Citation Nr: 18110808 Decision Date: 06/13/18 Archive Date: 06/13/18 DOCKET NO. 15-10 602A DATE: June 13, 2018 ORDER Entitlement to an evaluation of 100 percent for service-connected psychotic disorder is granted. FINDINGS OF FACT For the period on appeal, the symptoms and overall impairment caused by the Veteran’s psychotic disorder, including homicidal ideation, auditory hallucinations, paranoid beliefs, depression, impaired judgement, a chronic sleep impairment, a limited ability to attend to basic tasks of personal hygiene and medication management, impaired impulse control and an inability to communicate, most nearly approximated a total occupational and social impairment. CONCLUSIONS OF LAW The criteria for an evaluation of 100 percent for psychotic disorder are met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 3.400, 4.7, 4.130, Diagnostic Code 9411 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1987 to February 1991. Entitlement to an evaluation in excess of 50 percent for service-connected psychotic disorder. The Veteran’s service-connected psychotic disorder is currently evaluated as 50 percent disabling pursuant to 38 C.F.R. § 4.130, Diagnostic Code 9210. The Board finds a uniform 100 percent evaluation is warranted for the period on appeal. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App 119 (1999). A 100 percent rating is assigned for total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions; 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 closes relatives, own occupation, or own name. To the extent that the medical evidence reflects diagnoses of other psychiatric disorders, where it is not possible to distinguish the effects of nonservice-connected conditions from those of a service-connected condition, the reasonable doubt doctrine dictates that all symptoms be attributed to the Veteran’s service-connected disability. See Mittleider v. West, 11 Vet. App. 181 (1998). On VA examination in January 2013, the Veteran endorsed symptoms of homicidal ideation; however, it was noted the Veteran did not have a plan or intent. The Veteran was found to have auditory hallucinations, paranoid beliefs, depression, impaired judgement, and chronic sleep impairment. See January 2013 VA Examination. The Board notes that the examiner opined the Veteran should be reexamined after a period of sobriety. Also, the Veteran was found to be a persistent danger to himself and others; competency was subsequently addressed by the AOJ. See September 2013 Rating Decision. In support of his claim, the Veteran submitted a December 2014 psychiatric evaluation. This evaluation indicated that even when the Veteran’s polysubstance abuse disorder was in full remission, his psychotic disorder was manifested by a limited ability to attend to basic tasks of personal hygiene and medication management, impaired impulse control, and an inability to communicate. See December 2014 Psychiatric Opinion. While the December 2014 examiner, Dr. P. S., discusses other mental health diagnoses, specifically schizophrenia, the Board interprets this opinion to indicate the symptoms listed above are associated with the Veteran’s service-connected psychotic disorder. Mittleider, 11 Vet. App. at 181. In sum, the record reflects that the Veteran’s psychotic disorder was characterized by extremely severe symptoms, including homicidal ideation, a limited ability to attend to basic tasks of personal hygiene and medication management, impaired impulse control and an inability to communicate, auditory hallucinations, paranoid beliefs, depression, impaired judgement, a chronic sleep impairment, and inability to establish and maintain effective relationships, resulting in a total occupational and social impairment. These symptoms are most consistent with a 100 percent evaluation as they are indicative of a gross impairment in thought processes or communication; persistent delusions; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living. The Board has considered remanding the claim to determine the current severity of the Veteran’s psychotic disorder, however, his representative provided a December 2017 statement indicating his disability remains severe. (Continued on the next page)   Accordingly, affording reasonable doubt, a 100 percent rating is warranted. See Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990); 38 C.F.R. § 3.102. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Trickey, Jonathan