Citation Nr: 21072322 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 13-25 467A DATE: December 2, 2021 ORDER A higher 50 percent rating prior to August 1, 2017, for posttraumatic stress disorder (PTSD) is granted. A rating higher than 50 percent for PTSD prior to November 1, 2019, is denied. FINDINGS OF FACT 1. Prior to August 1, 2017, symptoms of PTSD more nearly approximated occupational and social impairment with reduced reliability and productivity. 2. Prior to November 1, 2019, symptoms of PTSD caused no worse than occupational and social impairment with reduced reliability and productivity. CONCLUSIONS OF LAW 1. The criteria for a higher 50 percent rating prior to August 1, 2017, for PTSD is granted have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.7, 4.130, Diagnostic Code (DC) 9411. 2. The criteria for a rating higher than 50 percent for PTSD at any time prior to November 1, 2019, have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.7, 4.130, DC 9411. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1966 to October 1968, to include service in the Republic of Vietnam. This matter is before the Board of Veterans' Appeals (Board) on appeal of a March 2011 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In October 2016, the Veteran did not appear at a scheduled hearing before the Board. Without good cause shown for the failure to appear, the request for a hearing is deemed withdrawn.38 C.F.R. § 20.704(d). PTSD Disability ratings are determined by the application of VA's Schedule for Rating Disabilities. 38 C.F.R. Part 4. The determination of whether an increased rating is warranted is based on review of the entire evidence of record and the application of all pertinent regulations. 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 claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999). The Veteran has been assigned a 30 percent rating from August 19, 2010, a 50 percent rating from August 1, 2017, and a total 100 percent rating from November 1, 2019, for his psychiatric disability. Since the Veteran has been in receipt of the maximum rating as of November 1, 2019, the Board will only discuss the period from August 19, 2010, to November 1, 2019, in this decision. The 30 percent rating contemplates occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, 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, and recent events). The higher 50 percent rating is assigned where there is 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 understanding complex commands; impairment of short- and long-term memory; impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. The higher 70 percent rating is assigned where there is 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 worklike setting); and inability to establish and maintain effective relationships. The maximum 100 percent rating is assigned when there is 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. The criteria listed above serve as examples of the type and degree of the symptoms or effects that would justify a rating and are not meant to be an exhaustive list. Mauerhan v. Principi, 16 Vet. App. 436, 442-44 (2002). Social and occupational impairment must be due to the symptoms listed for that rating level, "or others or others of similar severity, frequency, and duration." Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117 (Fed. Cir. 2013). The Veteran's treatment records and examination reports prior to November 2019 document moderate to severe psychiatric symptoms. For example, at a December 2010 VA examination, the Veteran endorsed PTSD symptoms including nightmares, flashbacks, detachment from others, restricted range of affect, sleep impairment, irritability, and hypervigilance. The examiner also noted mild symptoms of depression, related to trauma. The Veteran described being divorced twice and having no real relationship with his one son. He reported not having real friends and not liking to be around others. The Veteran had been employed for about 20 years installing security alarms and surveillance systems. The Veteran stated he has experienced memory problems as well. The examiner found that the Veteran's PTSD had a moderate to severe impact on several areas of the Veteran's life, including qualify of life, family role, relationships and employment. At an August 2017 VA examination, the examiner found that PTSD symptoms continued to cause moderate to severe impairments to the Veteran's family relationships, social functioning, mood and overall quality of life. The examiner opined that the symptoms caused occupational and social impairment with reduced reliability and productivity. The Veteran reported similar symptoms as in the December 2010 examination, with the addition of PTSD symptoms including intrusion symptoms, avoidance behavior and reckless or self-destructive behavior. The Veteran also endorsed additional psychiatric symptoms including depressed mood, anxiety, mild memory loss, flattened affect, disturbances of motivation and mood, difficulty establishing and maintaining effective relationships and problems concentrating. VA medical records during this period are consistent with VA examination reports, indicating moderate to severe symptoms of PTSD, including isolation, avoidant behavior, sleep impairment, irritability, nightmares, flashbacks, anxiety, hypervigilance, and exaggerated startle response. After review of the record and resolving all reasonable doubt in favor of the Veteran, the Board finds that the Veteran's PTSD symptoms were more nearly approximated by the 50 percent rating from August 19, 2010. During the appeal period, the Veteran consistently reported moderate to severe psychiatric symptoms which caused social and occupational impairment with reduced reliability and productivity. However, the Board finds that a higher 70 percent rating is not warranted at any time between August 19, 2010, and November 1, 2019. During the appeal period, the evidence of record demonstrates that the Veteran maintained adequate grooming and hygiene. The Veteran remained alert and oriented to person, time, place, and situation. Speech, thought process, and thought content were all within normal limits. While the Veteran's social relationships were impacted by PTSD, he was able to maintain employment installing security alarms and surveillance systems throughout the appeal period. The Veteran consistently denied suicidal or homicidal ideation, was not a persistent danger to himself or others, and showed no evidence of hallucinations or delusional thoughts. The evidence is otherwise negative for any grossly inappropriate behavior, disorientation to time or place, memory loss for basic concepts such as his own name, or other symptoms which might suggest a higher 70 percent rating or total occupational and social impairment consistent with a 100 percent rating at any time prior to November 1, 2019. Therefore, a rating higher than 50 percent is not warranted. Accordingly, the Board finds that an initial 50 percent rating is warranted for the Veteran's PTSD. However, a rating higher than 50 percent is not warranted at any time during the appeal period prior to November 1, 2019. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board H. Ahmad 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.