Citation Nr: 21026261 Decision Date: 04/30/21 Archive Date: 04/30/21 DOCKET NO. 19-18 302 DATE: April 30, 2021 ORDER A rating higher than 70 percent for posttraumatic stress disorder (PTSD) is denied. FINDING OF FACT PTSD symptoms during the appeal period resulted in occupational and social impairment with deficiencies in most areas, but not total social impairment. CONCLUSION OF LAW The criteria for a rating in excess of 70 percent for PTSD are not met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.7, 4.130, Diagnostic Code (DC) 9411. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1977 to March 1981, from May 1981 to March 1989, from December 1990 to June 1991, from August 1994 to August 1995, from November 2004 to July 2005 and from March 2006 to December 2006. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an August 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that the issue of a total disability rating based on individual unemployability is being separately adjudicated, and therefore will not be addressed in this decision. 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). Since April 26, 2010, the Veteran has been assigned a 70 percent rating for PTSD. This rating contemplates 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 higher 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). Neither the Veteran nor his representative have asserted why a higher 100 percent rating is warranted, and they have not cited evidence supporting such a rating. Based on a review of the evidence, the Board finds that a 100 percent rating is not warranted. The Veteran’s treatment records and examination reports during the appeal period document severe psychiatric symptoms. At the July 2010 VA examination, the Veteran endorsed recurrent and distressing memories, dreams and flashbacks, avoidance behaviors, hypervigilance, sleep disturbances, panic attacks and isolation At April 2019 and October 2020 VA examinations, the Veteran additionally endorsed irritable behavior and angry outbursts, exaggerated startle response, markedly diminished interest and participation in significant activities, depressed mood, disturbances of motivation and mood, anxiety, flattened affect, mild memory loss, difficulty establishing and maintaining relationships and difficulty adapting to stressful circumstances. At the July 2010 VA examination, the Veteran was homeless, and was struggling with employment. He reported leaving his job with a prison due to PTSD symptoms, including flashbacks, irritability and difficulty getting along with others. The Veteran had a history of three marriages, and while he remained married to his third wife at the most recent VA examination, the Veteran and his wife lived separately. The Veteran maintained one close friendship and was generally estranged from or had strained relationships with his son and stepchildren. (Continued on the next page)   Other evidence of record demonstrates adequate grooming and hygiene, ability to perform activities of daily living, orientation, thought and speech within normal limits and no evidence of delusions, or hallucinations. The Board notes that in the April 2019 Notice of Disagreement and at an August 2017 hearing, the Veteran endorsed suicidal ideation. While the Veteran repeatedly denied suicidal ideation in other evidence of record, including VA treatment records and at VA examinations, he reported at the hearing that he did not endorse these thoughts because he was afraid of losing his job. Specifically, the Veteran reported that admitting suicidal ideation would interfere with ability to carry a gun, as required by the job with a prison. The Board notes, however, that contrary to this assertion, the Veteran continued to deny suicidal ideation in VA treatment records and at VA examinations even after employment ended. While the Veteran’s symptoms of PTSD are indeed severe, the Board finds that these symptoms are all contemplated by a 70 percent rating. During 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 total occupational and social impairment consistent with a 100 percent rating. Although severe, the Board finds that the PTSD symptoms do not more nearly approximate total social and occupational impairment. Therefore, a rating higher than 70 percent is not warranted. Accordingly, the claim for increased rating must be denied. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board H. Ahmad, 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.