Citation Nr: 21009950 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 14-38 899A DATE: February 23, 2021 ORDER Entitlement to a rating of 70 percent, but not higher, for posttraumatic stress disorder (PTSD) for the entire period on appeal is granted. FINDING OF FACT For the entire period on appeal, the occupational and social impairment from the Veteran’s PTSD has been manifested by deficiencies in most areas. CONCLUSION OF LAW The criteria for a rating of 70 percent, but not higher, for PTSD have been met for the entire period on appeal. 38 U.S.C. §§ 1155, 5107 (2018); 38 C.F.R. §§ 4.7, 4.130, Diagnostic Code 9411 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active military service from June 1968 to July 1971. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In an August 2020 rating decision, the Veteran was assigned a 70 percent rating for his PTSD, effective August 3, 2020. That does not constitute a full grant of the benefit sought on appeal. However, the Board has limited its consideration accordingly. This matter was previously before the Board in September 2018, at which time it was remanded for additional development. The case has now been returned to the Board for further appellate action. Initial Increase Rating – PTSD The Veteran asserts that he should have higher ratings for his PTSD as his symptoms are worse than those contemplated by the currently assigned ratings. A review of the record shows that the Veteran has received mental health treatment through the VA Medical Center. In a February 2012 treatment note, the Veteran was noted as being diagnosed with PTSD and an Anxiety Disorder non-specific (NOS). The Veteran was referred to psychotherapy and attended a Trauma Seminar. He went to Mindfulness groups in order to learn anxiety management and relaxation techniques. The Veteran then began attending a weekly group through Coping and Meditation as part of a PTSD research study. A March 2012 treatment note includes information on the Veteran’s PTSD symptoms. Those symptoms included several panic attacks per week, avoidance of small spaces, flashbacks, anxious mood, and decreased enjoyment of previously enjoyed avocations. At a May 2012 VA examination, the Veteran reported that he had been in several long term relationships, but had never married. He reported that he currently lived with his adult son. He reported that his relationship with his family was strained, but he had recently moved to be closer to his siblings. The Veteran reported that his prior romantic relationships had ended because he was argumentative and “had a bad attitude”. He reported that he did not engage in social activities, as he did not have the finances to partake. The Veteran reported that his typical day included doing yard work, watching television, reading his bible, attending church weekly, and working on cars. He reported having a few friends, but that he did not have much contact with them due to his recent move. The Veteran reported that he had worked most of his life for the Department of Defense as a fire alarm specialist from 1981 to 2010. He reported that he did have some difficulty at work prior to retiring because he did not “go along with the games” and had been written up for abuse of annual leave. The Veteran reported that he disliked being in crowds, and that he would ge anxious when going into large buildings. The Veteran reported that he tried to run errands such as grocery shopping early in the day when the stores were less crowded. He reported that he often felt like places would close in on him after a period of time, and as a result, tended to move every 2-3 years. The Veteran reported that he avoided relationships, he had difficulty sleeping, he often became preoccupied with worry, that he had an exaggerated startle response, and that he had a history of irritability. The Veteran reported that he experienced panic attacks anywhere from once a week to every day depending on stressors. He reported that he had no feelings of sorry or remorse, and that he did not experience an emotional response when someone he knew died. The examiner noted that the Veteran experienced psychological distress at exposure to internal and external cues of his trauma, avoidance, inability to recall important aspects of trauma, markedly diminished interest or participation in significant activities, feelings of detachment, restricted range of affect, sense of foreshortened future, irritability, angry outbursts, hypervigilance, and exaggerated startle response. The examiner confirmed the diagnosis of PTSD, and noted that the occupational and social impairment caused by the Veteran’s PTSD was manifested by occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. At an August 2020 VA examination, the Veteran reported that he continued to live with his son, but that he was not currently in a relationship and had no friends. He reported that all his friends were “gone.” He reported that he stayed to himself, but that he did have a good support system. He reported that he enjoyed playing golf. The Veteran reported that he was currently retired. The Veteran reported symptoms of anxiety, depression, intrusive images, nightmares, flashbacks, physiological reaction to triggers, avoidance behaviors, detachment, anhedonia, irritability, angry outbursts, hypervigilance, exaggerated startle response, and sleep impairment. He denied suicidal ideation, and he denied thoughts of hurting others. Upon mental status examination, the Veteran was noted to be alert and oriented, and he was adequately groomed. The Veteran’s attention, concentration, and memory were within normal limits. His behavior was appropriate, he was polite and pleasant, and was cooperative with the examination. He reported appropriately to questions and maintained eye contact, but his mood was anxious. His affect was appropriate. The examiner noted that the Veteran’s symptoms included depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, disturbances in motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, and an inability to establish and maintain effective relationships. The examiner confirmed the diagnosis of PTSD, and noted that the occupational and social impairment caused by such resulted in occasional decrease in work efficiency and intermittent inability to perform occupational tasks. The Board finds that the Veteran is entitled to a 70 percent rating for PTSD for the entire period on appeal. In this regard, the Board notes that the Veteran was assigned a 70 percent rating based on the findings of the August 2020 VA examination. Those findings are not manifestly different than those noted in the prior May 2012 VA examination. As such, a higher rating is warranted for the entire period on appeal. 38 C.F.R. § 4.130, Diagnostic Code 9411. Consideration has been given to assigning a higher rating. however, there is no indication from the record that the Veteran has total occupational and social impairment as a result of his PTSD. In this regard, while there is an indication from the record that the Veteran experienced some difficulty in an employment setting, the Veteran was noted to have retired from Federal service due to eligibility and not as a result of increased behavioral issues. Further, the Veteran maintains a relationship with his adult son and specifically reported that he had a good support system. The Veteran’s speech has not been found to be abnormal, there is no indication that he experiences hallucinations or delusions, or that his thought processes are disturbed. There is no indication from the record that the Veteran has difficulty maintaining his personal hygiene, and while he has been noted to be hypervigilant, he does not have obsessional rituals that interfere with his ability to perform activities of daily living. While the Veteran has been noted to have memory impairment, that impairment is mild and not noted to be significant in nature. Additionally, there is no indication from the record that the Veteran has been considered to be a persistent danger to himself or others. As such, the Board finds that a rating in excess of 70 percent for PTSD is not warranted. 38 C.F.R. § 4.130, Diagnostic Code 9411. Consideration has been given to assigning staged ratings. However, at no time during the period in question has the disability warranted a higher schedular rating than that assigned. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Andrew Ledman II 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.