Citation Nr: 21073949 Decision Date: 12/13/21 Archive Date: 12/13/21 DOCKET NO. 20-21 624 DATE: December 13, 2021 ORDER Entitlement to an earlier effective date for service connection of posttraumatic stress disorder (PTSD) with residual schizophrenia is denied. REMANDED Entitlement to a rating in excess of 30 percent for posttraumatic stress disorder (PTSD) with residual schizophrenia is remanded. FINDING OF FACT Service connection is already in effect for posttraumatic stress disorder (PTSD) with residual schizophrenia since July 22, 1969, the day after Veteran's discharge from service. CONCLUSION OF LAW There being no justiciable case or controversy, the Veteran's claim of an earlier effective date for service connection of posttraumatic stress disorder (PTSD) with residual schizophrenia is denied. 38 U.S.C. § 7105. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from April 1965 to July 1969, including service in the Republic of Vietnam. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In September 2017, the RO granted service connection for PTSD and assigned a single 30 percent evaluation for the PTSD and service-connected residual schizophrenia to encompass the occupation and social impairment caused by both disorders. 1. Entitlement to an earlier effective date for service connection of posttraumatic stress disorder (PTSD) with residual schizophrenia In the September 2017 rating decision, the RO expanded the definition of the Veteran's service-connected psychiatric disability to include PTSD. As the PTSD was combined with Veteran's residual schizophrenia and assigned a single 30 percent evaluation, the effective date for PTSD, as part of the combined service-connected psychiatric disability, is July 22, 1969, the day following the Veteran's discharge from service. Therefore, his claim of entitlement to an earlier effective date for service connection of PTSD with residual schizophrenia is thus moot as an effective date earlier than the presently assigned effective date of July 22, 1969 is not warranted for the psychiatric disability. See Baughman v. Derwinski, 1 Vet. App. 563, 566 (1991). As such, the appeal must be denied. REASONS FOR REMAND 1. Entitlement to a rating in excess of 30 percent for posttraumatic stress disorder (PTSD) with residual schizophrenia is remanded. The Veteran asserts he is entitled to an increased rating for his service-connected psychiatric disability. The Veteran has been rated 30 percent disabling for his service-connected PTSD with residual schizophrenia under Diagnostic Code 9411. In a May 2009 VA Mental Disorders examination, the Veteran was diagnosed with residual schizophrenia while PTSD criteria were not met. In a May 2009 letter in support of Veteran's claim, a social worker wrote to the VA that Veteran had been diagnosed with PTSD, with recurrent, intrusive and distressing recollection of events, distressing dreams and throughs with intensified distress in social and occupational functioning. Veteran was noted to exhibit sleep difficulty, hypervigilance and panic/anxiety. Veteran's Global Assessment of Functioning (GAF) score was recorded at 40. See May 2009 Third Party Correspondence. In an April 2014 VA PTSD examination, the Veteran was diagnosed with PTSD and was noted to have occupational and social impairment due to mild and transient symptoms which decrease work efficiency and ability to perform occupational tasks only during period of significant stress. Veteran's symptoms included depressed mood, anxiety and chronic sleep impairment. Veteran was working full-time as a readjustment counsel for a VAMC and was capable of managing his financial affairs. In a November 2016 VA PTSD examination, the Veteran's PTSD was again manifested by occupational and social impairment due to mild and transient symptoms which decrease work efficiency and ability to perform occupational tasks only during period of significant stress; no significant changes were reported from the previous evaluation. Veteran was noted to exhibit depressed mood, anxiety and panic attacks that occurred weekly or less often. In a subsequent March 2020 VA PTSD examination, the Veteran's PTSD was assessed as mild-to-moderate in severity, manifested by mild and transient symptoms which decrease work efficiency and ability to perform occupational tasks only during period of significant stress. Veteran had since retired, exhibited depressed mood, but was again capable of managing his financial affairs. The Veteran also submitted an independent medical evaluation from May 2019 by a licensed clinical psychologist regarding the severity of Veteran's service-connected PTSD. The psychologist concluded that Veteran's PTSD was severe, since at least 2008, with symptoms worsening over time. The psychologist opined that Veteran's occupational and social impairment manifested in deficiencies in most areas, such as work, family relations, judgment, thinking and mood; with this severe impairment being due to such symptoms such as suicidal ideation, near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively. The psychologist stated that the C&P examiners from April 2014 and November 2016 produced "directly conflicting and ... grossly inaccurate medical opinions, and inaccurately assessed the veteran's mental health condition." See May 2019 Medical Treatment Record. The May 2019 medical evaluation report, and lay statements from the Veteran himself indicating a worsened disability, shows a significantly different disability picture than that of the April 2014 and November 2016 C&P examinations. Due to the conflicting medical evidence, the Board finds that a more contemporaneous examination would substantially assist the Board in reconciling the conflicting evidence and accurately assessing the Veteran's current disability picture. Accordingly, a remand is warranted for a new VA examination to determine the current nature and severity of the Veteran's service-connected PTSD. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) with an appropriate clinician to determine the current severity of his service-connected PTSD with residual schizophrenia. The examiner should review the evidence associated with the record. The examiner should identify the nature, frequency, and severity of all current manifestations of the Veteran's psychiatric disability and specify the degree of occupational or social impairment. In particular, the examiner should note the May 2019 private examination and opinion letter from Dr. J.S.S in which the Veteran's PTSD symptoms were opined as causing "occupational and social impairment in most areas, such as work, family relations, judgment, thinking and mood; with this severe impairment being due to such symptoms such as suicidal ideation, near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively." The examiner must provide a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Zarar Ahmed, Attorney Advisor 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.