Citation Nr: 21077600 Decision Date: 12/30/21 Archive Date: 12/30/21 DOCKET NO. 17-10 959A DATE: December 30, 2021 ORDER Entitlement to a disability rating of 100 percent for an acquired psychiatric disability from September 10, 2007 until September 9, 2018 is granted. Entitlement to a total disability rating based upon individual unemployability due to service-connected disability (TDIU) prior to September 10, 2018 is dismissed as moot. FINDINGS OF FACT 1. As of September 10, 2007, the Veteran's acquired psychiatric disability caused total occupational and social impairment. 2. As the Veteran has been granted a 100 percent schedular rating for PTSD since September 10, 2007, the issue of TDIU is moot. CONCLUSIONS OF LAW 1. The criteria for an effective date of September 10, 2007, for the award of a 100 percent evaluation for acquired psychiatric disability have been met. 38 U.S.C. § 7105; 38 C.F.R. § 3.400. 2. Entitlement to a TDIU is moot. 38 U.S.C. § 1155; 38 C.F.R. § 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had honorable active duty service with the United States Air Force from June 1969 to August 1970. This matter is before the Board of Veterans' Appeals (Board) on appeal from an August 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO), which effectuated an August 2013 Board decision granting service connection for an acquired psychiatric disability. In July 2021, the Board remanded this case for the RO to correct a procedural error. The Board finds that the RO's most recent Supplemental Statement of the Case is legally sufficient. In December 2021, the Veteran's representative wrote the Board seeking a 90-day extension to submit additional evidence. The Board is able to immediately render a decision without prejudicing the Veteran. Therefore, the Representative's request is denied for mootness. Acquired psychiatric disability prior to August 29, 2019. The Veteran was initially assigned a 30 percent rating for PTSD effective September 10, 2007, and the Veteran appealed this rating. In a June 2020 rating decision, the Veteran's evaluation for PTSD was increased to 100 percent, effective August 29, 2019, and the issue was therefore fully granted from that date onward. In July 2021, the Board remanded the issues of entitlement to a rating higher than 30 percent for an acquired psychiatric disorder prior to August 29, 2019. In a November 2021 rating decision, the effective date for the increased 100 percent evaluation was revised to September 10, 2018. The period on appeal before the Board is therefore from September 10, 2007 to September 9, 2018. Disability ratings are determined by applying the criteria set forth in the VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10. In determining the severity of a disability, the Board is required to consider the potential application of various other provisions of the regulations governing VA benefits, whether or not they were raised by the Veteran, as well as the entire history of the Veteran's disability. If the disability more closely approximates the criteria for the higher of two ratings, the higher rating will be assigned; otherwise, the lower rating is assigned. 38 C.F.R. § 4.7. It is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. In deciding this appeal, the Board has considered whether separate ratings for different periods of time, based on the facts found, are warranted, a practice of assigning ratings referred to as "staged" ratings. Given the nature of the present claim for a higher initial evaluation, the Board has considered all evidence of severity since the effective date for the award of service connection. Fenderson v. West, 12 Vet. App. 119 (1999). Under the General Rating Formula for Mental Disorders, the Board must conduct a "holistic analysis" that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013). The Board finds that the Veteran's symptoms more closely approximated the symptoms associated with a 100 percent rating during the appeal period. A 100 percent 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; or memory loss for names of close relatives, own occupation or own name. See 38 C.F.R. § 4.130, Diagnostic Code 9413. The Veteran was assigned an effective date of September 10, 2018 for her increased 100 percent rating due to the findings of a September 2018 psychiatric evaluation. By the time of the Veteran's September 2018 psychiatric evaluation, her symptoms were found to be quite severe, including suicidal ideation, near-continuous depression and anxiety, insomnia, impaired impulse control, anger outbursts, and inability to handle relationships. The examiner also discussed evidence indicating that these symptoms had started well before the September 2018 examination, and the Board therefore finds that the date of the examination is not appropriate for setting the effective date of the increased 100 percent rating, and that it should be considered whether these symptoms were actually shows to begin earlier in the appeal period. See Swain v. McDonald, 27 Vet. App. 219, 224 (2015) (Effective dates should not be mechanically assigned based solely on the date of the VA examination, but should include consideration of all of the facts to determine the date that the increase in disability was ascertainable.). For much of the appeal period, the Veteran had suicidal ideation. Moreover, she wrote many letters to the Board. Some of the statements made and the tone the letters portray indicate that the Veteran likely does have a gross impairment in thought process. This impairment in thought process is confirmed by the Veteran's daughter, A.B. In A.B.'s August 2018 letter, she writes that her mother cries over nothing, everything causes an abnormal degree of anxiety, her mother "can't think straight...She has a high level of paranoia." A.B. added that the Veteran always retells stories differently than how the events happened and may have zero memory of something happening. She added that her mother, at times, lives in her own reality. The Board is able to see this in some of the letters written to the VA by the Veteran. For example, the Veteran stated that the VA is trying to kill her, and that the VA and the armed services are killing other veterans. As for the medical evidence, a September 2007 examination revealed someone was that was severely depressed, anxious, and agitated. In April 2008, a VA examiner stated that on a daily basis the Veteran was depressed, anxious, and had anhedonia, withdrawal, and suicidal ideations. In February 2010, she experienced dissociative episodes. In April that year, she reported that it took everything she had to leave her house. In February 2011, she said the only person in the world she could trust was her mother. In May 2011, the Veteran reported increased anxiety, hypervigilance and only sleeping 3 hours a night after taking prescription medications. Throughout the record, the Veteran regularly woke due to panic attacks. In November 2012, she was anxious with agoraphobic behaviour. She was using alprazolam as a rescue drug for severe anxiety. At times, during her therapy sessions, despite ambulating with a cane, she would stand against the wall near the door, demonstrating an uneasiness. The Veteran's thought process, her inability to recount stories, impaired impulse control, inappropriate behavior, suicidal ideation, and difficulty leaving the house are the reasons the Board finds that it is as likely as not that her symptoms, for the entire period of September 10, 2007 to September 9, 2018, more nearly approximated total occupational and social impairment. A grant of a 100 percent rating for the entire appeal period prior to September 10, 2018 is therefore granted. TDIU During the entire appeal period in question the Veteran has had a combined disability rating of 100 percent. A 100 percent rating under the Schedule for Rating Disabilities means that a veteran is totally disabled. Holland v. Brown, 6 Vet. App. 443, 446 (1994). Thus, if VA has found a Veteran to be totally disabled as a result of a service-connected disability or combination of disabilities pursuant to the rating schedule, there is no authority to otherwise rate that Veteran totally disabled on any other basis. See Herlehy v. Principi, 15 Vet. App. 33, 35 (2001) (finding a request for TDIU moot where 100 percent schedular rating was awarded for that same period). The Board has considered the holding in Bradley v. Peake, 22 Vet. App. 280 (2008), in which the Court of Appeals for Veterans Claims held that, although no additional disability compensation may be paid when a total schedular disability rating is already in effect, a separate award of a TDIU predicated on a single disability other than that which was the basis for the 100 percent schedular rating may form the basis for an award of special monthly compensation. In this case, the Veteran's only service-connected disability is her psychiatric disorder, and there is therefore no basis for an award of special monthly compensation under 38 U.S.C. § 1114(s). The Board finds that the claim for a TDIU is moot and must be dismissed. Mary E. Rude Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. Chalker, 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.