Citation Nr: A25020439 Decision Date: 03/05/25 Archive Date: 03/05/25 DOCKET NO. 240209-415364 DATE: March 5, 2025 ORDER Entitlement to a disability rating greater than 20 percent for right shoulder impingement syndrome with rotator cuff tendonitis is denied. Entitlement to a disability rating greater than 70 percent for posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. The Veteran's right shoulder condition is not manifest by limitation of arm motion midway between the side and shoulder level. 2. The Veteran's PTSD is not manifest by total occupational and social impairment. CONCLUSIONS OF LAW 1. The criteria to establish a rating greater than 20 percent for a right shoulder condition have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.59, 4.71a, Diagnostic Code 5201. 2. The criteria to establish a rating greater than 70 percent for PTSD have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.130, Diagnostic Code 9411. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 2007 to June 2012 and from July 2016 to March 2017. He appeals January and February 2024 rating decisions by the Agency of Original Jurisdiction (AOJ). The Veteran requested that his appeal be placed on the direct review docket. See February 2024 VA Form 10182. Under the direct review docket, the Board is only authorized to review the evidence of record at the time of the AOJ's January and February 2024 rating decisions. 38 C.F.R. § 20.301. 1. Entitlement to an increased rating for right shoulder impingement syndrome with rotator cuff tendonitis The Veteran contends that his right shoulder impingement syndrome with rotator cuff tendonitis is more severe than his present 20 percent rating would indicate. The Veteran's condition is rated under Diagnostic Code (DC) 5201, which contemplates limitation of motion of the arm. Under DC 5201, limitation of motion of the arm at shoulder level (flexion and/or abduction limited to 90 degrees) warrants a 20 percent rating for both the major and minor extremity. Limitation of motion of the arm midway between side and shoulder (flexion and/or abduction limited to 45 degrees) warrants a 20 percent rating for the minor extremity and a 30 percent rating for the major extremity. Limitation of motion of the arm (flexion and/or abduction) to 25 degrees from side warrants a maximum 30 percent rating for the minor joint and a maximum 40 percent rating for the major joint. 38 C.F.R. § 4.71a, DC 5201. When assigning a disability rating, some of the regulations preceding the rating schedule add flexibility to the listed Diagnostic Codes. The provisions of 38 C.F.R. § 4.59, in particular, acknowledge that a claimant's disability may cause actual pain or painful motion but still not be severe enough to warrant a compensable rating under the appropriate Diagnostic Code. Accordingly, when there is evidence of painful motion, § 4.59 operates to provide at least the minimum compensable rating available under the Diagnostic Code for the joint. See Sowers v. McDonald, 27 Vet. App. 472, 478 (2016). The Board notes that the Veteran is right-handed. See February 2024 VA examination. This means that his right shoulder is considered the "major" joint under DC 5201. The Veteran was given a VA examination in February 2024. The Veteran reported that his shoulder condition limited his ability to lift objects, perform upper body exercise, perform overhead movements, and to look over his shoulder. Range of motion testing found flexion and abduction endpoints of 170 degrees. The examiner found that there was no additional functional loss after repeated use over time. While the Veteran reported flare ups, the examiner found that these flare ups did not cause any additional functional loss. See February 2024 VA examination. These results do not show that the Veteran's limitation of motion is severe enough to warrant a higher rating under DC 5201. Furthermore, the evidence does not indicate the presence of any symptoms which would warrant a separate rating or a higher rating under a different diagnostic code. Accordingly, entitlement to a disability rating greater than 20 percent for right shoulder impingement syndrome with rotator cuff tendonitis is denied. 2. Entitlement to an increased rating for PTSD The Veteran also seeks an increased rating for his service-connected PTSD. The Veteran's PTSD is currently rated as 70 percent disabling under DC 9411. See January 2024 rating decision; 38 C.F.R. § 4.130. Under DC 9411, a 70 percent rating is appropriate when symptoms result in 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 worklike setting); inability to establish and maintain effective relationships. 38 C.F.R. § 4.130. A higher rating of 100 percent is appropriate when symptoms result in 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; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. Id. In a November 2023 VA examination, the Veteran reported feeling unable to deal with his job and life in general, and that he does not get help to manage his PTSD symptoms. The examiner noted symptoms of depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, impairment of short- and long-term memory, flattened affect, difficulty in understanding complex commands, disturbances of motivation and mood, difficulty in establishing effective work and social relationships, difficulty in adapting to stressful circumstances, and inability to establish and maintain effective relationships. The examiner did not note any additional symptoms. The examiner concluded that the Veteran's PTSD resulted in 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. See November 2023 VA examination. This evidence does not demonstrate that the Veteran suffers the type of symptoms, or those of similar frequency, duration, or severity, contemplated in the 100 percent rating criteria. See Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-19 (Fed. Cir. 2013). The evidence also fails to demonstrate that the Veteran's symptoms result in total occupational and social impairment. See id. (noting that while symptomatology is the primary consideration, the evidence must also show that the Veteran meets the specified level of occupational and social impairment). Here, the record reflects that the Veteran is employed and recently married. See November 2023 VA examination. He reported that he enjoys spending time with his daughter and has a supportive relationship with his cousin. See September 2020 medical record. Thus, total occupational and social impairment has not been shown and the Board concludes that a disability rating greater than 70 percent for PTSD is not warranted. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moore, Thomas J. 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.