Citation Nr: 20006554 Decision Date: 01/28/20 Archive Date: 01/27/20 DOCKET NO. 15-41 526 DATE: January 28, 2020 ORDER Entitlement to a 100 percent disability rating for an acquired psychiatric disability is granted. FINDING OF FACT Throughout the period on appeal, the Veteran’s acquired psychiatric disorder produced total occupational and social impairment. CONCLUSION OF LAW The criteria for a 100 percent disability rating for an acquired psychiatric disability have been met. 38 U.S.C. § 1155, 5107; 38 C.F.R. § 4.130, Diagnostic Code (DC) 9411. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 2003 to November 2008. In the Board’s April 2019 decision, a 70 percent disability rating and TDIU was granted. However, the claim was bifurcated under the same docket number to remand to obtain records that may show the Veteran’s acquired psychological disability warranted a total disability rating. The additional development was completed, and claim has returned to the Board. Entitlement to a disability rating greater than 70 percent for an acquired psychiatric disability Ratings for service-connected disabilities are determined by comparing the Veteran’s symptoms with criteria listed in VA’s Schedule for Rating Disabilities, which is based, as far as practically can be determined, on average impairment in earning capacity. Separate diagnostic codes identify the various disabilities. 38 C.F.R. Part 4. When rating a service-connected disability, the entire history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). The Veteran’s PTSD is currently evaluated as 70 percent disabling from November 7, 2008; 100 percent disabling from October 17, 2012, and; 70 percent from December 1, 2012, pursuant to 38 C.F.R. § 4.130, Diagnostic Code 9413. The Board finds that a 100 percent rating is warranted for the entire period on appeal. Under Diagnostic Code 9413, a rating of 100 percent is assignable 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. 38 C.F.R. § 4.130, Diagnostic Code 9413. During the December 2012 VA examination, the Veteran reported that he was unemployed prior to the VA finding employment for him. At his February 2019 Board hearing, the Veteran testified that he regularly gets into heated arguments with coworkers. The Veteran also advised that he has been married twice and has no relationships with his siblings or parents. The Veteran regularly had suicidal ideations with previous attempts and reported habitual self-harm (over 31 body piercings) in existing treatment records, the December 2012 VA examination and his February 2019 Board hearing. Prior to the Board’s April 2019 remand, the records that were in the file at the time showed that the Veteran’s psychiatric disorder manifested symptoms associated with a 70 percent rating (e.g., suicidal ideation, depression affecting the ability to function appropriately and effectively, difficulty in adapting to stressful circumstances and inability to establish and maintain effective relationships). He also had symptoms associated with a 50 percent rating (e.g. panic attacks more than once a week and disturbances of motivation and mood) and other symptoms that are not listed with a specific rating, such as alcohol abuse, chronic sleep impairment and anxiety. During the Veteran’s February 2019 Board hearing, he testified that during the period on appeal he was hospitalized for suicide attempts and had suicidal ideations. The Veteran was also homeless. None of these records were in the file. Subsequently, the Board decided in an April 2019 decision to bifurcate the issue on appeal to allow a grant of a 70 percent disability rating and TDIU and to also remand the claim to obtain the missing records in effort to identify whether the Veteran was entitled to a total disability rating. Pursuant to the Board’s April 2019 remand, the Veteran’s outstanding treatment records were obtained and associated with the record. These records show that in August 2014, the Veteran was admitted to a hospital following a suicide attempt and reported having suicidal thoughts since that attempt two to three times per week. In October 2019, the Veteran contacted the suicide hotline after having suicidal ideations. The Veteran also told the intervention counselor that he had various plans; he was also argumentative and combative with the counselor and refused a safety plan. The suicide hotline center notified local police to check the Veteran’s wellbeing. VA treatment records from December 2019 show that police involuntarily brought the Veteran to the hospital for a mental health evaluation after a suspicious text message to his girlfriend about waking up alive. During the hospital evaluation the Veteran reported experiencing audiological hallucinations but denied suicidal ideation. The Veteran had a VA examination in May 2019. The examiner did not have the records the Board remanded the claim for at the time of the examination. It is also apparent that the Veteran was less than truthful with the examiner pertaining to his alcohol consumption reporting to the examiner that he only drinks on occasion. However, the Veteran did report that he was self-medicating with alcohol for his PTSD symptoms. Since the examiner did not have access to the pertinent private treatment records, the Board finds this examination to be inadequate. The Board finds the severity, frequency, and duration of the Veteran’s symptoms more closely approximate the symptoms contemplated by a 100 percent rating. The Veteran experienced total occupational and social impairment, due to such symptoms as: persistent hallucinations, persistent danger to hurting himself and intermittent inability to perform activities of daily living (maintenance of minimal personal hygiene) with his excessive odor of alcohol. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. G. Perkins, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.