The Board consequently finds that the evidence does not establish that the Veteran has a neurologic condition associated with the thoracolumbar spine disorder; a separate rating for such a condition is not for application. Turning to the evidence of disc herniation, the Board has considered whether a rating higher than 10 percent is warranted under the IVDS code. For a rating higher than 10 percent, the evidence must show incapacitating episodes of IVDS lasting at least two weeks during a year. The record does not contain any suggestion, including from the Veteran that she experienced any incapacitating episodes that required physician-prescribed bed rest. The Board consequently finds that a rating in excess of 10 percent based on the IVDS criteria is not warranted. Therefore, the claim for entitlement to a disability rating in excess of 10 percent for lumbar strain is denied. 38 U.S.C. § 5107; Gilbert v Derwinski, 1 Vet. App. 49, 54 (1990). 2. Entitlement to a disability rating in excess of 30 percent for an acquired psychiatric disorder For the sake of economy, the Board will refer to the Veteran’s acquired psychiatric disorder as “PTSD.” The Veteran is currently rated as 30 percent disabled for PTSD, under 38 C.F.R. § 4.130, Diagnostic Code 9411. She contends that her disorder is more severe than currently contemplated by her assigned disability rating. When rating a medical disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and a veteran’s capacity for adjustment during periods of remission. The rating agency shall assign a rating based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner’s assessment of the level of disability at the moment of the examination. When rating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment, but shall not assign a rating solely on the basis of social impairment. 38 C.F.R. § 4.126. Under 38 C.F.R. § 4.130, Diagnostic Code 9440: A 30 percent rating is assigned when a veteran’s psychiatric disorder causes occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, or mild memory loss (such as forgetting names, directions, recent events). A 50 percent rating is assigned when a veteran’s psychiatric disorder causes 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-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; or difficulty in establishing and maintaining effective work and social relationships. A 70 percent evaluation is assigned when a veteran’s psychiatric disorder causes 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 worklike setting); or an inability to establish and maintain effective relationships. A 100 percent rating is assigned when a veteran’s psychiatric disorder causes total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; danger of hurting self or others; intermittent inability to perform activities of living (including maintenance of minimal hygiene); disorientation to time or place; or, memory loss for names of close relatives, occupation, or own name. 38 C.F.R. § 4.130. Analysis The use of the term ‘such as’ in the general rating formula for mental disorders 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 symptoms, or their effects, that would justify a particular rating. It is not required to find the presence of all, most, or even some, of the enumerated symptoms recited for particular ratings. The use of the phrase ‘such symptoms as,’ followed by a list of examples, provides guidance as to the severity of the symptoms contemplated for each rating, in addition to permitting consideration of other symptoms particular to each veteran and disorder, and the effect of those symptoms on his/her social and work situation. Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). In Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013), the United States Court of Appeals for the Federal Circuit (Federal Circuit) stated that “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.” It was further noted that “§ 4.130 requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment in most of the referenced areas.” Id. The Veteran contends that her PTSD is more severe than represented by the present evaluation. The Veteran provided copies of private medical reports to VA for the appeal period. A letter from one of her private providers, dated September 26, 2016, stated that the Veteran had received treatment at their facility for psychiatric services since August 12, 2016, and that she was attending weekly sessions. During an August 2015 VA examination, the examiner summarized the Veteran’s level of occupational and social impairment as being due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. The VA examiner described the Veteran’s behavior as being: calm; somewhat blunted and depressed affect; anxious; and very tearful at times during the interview. She also had feelings of detachment from others and suffered from persistent negative views about the world and others. The Veteran wished to avoid talking about her traumatic history as it related to one of her duties as a prison guard in Afghanistan. She was constantly ridiculed, harassed, and physically threatened by the prisoners; who at one point, found out her full-name and where she was from in the United States. The Veteran also indicated that the situation was especially difficult on her because of the fact that she was a female of Arab decent, but was also a Christian. The prisoners called her a “traitor” and threatened to kill her and her family in America. She reported that such an emotionally traumatic experience caused her to have feelings of isolation and disconnectedness with relatives once she returned from her deployment. Despite having those feelings, the Veteran stated that she was living with her mother and two brothers and that they had a good relationship. The Veteran also indicated that she graduated from with a criminal justice degree in 2013 and was working full-time as a police officer. She reported getting along well with her fellow officers and superiors. It was also noted during the examination that the Veteran had attended visits with a psychologist and that she felt the sessions were beneficial. The VA examiner observed that the Veteran’s speech and thinking processes were both logical and productive. Additionally, the Veteran denied suicidal or homicidal ideations. The Board acknowledges that the VA examiner mistakenly used the male pronoun in his report. The Veteran contends that this mistake damages the probative value of the report. However, in assigning probative weight to any medical opinion, the Board must consider whether it is: (1) based on sufficient facts or data; (2) the product of reliable principles and methods; and (3) the result of principles and methods reliably applied to the facts. