Citation Nr: 21042006 Decision Date: 07/11/21 Archive Date: 07/11/21 DOCKET NO. 13-29 990 DATE: July 11, 2021 ORDER Entitlement to a rating in excess of 30 percent for posttraumatic stress disorder (PTSD) is denied. FINDING OF FACT The Veteran's PTSD is characterized as occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks due to symptoms such as depressed mood, anxiety, suspiciousness, chronic sleep impairment, and mild memory loss. CONCLUSION OF LAW The criteria for a rating in excess of 30 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.321, 4.3, 4.7, 4.130, Diagnostic Code 9411. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from June 2007 to September 2007 and from August 2010 to August 2011. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) in Des Moines, Iowa. In May 2016, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In November 2017, the Board remanded the claim to obtain updated treatment records and new VA examination that indicates current severity of PTSD. In August 2020, the Board again remanded the claim because the Veteran was not provided a new VA examination pursuant to the November 2017 remand directives. Increased Rating Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities. The percentage ratings are based on the average impairment of earning capacity and individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Veteran's post-traumatic stress disorder (PTSD) is evaluated under Diagnostic Code (DC) 9400. Under DC 9411, which is governed by a General Rating Formula for Mental Disorders (General Rating Formula), a 30 percent rating is warranted for occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). A 50 percent rating is warranted where there is occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. Id. A 70 percent rating is warranted for 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, 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 work-like setting); and/or inability to establish and maintain effective relationships. Id. A 100 percent rating is warranted 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; inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and/or memory loss for names of close relatives, own occupation, or own name). Id. When determining the appropriate disability evaluation to assign, the Board's primary consideration is a Veteran's symptoms, but it must also make findings as to how those symptoms impact a Veteran's occupational and social impairment. Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013); Mauerhan v. Principi, 16 Vet. App. 436 (2002). Because the use of the term "such as" in the rating criteria demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, the Board need not find the presence of all, most, or even some, of the enumerated symptoms to award a specific rating. Id. at 442. Nevertheless, all ratings in the General Rating Formula are also associated with objectively observable symptomatology and the plain language of the regulation makes it clear that the Veteran's impairment must be "due to" those symptoms, a Veteran may only qualify for a given disability rating by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. Vazquez-Claudio, 713 F.3d at 118. 1. Entitlement to a rating in excess of 30 percent for posttraumatic stress disorder (PTSD). The Veteran contends that symptoms of his service-connected posttraumatic stress disorder (PTSD) have worsened and warrant a rating in excess of 30 percent. He is in receipt of a 30 percent rating for PTSD, effective August 21, 2011. He timely perfected his appeal to the January 2013 decision by the RO that initially evaluated his PTSD. As such, the period under review is from the effective date of rating. The Veteran testified that his PTSD symptoms have worsened, including that he suffers increased memory problems. He further testified that he is pretty much reclusive and unable to socialize with other people. See May 2016 hearing transcript. December 2012 PTSD addendum stated PTSD with minimal to mild impairment that at times interferes with social interactions and initiation of tasks. The PTSD addendum also found the PTSD symptoms described above do not cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. October 2015 PTSD DBQ found there was occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication. March 2021 VA examination showed occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. The Veteran exhibited anxiety, suspiciousness, and chronic sleep impairment, irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. He reported that he works as a maintenance manager, has a 4 on 4 off work shift. Has been in this job for two years, really enjoys it, but indicated some challenges and frustration with management. Gets along well with people, has a close community. Reports having a few friends in the area that he wants to spend time with. Thought patterns were coherent and goal-directed. He had no delusions, hallucinations, or obsessions. The Board finds that the evidence does not show that a rating in excess of 30 percent for PTSD is warranted. The Veteran's PTSD was characterized as occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. See March 2021 VA examination. He exhibited symptoms such as depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss. Impairment of short- and long-term memory was not shown. Although the Veteran showed some symptoms of unprovoked irritability, it has not resulted in violence. He had depressed mood, but it did not affect his ability to function. This level of impairment is consistent with a 30 percent rating. Moreover, he did not have panic attacks or show impaired judgement or impaired abstract thinking. Based on the above, the Board finds that the Veteran's occupational and social impairment did not meet the criteria for a higher 50 percent rating. The Board has carefully considered the level of impairment contemplated by the various levels delineated in the rating schedule and found that the evidence indicates that the overall level of disability most nearly approximates a 30 percent rating. The Board has considered the lay and medical evidence of the occupational and social impairment caused by all symptoms of the disability. Considering all symptoms of the disability, to include those listed and those unlisted in the schedule, the Board finds that the disability most nearly approximates that represented by the current 30 percent rating. The Board has further specifically considered the representative's contention that a 50 percent rating is warranted. For the reasons discussed, the Board finds that the evidence does not support entitlement to this higher rating. Although the representative has contended that in the alternative that another remand is warranted, the record reveals that the March 2021 VA examination is complete and provides a full picture of the current level of severity of the service-connected disability. The Board finds that the Veteran's impairment is contemplated by the 30 percent rating but no higher when considering the frequency, severity, and duration of these symptoms. Entitlement to an increased rating is denied. Nathaniel J. Doan Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Ottley III 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.