Citation Nr: 23051188 Decision Date: 09/15/23 Archive Date: 09/15/23 DOCKET NO. 15-27 465 DATE: September 15, 2023 ORDER Entitlement to a permanent and total disability evaluation for service-connected posttraumatic stress disorder (PTSD), which is currently 100 percent disabling, is granted. FINDING OF FACT The Veteran's PTSD is permanent and rated as 100 percent (total) disabling. CONCLUSION OF LAW The criteria for a permanent and total disability evaluation for service-connected PTSD have been met. 38 C.F.R. §§ 3.340, 3.327. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1985 to January 1989 and from March 1989 to March 1993. This matter comes to the Board of Veterans' Appeals (Board) on appeal from an August 2013 Department of Veterans Affairs (VA) regional office (RO) rating decision. In August 2023, the Veteran participated in a hearing before the undersigned; a transcript is associated with the claims file. Entitlement to a permanent and total evaluation The Veteran contends that he is entitled to a 100 percent rating for his PTSD on a permanent and total basis. A total disability permanent in nature is one where impairment is reasonably certain to continue throughout the life of the disabled person. 38 C.F.R. § 3.340(b). The term contemplates diseases and injuries of long standing which are totally incapacitating and where the probability of permanent improvement under treatment is remote. 38 C.F.R. § 3.340(b). The age of the disabled person may be considered in determining permanence. 38 C.F.R. § 3.340(b). Once permanence is established, a veteran need not undergo further VA examinations in order to retain a 100 percent disability rating for the permanent disability. 38 C.F.R. §§ 3.327(b)(2)(iii). The Veteran is already rated at 100 percent disabling for his PTSD since October 13, 2010. As such, the question for the Board is whether the Veteran's PTSD is permanent (static) in nature. A June 2015 VA examiner opined that the Veteran has psychiatric symptoms such as distressing dreams, avoidance, negative emotional state, problems with concentration, depressed mood, anxiety, sleep impairment, and possible delusions producing reduced reliability and productivity. The examiner stated that his condition is "very improved." A September 2016 VA examiner opined that the Veteran has psychiatric symptoms such as distressing dreams, dissociative reactions, intense psychological distress, avoidance, negative emotional state, diminished interest, feelings of detachment, inability to experience positive emotions, irritability, reckless behavior, hypervigilance, problems with concentration, sleep disturbance, depressed mood, anxiety, suspiciousness, guarded affect, marginal hygiene and poor grooming resulting in reduced reliability and productivity. At the August 2023 hearing, the Veteran's wife pointed out that his PTSD has been rated as 100 percent disabling for about 10 years, that he has had three different increases in medication without improvement, that he "gets worse" the older he gets, is like a "hermit" and can only really "deal" with his grandchildren. The Veteran added that his PTSD is not improving and that it is "getting worse." Based on the above, the Board finds that the Veteran is entitled to a permanent and total disability evaluation for service-connected PTSD. The evidence is at least in equipoise that his PTSD symptomatology has been static, if not in fact worsening, since the origin of his 100 percent disability rating. The Board finds that the Veteran and his wife's testimony that his PTSD is "getting worse" and that any chance of permanent improvement of his PTSD is remote credible and competent. Layno v. Brown, 6 Vet. App. 465 (1994). To that end, the Board notes that the Veteran's PTSD has been at constantly rated as 100 percent disabling for a significant period of time (at this point, well over 10 years). For this reason, entitlement to a permanent and total disability evaluation for service-connected PTSD is warranted. The claim is granted. Caroline B. Fleming Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Finelli, Christopher 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.