Citation Nr: A24036282 Decision Date: 07/08/24 Archive Date: 07/08/24 DOCKET NO. 210311-146211 DATE: July 8, 2024 ORDER An initial rating of 50 percent, but not more, for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is granted. FINDING OF FACT The Veteran's acquired psychiatric disorder, to include PTSD, has been predominantly characterized by depression, anxiety, nightmares, anger, difficulty expressing his emotions, and disturbances in motivation and mood. However, occupational and social impairment with deficiencies in most areas, such as work, school, family relationships, judgment, thinking, or mood, due to symptoms such as obsessional rituals which interfere with routine activities, near-continuous panic or depression affective ability to function independently, appropriately, and effectively, spatial orientation, speech that is intermittently illogical, obscure, or irrelevant, neglect of personal appearance and hygiene, difficulty in adapting to stressful circumstances, and inability to establish and maintain effective relationships have not been shown. CONCLUSION OF LAW The criteria for an initial rating of 50 percent, but not more, for an acquired psychiatric disorder, to include PTSD, have been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.7, 4.130, Diagnostic Code (DC) 9411. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 2008 to December 2012. The rating decision on appeal was issued in March 2020 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In his March 2021 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Evidence Review docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal and within 90 days of the Veteran's notice of disagreement. 38?C.F.R. § 20.301. Increased Ratings Disability evaluations are determined by the application of the Schedule for Rating Disabilities, which assigns ratings based on the average impairment of earning capacity resulting from a service-connected disability. 38 U.S.C. § 1155; 38 C.F.R. Part 4. 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 required for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. In determining the present level of a disability for any rating claim, the Board must consider the possible application of "staged ratings" for diverse symptoms meeting the criteria for different ratings in distinct time periods during the course of the appeal, whether it is an initial rating case or not. See Hart v. Mansfield, 21 Vet. App. 505 (2007); See Fenderson v. West, 12 Vet. App. 119, 126 (1999). 1. Entitlement to an increased rating for PTSD The Veteran is seeking an increased rating for his psychiatric disability, to include PTSD. Specifically, he contends that his service-connected psychiatric disorder causes depression, anxiety, difficulty maintaining and establishing effective work and social relationships, anger, difficulty sleeping, nightmares, and a tendency to isolate. Throughout the period on appeal, the Veteran has been assigned a 30 percent rating for a psychiatric disorder, characterized as PTSD under 38 C.F.R. § 4.130, DC 9411. As an initial matter, based upon the evidence of record, the Board finds that an initial rating of 50 percent is warranted. In support, the Board notes that the Veteran's February 2020 VA examination and medical treatment records indicate that his symptoms on balance caused occupational and social impairment with reduced reliability and productivity noting symptoms such as disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships. However, a rating in excess of 50 percent is not warranted. Specifically, during a February 2020 VA examination, the VA examiner opined that his PTSD caused 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. He did not report suicidal or homicidal ideation. He also denied inpatient treatment noting that he does see a counselor once per month. It was noted that he experiences irritable behavior, reckless behavior, hypervigilance, exaggerated startle response, problems with concentration, and sleep disturbances. His symptoms were anxiety, suspiciousness, chronic sleep impairment, and difficulty in establishing and maintaining effective work and social relationships. During the examination, the Veteran was friendly and engaged. His mood was lethargic. Moreover, at no point during the period on appeal has the Veteran's VA examinations nor medical treatment records reflect that the Veteran has occupational and social impairment with deficiencies in most areas. Specifically, that while the Veteran has been treated for depression and anxiety, there is nothing shows a 70 percent rating noting that the Veteran has not endorsed suicidal ideation. Overall, while the Veteran may exhibit some symptoms of a 70 percent rating, including irritability, anxiety, and anger, a holistic view of the Veteran's symptoms is better categorized by a 50 percent rating, particularly in light of the record containing no evidence of psychosis, obsessive rituals, thought disorder, hallucinations, delusions, or suicidal ideation. See Vazquez-Claudio v. Shinseki, 713 F.3d at 112, 115-17 (2013). Next, although the general rating formula provides specific examples of symptoms that may result from various acquired psychiatric disorders, the Board emphasizes that its analysis should also consider any other relevant criteria outside of the rating code in order to determine the level of occupational and social impairment. Mauerhan v. Principi, 16 Vet. App. 436, 444 (2002). As such, the Board has also considered the extent to which there are other indications of occupational and social impairment, such as difficulty in adapting to stressful circumstances or the inability to establish and maintain effective relationships that may cause deficiencies in most areas, to include social and occupational inadaptability. In this regard, the evidence shows that the Veteran's psychiatric disability and its manifestations are adequately contemplated by a 50 percent rating. Here, the Veteran is gainfully employed as a fireman. Therefore, it would not appear that he is impaired in most areas. In considering the appropriate disability ratings, the Board has considered the statements from the Veteran his service-connected psychiatric disorder is worse than the rating he currently receives, including that his disabilities cause impairment with his activities of daily living. In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency of evidence differs from weight and credibility. While the Veteran is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of disability of the Veteran's service-connected disabilities according to the appropriate diagnostic codes. Rucker v. Brown, 10 Vet. App. 67, 74 (1997). On the other hand, such competent evidence concerning the nature and extent of the Veteran's psychiatric disorder has been provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings (as provided in the examination reports) directly address the criteria under which the psychiatric disability is evaluated. Therefore, the Board concludes that a 50 percent rating, but no more, is warranted for the period on appeal. 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. 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. B.T. KNOPE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Billinger, Associate Counsel