Citation Nr: 18161319 Decision Date: 12/31/18 Archive Date: 12/31/18 DOCKET NO. 15-39 012 DATE: December 31, 2018 ORDER A 100 percent disability rating for posttraumatic stress disorder (PTSD) with major depressive disorder is granted. FINDING OF FACT Giving the Veteran the benefit of the doubt, for the entire appeal period, the Veteran’s PTSD is manifested by total occupational and social impairment. CONCLUSION OF LAW The criteria for a maximum 100 percent disability rating for PTSD 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 9411 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1987 to October 1993. The Veteran testified at a hearing before the RO in January 2016. He did not attend his scheduled November 2018 Board hearing. The Board notes that in a January 2018 rating decision, the RO granted a total disability rating based on individual unemployability (TDIU) to the Veteran, based on his PTSD and obstructive sleep apnea. The Veteran has not claimed, and per the evidence of record, the Veteran would not be considered unemployable solely due to his service-connected sleep apnea, metatarsalgia unilateral with acquired pes cavus, or right thumb fracture, without consideration of his PTSD. 1. A disability rating higher than 70 percent for PTSD with major depressive disorder. The Veteran contends that a 100 percent disability rating is warranted for his PTSD with major depression, 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 9411. Giving the Veteran the benefit of the doubt, the Board finds that a 100 percent disability rating is warranted. The Board notes that VA examinations have generally indicated findings consistent with ratings lower than 100 percent. The November 2014 VA examination found 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, indicative of a 30 percent disability rating. A March 2017 VA examination found - occupational and social impairment with reduced reliability and productivity, indicative of a 50 percent disability rating. The Board finds, however, that VA medical records, Vet Center records, and credible lay statements support finding that his symptoms are worse than indicated by the VA examinations. VA medical records generally show periods of worse symptoms than indicated by the VA examinations, including in treatment appointments that occurred around the time of the VA examinations. For example, a March 2015 VA medical record documented that the Veteran’s wife reported that he had threatened self-harm to her a few months previously. A December 2016 VA medical record noted occasional visual hallucination of colors. A January 2017 VA medical record documented a report of possible mild auditory hallucinations. A February 2017 VA medical records also documented possible auditory hallucination. A February 15, 2017, record documented reports of increased depression symptoms and a period of increased self-harm thoughts and unhealthy behavioral choices, such as skipping shows and shaving and wearing dirty clothes. An August 2015 Vet Center record similarly indicates more severe PTSD symptoms. For example, his provider reported that his behavior bordered on being a persistent danger of hurting himself or others, that his memory was worsening and that he would forget the previous day or forget how to get to places. The provider also noted reports that the Veteran did not have the ability to think abstractly and see the consequences of his actions, though he could justify it in his mind. He would also become disoriented when he wakes up and sometimes hallucinate. Credible lay testimony during a January 2016 RO hearing also showed more severe symptoms. For example, his wife reported that the Veteran talked about suicide more. His memory had gotten very poor. She reported that his hygiene had worsened, and he would need to be reminded to shower and brush his teeth. Additionally, sometimes he would hallucinate, such as believing a bird was attacking him. The Board finds that giving the Veteran the benefit of the doubt, his symptoms are 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