Citation Nr: 25012425 Decision Date: 10/02/25 Archive Date: 10/02/25 DOCKET NO. 18-51 870 DATE: October 2, 2025 ORDER Entitlement to an increased rating for service-connected posttraumatic stress disorder (PTSD), previously other specified trauma disorder, rated as 50 percent prior to August 12, 2021 and as 70 percent thereafter, is denied. FINDING OF FACT Prior to August 12, 2021, the severity, frequency, and duration of the Veteran's other specified trauma disorder did not most closely approximate occupational and social impairment with deficiencies in most areas; thereafter, the Veteran's PTSD severity, frequency, and duration of the Veteran's symptoms did not most closely approximate total occupational and social impairment. CONCLUSION OF LAW The criteria for an initial disability rating in excess of 50 percent prior to August 12, 2021 and in excess of 70 percent thereafter for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9411. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army, including from February 2009 to February 2010 and September 2011 to November 2012. This matter was previously before the Board of Veterans' Appeals (Board) in November 2023. The Board issued a remand. The matter comes back before the Board for adjudication. The Veteran claims entitlement to an initial rating in excess of 50 percent for other specified trauma disorder, prior to August 12, 2021, and entitlement to a 70 percent rating for PTSD, thereafter. For the reasons described below, the Board finds that the evidence does not support ratings higher than those already awarded. Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities. Ratings are based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where entitlement to compensation has already been established, and an increase in the disability rating is at issue, the present level of disability is of primary concern. Although a rating specialist is directed to review the recorded history of a disability in order to make a more accurate evaluation, the regulations do not give past medical reports precedence over current findings. See Francisco v. Brown, 7 Vet. App. 55 (1994); 38 C.F.R. § 4.2. Staged ratings are, however, appropriate for an increased rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. The relevant focus for adjudicating an increased rating claim is on the evidence concerning the state of the disability from the time period one year before the claim was filed until VA makes a final decision on the claim. See generally Hart v. Mansfield, 21 Vet. App. 505 (2007). 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. See 38 C.F.R. § 4.7. Under the General Formula for Mental Disorders (General Formula), the Board must conduct a "holistic analysis" that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013). Under the General Formula, a 50 percent rating is assigned when symptoms such 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; or difficulty in establishing and maintaining effective work and social relationships cause occupational and social impairment with reduced reliability and productivity. A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; 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); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. A 100 percent rating is assigned when symptoms such 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; or memory loss for names of close relatives, own occupation or own name cause total occupational and social impairment. The Board finds that the most pertinent evidence bearing on the relevant issues in this appeal consists of the Veteran's statements, his VA medical treatment records, and the reports of the VA examinations that the Veteran was afforded. The Veteran claims that his mental disorder is severe, renders him having impaired impulse control, difficulty driving, and reduced reliability. See March 2023 Hearing Transcript. The Veteran underwent an initial PTSD VA examination in March 2016. Here, the examiner did not find a diagnosis of PTSD. The examiner noted a symptom of chronic sleep impairment. The examiner, after review of the record and evaluation of the Veteran, found that the Veteran does not meet criteria for PTSD or any other mental conditions. See March 2016 VA Initial PTSD Disability Benefits Questionnaire (DBQ). VA treatment records note reports of insomnia, vivid dreams, anxiety, and avoidance. See August 2016 VA Primary Care Note. The Veteran also reported sleep disturbances, avoidance, hypervigilance, intrusive thoughts, and exaggerated startle response. The Veteran was noted to have a diagnosis of PTSD. See October 2016 VA Mental Health Note. The Veteran reported being distracted at work, hypervigilance, uncomfortable in crowds, startles quickly, and experiencing intrusive thoughts. He states that his "mind is always going," and he experiences insomnia, and anxiety. The Veteran also reported having mild impairments in his daily life. See August 2016 Primary Care Note, August 2017 VA Primary Care Note, September 2017 VA Mental Health Note, and October 2017 Psychology Note. In November 2017, the Veteran was afforded another VA examination for PTSD. Here, the examiner noted a diagnosis of other specified trauma and stressor related disorder which amounted to 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. The Veteran's symptoms were noted as anxiety and chronic sleep impairment. There was no sign of a thought disorder, delusions, or hallucinations. He was fully oriented to person, place, time, and circumstances. No findings of impaired memory. The examiner stated that his condition