Citation Nr: 21070635 Decision Date: 11/24/21 Archive Date: 11/24/21 DOCKET NO. 15-32 796 DATE: November 24, 2021 ORDER A 70 percent disability rating for posttraumatic stress disorder (PTSD), but not higher, is granted throughout the duration of the appeal, subject to the laws and regulations governing the award of monetary benefits. FINDING OF FACT Throughout the duration of the appeal, the probative evidence of record indicates the Veteran's PTSD has been productive of occupational and social impairment with deficiencies in most areas, including work, judgment, thinking and mood. CONCLUSION OF LAW The criteria for a 70 percent rating, but not higher, for PTSD throughout the appeal period 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 June 2007 to June 2011. The Veteran's PTSD has been assigned a 30 percent disability rating prior to April 15, 2015, a 50 percent disability rating prior to August 25, 2017 and a 70 percent disability rating from August 25, 2017 under 38 C.F.R. § 4.130, DC 9411, which is evaluated under the general rating formula for mental disorders. Under this general rating formula for psychiatric disabilities, a 30 percent disability rating is warranted when a 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, mild memory loss (such as forgetting names, directions, recent events). A 50 percent rating is warranted when a 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 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; difficulty in establishing and maintaining effective work and social relationships. 38 C.F.R. § 4.130. A 70 percent rating is warranted when a 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 work-like setting); inability to establish and maintain effective relationships. Id. A 100 percent rating is warranted when a 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; 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. Id. When determining the appropriate disability evaluation to assign, the Board's primary consideration is the Veteran's symptoms, but it must also make findings as to how those symptoms impact the Veteran's occupational and social impairment. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013). Because the use of the term "such as" in the rating criteria demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, the Board need not find the presence of all, most, or even some, of the enumerated symptoms to award a specific rating. Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). Nevertheless, as all ratings in the general rating formula are also associated with objectively observable symptomatology and the plain language of the regulation makes it clear that the Veteran's impairment must be "due to" those symptoms, a veteran may only qualify for a given disability by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. Vazquez-Claudio, 713 F.3d at 118. The probative evidence of record, including the VA medical records, the June 2016 and March 2018 letters from VA treatment providers and the October 2011, April 2014, August 2015, April 2017 and April 2018 VA examination reports, collectively indicates that, throughout the duration of the appeal, the Veteran's PTSD was productive of symptoms, at worst, resulting in occupational and social impairment with deficiencies in most areas, including work, judgment, thinking and mood. These records demonstrate the Veteran's psychiatric symptoms, at worst, included: high anxiety; severe depression; weekly panic attacks; chronic sleep disturbance; nightmares; flashbacks; irritability and anger with violent outbursts; chronic to passive suicidal thoughts and ideation; poor energy and concentration; reckless and destructive behavior; visual hallucinations of feeling someone in the room daily; social isolation and withdrawal; exaggerated startle response; hypervigilance; phobia of small children crying triggered traumatic experience; difficulty adapting to stressful circumstances; suspiciousness; and difficulty in maintaining effective work and social relationships. In the October 2011 VA examination, the Veteran's PTSD symptoms were found to cause moderate to severe interference with social and occupational functioning due to anxiety and depression. In a June 2015 VA treatment report, a VA treatment provider found the Veteran's PTSD symptoms caused significant distress and functional impairment. In a June 2016 letter, a VA mental health treatment provider found that the Veteran exhibited grossly impaired function in all areas of family, work and social interactions. Although the April 2018 VA examiner found that psychiatric testing indicated malingering in the Veteran's reports, he also noted the Veteran had PTSD symptoms that were consistent with symptoms reported in his VA outpatient treatment reports. Here, the Board finds it reasonable to conclude that the acquired psychiatric condition symptomatology described in the record most closely approximates the criteria for a 70 percent rating and has for the entire period on appeal. Although an increased 70 percent rating is warranted, the weight of the evidence is against a finding that a rating in excess of 70 percent is warranted at any time throughout the duration of the appeal. As noted in Mauerhan, the Veteran need not have all or even most of the particular symptoms in order to warrant a 100 percent evaluation, however, his psychiatric symptomatology does not demonstrate total social impairment and total occupational impairment. See Mauerhan, 16 Vet. App. 436. Although the June 2016 VA mental health treatment provider stated the Veteran was totally and permanently disabled from his PTSD, depression, anxiety and panic disorder, the totality of the evidence does not otherwise show that the disability actually resulted in total social and total occupational impairment. The evidence of record does not indicate that the Veteran's PTSD has been manifested by such symptoms as gross impairment in thought processes or communication, persistent delusions or hallucinations, disorientation to time or place, or memory loss for names of close relatives, or his own name. Despite some reports and findings of suicidal thoughts and ideation, the probative evidence of record does not demonstrate that the Veteran has been shown to be a persistent danger of hurting himself or others. VA outpatient treatment reports continued to reflect that the Veteran was assessed as a low suicide risk. In addition, VA medical records reflect the Veteran maintained relationships with family, especially with his brother, whom he has lived with throughout at least portions of the appeal period. Moreover, the evidence indicates that the Veteran is able to function independently, perform activities of daily living, and manage his own finances. Considering all the lay and medical evidence of record as it relates to PTSD's impact on the Veteran's functional and occupational impairment, the Boards finds that the evidence does not demonstrate total impairment. Therefore, the probative evidence of record does not more nearly approximate the criteria for a 100 percent schedular disability rating at any time since the filing of the claim for this disability. 38 C.F.R. §§ 4.3, 4.7. The Board has considered the lay statements of record regarding the severity of the Veteran's PTSD and has relied on these reports in determining appropriate disability rating under the benefit-of-the-doubt doctrine. 38 C.F.R. §§ 4.3, 4.7. The Veteran is competent to report on factual matters of which he has firsthand knowledge and his statements regarding his symptoms are also credible, and thus, probative. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Where the Veteran has not discussed particular findings that are necessary for application to the rating criteria, the Board has accorded greater probative weight to objective medical findings of record which specifically address the rating criteria. See Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). Accordingly, a 70 percent rating for PTSD, but no higher, throughout the duration of the appeal, is granted. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Saira Spicknall, 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.