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008). It may also consider whether the examiner had access to the claims file, reviewed prior clinical records and pertinent evidence, and provided a thorough, detailed and definitive opinion supported by a detailed rationale. Prejean v. West, 13 Vet. App. 444, 448-9 (2000). The August 2015 VA Examination/DBQ is adequate to address the Veteran’s claim. It is predicated upon a review of the claims file and the medical records contained therein, it includes a description of the Veteran’s PTSD, and it contains an adequate medical opinion along with reasons and bases for the opinion rendered. The Board finds no indication that the examiner was evaluating anyone else other than the Veteran, or that he was inaccurate in any other observation. The Board finds the improper use in this case of the male pronoun is of no significance to the probative weight of the report. Accordingly, it is entitled to great probative weight. The Veteran maintained that after her August 2015 VA examination, she was still suffering from chronic sleep disturbances as well as panic attacks; anxiety; and difficulty remembering to complete tasks. She also stated that she was still feeling emotionally distant from her family and friends, and that she felt her mood was still was still being negatively impacted by her PTSD. The Veteran contended that all of these factors were making it hard for her to function at work. The Board notes that the Veteran is competent to attest to her symptoms and how she feels they have impacted her ability to perform her duties at work. Additionally, the Veteran is competent to describe how her PTSD affects her social relationships because she had been feeling more distant from people. Jandreau, 492 F. 3d at 1372. The Board acknowledges that it is required to consider all the evidence of record, including both lay and medical evidence when making competence, credibility, and weight determinations. Washington, 19 Vet. App. at 368. The Board also acknowledges that while the Veteran is competent to convey that which comes to her through her senses, she is not competent to make the determination that her symptoms are such that, her PTSD is severe enough to warrant a higher disability rating than what she is currently rated at. Layno, 6 Vet. App. at 469. Lay persons are competent to provide opinions on some medical issues, Kahana, 24 Vet. App. at 435, the specific issue here; i.e.: the severity of her PTSD, falls outside the realm of common knowledge of a normal person. Jandreau, 492 F. 3d at 1377. The severity of the disability at issue and the percentages associated therewith, are not the types of things readily amenable to lay diagnosis or probative comment regarding etiology or increases in severity to a certain degree. Davidson, 581 F. 3d at 1313; Woehlaert, 21 Vet. App. at 462. The Veteran’s mere assertion that an assigned disability rating should be higher without at least one competent medical professional’s well-reasoned analysis in support of that opinion, does not warrant an increased rating. Despite the Veteran’s contentions and based on the evidence presented in the instant case, a higher disability rating is not warranted because the objective medical evidence does not rise to a level of total occupational and social impairment; occupational and social impairment with deficiencies in most areas; or, occupational and social impairment with reduced reliability and productivity. Mauerhan, 16 Vet. App. at 442. The Veteran consistently reported feeling disconnected and isolated from her family and friends, but the record reflects that she has, in fact maintained her personal and work relationships over the course of the appellate period. She reported having “good” relationships with her family and she reported that she gets along with her coworkers and supervisors. The Veteran has also reported feeling so depressed that it is difficult for her to function at her job as well as having memory loss and sleep issues. Notably, however, she has denied any suicidal ideation, and the record does not suggest near continuous depression. While she does evidence disturbance of mood, the Board finds that this symptom alone particularly in the absence of other symptoms contemplated in higher ratings, is not of sufficient frequency or severity as to warrant a higher rating. Moreover, the Veteran has been able to function adequately in society by finishing college and becoming gainfully employed. In fact, she has shown to be able to consistently hold down a job where she must interact with coworkers and the public at all times. Her thought processes were also described as productive. Although she reports experiencing panic attacks, she has not described near continuous panic, or even panic attacks occurring more than once per week. The Board notes that she evidenced blunting of affect on examination. Notably however, the examiner did not identify any flatting of affect. The August 2015 examiner noted that the Veteran’s level of occupational and social impairment with regard to her PTSD was due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. In essence, the examiner determined that her psychiatric impairment was consistent with a 30 percent rating. The Board also finds that the Veteran’s current level of symptomatology more nearly approximates the criteria for no more than a 30 percent rating. She has shown consistently throughout the appellate period that she can be effective at her job, and that she can maintain her close relationships despite periods of feeling depressed/isolated. She has not demonstrated that her symptoms are of the type, frequency or severity as to warrant a higher rating. Based upon the foregoing, as well as the most probative evidence of record, the Board finds that the Veteran’s service connected PTSD is manifested by no more than occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress. The pertinent evidence shows that the Veteran’s occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks have not prohibited her from being able to perform her job duties as a police officer. Nor have the occasional decreases prohibited her from being able to maintain effective work and social relationships. Hence, there is not enough probative evidence in the record to demonstrate an occupational and social impairment with reduced reliability and productivity due to the Veteran’s PTSD. Here, the VA examination report is found to be adequate and persuasive, and the evidence suggests that the Veteran’s current disability rating of 30 percent is most appropriate. The medical findings in this case directly address the criteria under which this disability is evaluated and the objective medical evidence is accorded greater weight than the subjective assertions by the Veteran that her current symptomatology warrants a higher disability rating. The Veteran is competent to report the symptoms that she is experiencing, but not to identify a specific level of disability. The law dictates that, “when a veteran seeks benefits and the evidence is in relative equipoise, the veteran prevails.” In this case, the preponderance of the evidence is against the Veteran’s claim for an increased rating for PTSD. 38 U.S.C. § 5107; Gilbert v Derwinski, 1 Vet. App. 49, 54 (1990). Therefore, the claim for entitlement to a disability rating in excess of 30 percent for PTSD is denied. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Meiners