was due to combat in service. See November 2017 VA Initial PTSD DBQ. In August 2021, the Veteran underwent another VA examination for PTSD. Here, the examiner confirmed a diagnosis of PTSD with dissociative features amounting to 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 reported experiencing nightmares, avoidance, suspiciousness, periods of depression and isolation, periods of intense agitation and anxiety with exposure to stimuli associated with traumatic events, sleep difficulties, and complaints of forgetfulness. The Veteran denied suicidal ideation and homicidal ideation in active and passive forms. The Veteran denied seeing mental health providers or using medications since November 14, 2017. The examiner noted the Veteran's symptoms as depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, difficulty establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, and impair impulse control. The examiner stated that at the time of the examination, he then experienced symptoms consistent with PTSD. The examiner noted the Veteran's memory was moderately impaired, and his social interactions were moderately to episodically impaired. There was no finding of impairment in the Veteran's ability to manage activities of daily living, maintain a routine work schedule, and adequate capacity to recognize normal hazards and take appropriate action. See August 2021 VA Review PTSD DBQ. In a November 2021 VA medical opinion, the examiner stated that the Veteran's mental disorder did not meet the criteria for a diagnosis of PTSD prior to August 12, 2021. The examiner noted the gap in treatment from 2017 until the 2021 VA examination. See November 2021 VA Medical Opinion DBQ. Regarding the VA examinations in 2016 and 2017, the Board acknowledges the Veteran's argument that the VA examiner did not adequately assess his condition. Furthermore, the Veteran, through his representative, argues that the VA examiner is inadequate to assess the Veteran as the examiner is not considered active and up to date on training by the VA's standards. The Veteran asserts that the examiner's "certification was pulled by the VA". The Veteran states that the examiner was "terminated for cause and is unable to be considered competent". See October 2024 Informal Hearing Presentation (IHP). However, the Board finds otherwise. According to the Curriculum Vitae (CV) for the 2016 and 2017 VA examination examiner, it was noted that the Veteran completed required trainings. Specifically, in 2015, the examiner underwent six trainings and one training in August 2017. All trainings were noted as completed on the CV. Here, the Board finds the examiner was up to date at the time of completion of the Veteran's March 2016 and November 2017 VA examinations. The assertions made by the Veteran's representative that the said examiner is incompetent are broad assertions. The Veteran, through his representative, did not provide evidence specific to the Veteran's VA examinations establishing wrong doing by the examiner. The representative merely made the broad assertions of an "incompetent" examiner. Overall, the Board finds that that the Veteran's examinations and treatment reports do not contain evidence supporting a rating in excess of 50 percent prior to August 12, 2021, or in excess of 70 percent thereafter. Rather, the symptoms described above are consistent with the assigned ratings during the noted time periods. The evidence does not support total occupational and social impairment at any time during the period on appeal. Furthermore, the November 2021 VA medical opinion stated that the Veteran did not experience symptoms to warrant a diagnosis of PTSD prior to August 12, 2021. The examiner did not note any inadequacy of the 2016 or 2017 VA examinations with the evidence of record. The evidence of record notes that the Veteran continuously denied suicidal ideation, homicidal ideation, delusions, and hallucinations. The evidence does not indicate obsessive rituals, impaired speech, disorientation, or neglect of personal appearance and hygiene. Prior to August 12, 2021, the evidence does not support impaired impulse control. The Board is cognizant of the Veteran's difficulties; however, the evidence of record does not show symptoms of the severity for which a disability rating higher than 50 percent prior to August 12, 2021 or 70 percent effective August 12, 2021 would be warranted. The Veteran is married and has friends whom he talks to "quite a bit". The Veteran has hobbies such as woodworking and skateboarding. He reported listening to music and spending time with family when he is not working. See August 2021 VA Review PTSD DBQ. Accordingly, entitlement to an initial rating in excess of 50 percent for other specified trauma disorder prior to August 12, 2021, and 70 percent for PTSD thereafter, is denied. In making this determination, the Board notes that neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017). Moreover, as the Veteran has not contended, nor does the evidence show that this disability renders him unemployable, the issue of entitlement to a total disability rating based on individual unemployability has not been raised by the record. Rice v. Shinseki, 22 Vet. App. 447 (2009). Accordingly, and based on this evidentiary posture, the Board concludes that the evidence is persuasively against a finding that a disability rating in excess of 50 percent prior to August 12, 2021 or in excess of 70 percent effective August 12, 2021 is warranted. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Glaeser, Jennifer 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.