Citation Nr: 20032269 Decision Date: 05/07/20 Archive Date: 05/07/20 DOCKET NO. 18-39 686 DATE: May 7, 2020 ORDER Entitlement to an initial 50 percent rating, but no higher, for posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT 1. For the entire appeal period the Veteran’s PTSD has resulted in occupational and social impairment with reduced reliability and productivity and difficulty in establishing and maintaining effective work and social relationships. CONCLUSION OF LAW 1. Resolving all reasonable doubt in favor of the Veteran, the criteria for a 50 percent rating, but no higher, for PTSD have been met. 38 U.S.C. § 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.2, 4.3, 4.7, 4.126, 4.130, Diagnostic Code (DC) 9411. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1967 to February 1969. This matter is on appeal from a February 2018 rating decision. In the August 2018 substantive appeal, the Veteran limited his appeal to the issue of an initial increased rating for PTSD. He further limited his appeal of the disability rating to seeking a 50 percent disability rating for PTSD throughout the appeal period. The Veteran did not indicate that he is seeking a disability rating in excess of the percentage listed, the evidence does not suggest a higher rating is warranted, and the Veteran has not indicated that higher rating criteria are met or approximated. As such, the instant Board decision granting a 50 percent disability rating for PTSD for the entire rating period on appeal represents a full grant of benefit sought by the Veteran concerning this issue. 1. Entitlement to an initial 50 percent rating, but no higher, for PTSD Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4. The Rating Schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of or incident to military service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise the lower rating will be assigned. 38 C.F.R. § 4.7. All benefit of the doubt will be resolved in the Veteran’s favor. 38 C.F.R. § 4.3. While the Veteran’s entire history is reviewed when assigning a disability evaluation, where service connection has already been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55 (1994). However, the Court has since held that in determining the present level of a disability for any increased evaluation claim, the Board must consider the application of staged ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). In other words, where the evidence contains factual findings that demonstrate distinct time periods in which the service-connected disability exhibited diverse symptoms meeting the criteria for different ratings during the course of the appeal, the assignment of staged ratings would be necessary. The General Rating Formula for Mental Disorders provide for a noncompensable rating for a formally diagnosed mental condition manifested by symptoms that are not severe enough either to interfere with occupational and social functioning or to require continuous medication. A 10 percent for psychiatric disorders is warranted if there is occupational and social impairment due to mild or transient symptoms which decrease work efficiency and the ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. A rating of 30 percent is warranted if there is 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 for 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 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; and difficulty in establishing and maintaining effective work and social relationships. A 70 percent disability rating is assigned for 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 that is 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 work-like setting); and inability to establish and maintain effective relationships. A 100 percent disability rating is assigned 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; and memory loss for names of close relatives, or for the Veteran’s own occupation or name. 38 C.F.R. § 4.130. The symptoms recited in the rating schedule for evaluating mental disorders are “not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating.” Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). In adjudicating a claim for an increased rating, the adjudicator must consider all symptoms of a claimant’s service-connected mental condition that affect the level of occupational or social impairment. Id. at 443. The Veteran’s PTSD is rated under DC 9411. Such disability is rated under the General Rating Formula for Mental Disorders as set forth above. Based on the Veteran’s May and July 2018 statements wherein he discussed significant problems from anxiety, panic attacks and trouble establishing and maintaining work and social relationships as well as the reports from the most recent VA examination to assess the severity of the Veteran’s service connected PTSD conducted in January 2018 at which time he endorsed similar symptomatology, the undersigned has resolved all reasonable doubt in the Veteran’s favor to find that a 50 percent rating may be assigned for the Veteran’s PTSD. 38 U.S.C.§ 5107(b); 38 C.F.R. §§ 3.102, 4.7; Gilbert, supra. The Board notes that although the Veteran has limited his appeal to 50 percent the weight of the evidence is against the assigment of a rating in excess of 50 percent for PTSD. Such is based on the Veteran’s statements of his ability to maintain relationships with his family, and the fact that he was able to maintain the same employment for over 30 years and the circumstances surrounding his leaving the work force some 10 years ago were not related to his PTSD. Also considered in making this decision was the determination at the January 2018 VA examination that the Veteran’s PTSD only resulted in 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. In short therefore, as the preponderance of the evidence weighs against the assigment of a rating in excess of 50 percent for PTSD, such a rating cannot be assigned. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7, 4.130; Gilbert, 1 Vet. App. at 49. In reaching its determinations above, the applicable rating criteria have not been considered as an exhaustive list of symptoms, but rather as examples of the type and degree of the symptoms or effects that would justify a particular rating. The undersigned has not required the presence of a specified quantity of symptoms in the rating schedule in determining the proper rating for assigment. In summary, the Board finds that a higher 50 percent rating for the Veteran’s PTSD is warranted throughout the appeal period. The Veteran’s manifestations of his PTSD were relatively consistent throughout the appeal. This represents a full grant of the benefit sought on appeal. MARJORIE A. AUER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Kelly A. Gastoukian 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.