Citation Nr: 21010993 Decision Date: 02/26/21 Archive Date: 02/26/21 DOCKET NO. 16-63 430 DATE: February 26, 2021 ORDER A rating in excess of 70 percent for posttraumatic stress disorder with major depressive disorder and alcohol abuse is denied. FINDING OF FACT For the entire appeal period, the Veteran’s service-connected PTSD with major depressive disorder and alcohol abuse is not manifested by total occupational and social impairment. CONCLUSION OF LAW The criteria for a rating in excess of 70 percent for posttraumatic stress disorder with major depressive disorder and alcohol abuse have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.130, Diagnostic Code 9411. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from September 1996 to September 1999 and from December 2003 to July 2005, including service in Iraq from February to October 2004. The Veteran presented sworn testimony at a hearing before the undersigned in September 2020. In September 2020, the Board granted entitlement to a the Veteran’s claim of entitlement to a to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) and remanded the issue of a rating in excess of 70 percent for posttraumatic stress disorder with major depressive disorder and alcohol abuse for additional development. Entitlement to a rating in excess of 70 percent for posttraumatic stress disorder with major depressive disorder and alcohol abuse. The Veteran seeks a rating in excess of 70 percent for her PTSD with major depressive disorder and alcohol abuse disorder. Specifically, at the September 2020 Board hearing, the Veteran testified that her service-connected psychiatric disability has worsened since her previous June 2015 PTSD VA examination and that she was seeking a 100 percent schedular rating for her service-connected psychiatric disability. See September 2020 Hr’g Tr. The Veteran’s PTSD is currently rated at 70 percent, effective April 7, 2011. The Veteran’s PTSD has been evaluated under the General Rating Formula for Mental Disorders. 38 C.F.R. § 4.130, Diagnostic Code 9411. A 70 percent evaluation is warranted where there is objective evidence demonstrating 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, or 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; and the inability to establish and maintain effective relationships. A 100 percent disability evaluation is warranted 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 and place; and memory loss for names of close relatives, own occupation, or own name. Id. The symptoms listed in Diagnostic Code 9411 are not intended to constitute an exhaustive list, but rather serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002); see also Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117 (Fed. Cir. 2013) (explaining that the symptoms that could give rise to a given rating are those in like kind, i.e., of similar duration, severity, and frequency, to those provided in the non-exhaustive lists). The Veteran testified that her PTSD symptoms had worsened. The Veteran was afforded a VA examination in November 2020. The examiner summarized the Veteran’s impairment as occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood. Regarding social impairment, the Veteran reports that she is currently married. She has one sister, who she is in regular contact has regular contact with through texts and calls. She reports having four children. Two of her children live with her and one is disabled and living in a group home. She stated, “I really don’t have any friends I am close to other than my husband and a lady at the VA.” Regarding occupational impairment, the Veteran has not been employed since April 2015. The examiner notes the Veteran had the following symptoms: depressed mood; anxiety; suspiciousness; chronic sleep impairment; mild memory loss, such as forgetting names, directions or recent events; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships and difficulty adapting to stressful circumstances, including work or a work like setting. The Veteran reports nightmares 2-3 times per week and waking up disoriented. She described hypervigilance and constantly feeling on the defense. She reports being highly cautious and mistrustful of people; she avoids crowds and is uncomfortable and anxious even going to church. The VA examiner determined the Veteran’s current severity of the Veteran’s PTSD to be severe with deficiencies in most areas of occupational and social functioning. The VA examiner noted the Veteran does not currently present in acute emotional or psychological distress. See November 2020 PTSD DBQ. The evidence supports a finding that the disability picture for the Veteran’s psychiatric disability has more nearly approximated to occupational and social impairment with deficiencies in most areas (such as work, school, family relations, judgment, thinking, or mood) for the relevant part of the appeal period. The November 2020 VA examiner noted there was no indications of disordered thought, delusions, or hallucinations. The Veteran reported her mood was “numb” and if it were not for her husband and granddaughter, she would let it be depressed. She denied homicidal ideation and convincingly denied suicidal ideation, intent or plan at this time. The Veteran was oriented to time, place, circumstance and context and no impairment to her thought content. Id. The frequency, severity, and duration of the Veteran’s impairment and assessing his disability picture, the Board finds that the evidence of record demonstrates that disability due to the Veteran’s psychiatric disorder has approximated the schedular criteria for an initial rating of 70 percent. See Vazquez–Claudio v. Shinseki, 713 F.3d 112, 117 (Fed. Cir. 2013). The Board finds that the preponderance of the evidence is against a finding that the Veteran’s PTSD shows total occupational and social impairment sufficient to warrant a rating of 100 percent. The evidence does not symptoms such 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, disorientation to time or place, memory loss for names of close relatives, own occupation, or own name, or any symptomatology otherwise consistent with total occupational and social impairment. In light of the foregoing, the Board finds that a rating in excess of 70 percent for mood disorder is not warranted. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Jacquelynn M. Jordan, 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.