Citation Nr: 22014535 Decision Date: 03/14/22 Archive Date: 03/14/22 DOCKET NO. 17-38 454 DATE: March 14, 2022 ORDER An effective date earlier than January 5, 2016, for the grant of service connection for a delusional disorder, is denied. REMANDED Entitlement to special monthly compensation (SMC), based on aid and attendance or housebound status, is remanded. FINDINGS OF FACT 1. On January 5, 2016, the Veteran submitted a claim for service connection for a mental health condition. In a July 2016 rating decision, the RO granted service connection for a delusional disorder with persistent depressive disorder, effective January 5, 2016, the date of the Veteran's claim for service connection. In a February 2017 Notice of Disagreement, the Veteran marked that he disagreed with the July 2016 rating decision, noting that he disagreed with the effective date of the award of service connection for his delusional disorder. 2. Prior to his January 5, 2016 claim, the Veteran made no submission to VA which may be construed as a formal or informal claim for service connection for a delusional disorder. No such submission demonstrated an intent to apply for benefits for service connection for a delusional disorder (or any acquired psychiatric condition) prior to January 5, 2016. CONCLUSION OF LAW The criteria have not been met for an effective date earlier than January 5, 2016 for the grant of service connection for a delusional disorder. 38 U.S.C. §§ 5107, 5110; 38 C.F.R. §§ 3.102, 3.156, 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran had active military service from November 1977 to October 1979. These matters come before the Board of Veterans' Appeals (Board) on appeal from July 2016 and December 2016 rating decisions by the Department of Veteran Affairs (VA) Regional Office (RO). In February 2017 and March 2017, the Veteran disagreed with these rating decisions. In August 2021, the Veteran testified before the undersigned Veterans Law Judge (VLJ) via videoconference. A copy of the hearing transcript is of record and has been reviewed. Earlier Effective Dates An effective date earlier than January 5, 2016 for the grant of service connection for a delusional disorder is denied. Legal Criteria Unless otherwise provided, the effective date for an award of compensation for service-connected disability shall be fixed in accordance with the facts found but shall not be earlier than the date of receipt of application for benefits. The effective date will be the date of receipt of the claim, or the date entitlement arose, whichever is later. 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400. Facts and Analysis The Veteran alleges that the effective date for his service-connected delusional disorder should be July 2012. In a May 2010 Report of General Information, the RO employee who spoke to the Veteran reported that the Veteran wanted to file an informal claim for a "neck condition, lower back condition, bilateral knee condition, and arthritis in back and neck." The Board notes that this informal claim did not contain any reference to a mental health condition, a delusional disorder, or anything that could be construed as a claim for a psychological condition of any kind. After the Veteran's August 2021 hearing, his attorney submitted a July 2012 Statement in Support of Claim and noted that this was the basis of the Veteran's earlier effective date claim. In the July 19, 2012 Statement In Support of Claim, the Veteran wrote that: I went into the army November 1, 1977 to fight for my country. When I left for army I did not have high blood pressure are [sic] my knees were not bad they were good but when I got to basic training running heavy boots backpack putting pressure on my knees that what made them bad. Running 9 miles every day and night that what hurt my knees. The army are a mental thing [emphasis added] you know this but you don't want to give me my benefits you [t]old me that all my injury are service connected it in my military records from basic training. I can't go to VA for glass [sic] or dentist because you having gave me my VA rating. I am disable [sic] Veteran. Even after reviewing this statement in the light most favorable to the Veteran, and affording him the benefit of the doubt, the Board does not consider one use of the word "mental" expressly referring to "the army" and not connected to the Veteran's health or a medical condition to constitute an intent to file a claim for a delusional disorder or any mental health condition. Because of this, prior to his January 5, 2016 claim, the Veteran made no submission to VA which may be construed as a formal or informal claim for service connection for a delusional disorder or a mental health condition. No such submission demonstrated an intent to apply for benefits for service connection for a delusional disorder or a mental health condition prior to January 5, 2016. While the Veteran and his attorney noted after the August 2021 hearing that the effective date should be July 2012, there is no informal or formal claim any time prior to January 5, 2016. It is not legally possible for the grant of service connection to be any earlier than the current effective date of January 5, 2016. According to 38 C.F.R. § 3.400, the effective date of an award of compensation based on an original claim, "will be the date of receipt of the claim or the date entitlement arose, whichever is the later" (emphasis added). Because the Veteran did not submit his claim for service connection until January 5, 2016, that is the earliest effective date that service connection can be granted. Id. REASONS FOR REMAND Entitlement to SMC, based on aid and attendance or housebound status, is remanded. In the August 2021 hearing, the Veteran and his spouse testified that his service-connected conditions had worsened since he was last examined for SMC in September 2016. The Veteran testified that his service-connected psychiatric condition, knees, back, neck, high blood pressure, and erectile dysfunction had all worsened. He stated that he needed help at home and that his doctors had recommended that if his wife was not taking care of him, that he needed to hire someone else to. Concerning his service-connected delusional disorder, the Veteran testified that he had difficulty thinking and focusing sometimes and had to have his wife help him with reading, paying the bills, and other things. He reported that this led to sleeping problems and to his blood pressure rising. The Veteran testified that if his wife was not there to help him, he would be "in trouble." The Veteran's spouse testified that she basically took care of him. She also noted that she had concerns if he was by himself and she was not home. The Veteran's spouse testified that if she was not home, he would forget to take his medication. She noted that from a physical perspective, his physical conditions had worsened. She reported that it used to take the Veteran a day to mow the yard, but that it currently took him two to three days. The Veteran's spouse testified that she had to be outside watching him because he had fallen asleep a couple of times and had fallen. She noted that there was no one else to watch him. The Veteran's spouse testified that what the Veteran really needed was a support system. She stated that she would like someone to stop by for a couple of hours to make sure he was getting the assistance he needed, both mentally and physically. Based on this testimony, the Board determines that a new VA examination is needed to determine whether the Veteran is entitled to SMC based on aid and attendance or housebound status. The matters are REMANDED for the following actions: 1. Please note that, by law, ALL remanded claims must be processed expeditiously. 2. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), contact the Veteran for additional information about treatment for the above conditions and make efforts to obtain all VA and private treatment records concerning this claim. 3. The RO must undertake any and all development necessary to fulfill VA's duty to assist the Veteran in substantiating his appeal to establish SMC benefits based on the need for aid and assistance or at the homebound level, to include confirming the Veteran's educational and occupational history, scheduling and completing appropriate examinations, and obtaining retroactive medical opinions. 4. Schedule the Veteran for an SMC examination to assess his need for SMC based on aid and attendance or housebound status. Prior to the examination, the claims folder and a copy of this remand must be made available to the examiner for review of the case. A notation to the effect that this record review took place should be included in the report. All pertinent symptoms and medical findings must be reported in detail. Any indicated diagnostic tests and studies must be accomplished. Based on a detailed review of the evidence of record, including the Veteran's statements and the August 2021 hearing testimony, the examiner should provide an assessment about whether the Veteran is in need of aid and attendance or is housebound as a result of his disabilities. (Continued on next page) 5. A detailed explanation (rationale) is required for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested). VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Abrams, 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.