MAJOR DEPRESSIVE DISORDER

Summary

The Veteran, who served in the United States Air Force from September 1995 to November 2004, appeals the denial of an increased rating for depression with a cognitive disorder. The Board reviewed the evidence, including a June 2019 VA examination and an October 2018 Neuropsychological Evaluation. The VA examination noted occupational and social impairment due to depression, paranoia, disturbances in motivation and mood, difficulty with work and social relationships, and challenges adapting to stress. The Neuropsychological Evaluation indicated attention and memory deficits, affecting daily tasks like remembering schedules and names. A separate April 2019 Psychiatry Care Note mentioned frequent arguments with his wife. The Board found this evidence collectively demonstrated deficiencies in family relations, judgment, and thinking, consistent with a 70 percent rating. The Veteran's representative specifically sought a 70 percent rating. The Board granted a 70 percent disability rating for depression with a cognitive disorder, finding the criteria for this evaluation level were met.

Rationale

VA examination noted occupational and social impairment due to depression, paranoia, disturbances in motivation and mood, difficulty with work and social relationships, and challenges adapting to stress.; Neuropsychological Evaluation indicated attention and memory deficits affecting daily tasks.; Psychiatry Care Note mentioned frequent arguments with wife.; Evidence collectively shows deficiencies in family relations, judgment, or thinking.

Full Decision Text

Citation Nr: 22042721
Decision Date: 07/27/22	Archive Date: 07/27/22

DOCKET NO. 15-00 201A
DATE: July 27, 2022

ORDER

A 70 percent disability rating for depression with a cognitive disorder is granted.

FINDING OF FACT

The Veteran's major depressive disorder is manifested in occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood.

CONCLUSION OF LAW

The criteria for a 70 percent disability rating for depression with a cognitive disorder have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code (DC) 9434.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in active service in the United States Air Force from September 1995 to November 2004. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2014 rating decision. 

In November 2019 the Board issued a decision denying an increased rating for depression. The Veteran appealed this decision to the Court of Appeals for Veterans Claims (CAVC) which issued a memorandum decision in April 2021 setting aside the Board's decision and remanding the claim back to the Board for further adjudication.

Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities. The percentage ratings are based on the average impairment of earning capacity and individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Any reasonable doubt regarding a degree of disability will be resolved in favor of the veteran. 38 C.F.R. § 4.3. The Board may consider whether separate ratings may be assigned for separate periods of time - a practice known as "staged ratings," - whether or not the claim concerns an initial rating. Fenderson v. West, 12 Vet. App. 119, 126-27 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).

The Veteran's depression is rated under 38 C.F.R. § 4.130, DC 9434. The criteria authorize the Veteran's currently assigned 50 percent rating for occupational and social impairment with reduced reliability and productivity due to such symptoms such as impaired judgment, impaired abstract thinking, and disturbances of motivation and mood. Id. 

A higher 70 percent rating is assigned when depression causes 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 work like setting); inability to establish and maintain effective relationships.

The maximum 100 percent rating is warranted for 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.

When evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran's capacity for adjustment during periods of remission. The rating agency shall assign an evaluation based on all the evidence of record that bears on occupational and social impairment, rather than solely on the examiner's assessment of the level of disability at the moment of the examination. When evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment but shall not assign an evaluation solely on the basis of social impairment. 38 C.F.R. § 4.126. 

Upon review of the evidence, the Board finds that a higher 70 percent rating is appropriate. The Veteran underwent a VA examination in June 2019. This examination noted the Veteran had occupational and social impairment with reduced reliability and productivity. On examination, the Veteran was noted to have depressed mood, paranoia, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, including work or a worklike setting, inability
 of disability at the moment of the examination. When evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment but shall not assign an evaluation solely on the basis of social impairment. 38 C.F.R. § 4.126. 

Upon review of the evidence, the Board finds that a higher 70 percent rating is appropriate. The Veteran underwent a VA examination in June 2019. This examination noted the Veteran had occupational and social impairment with reduced reliability and productivity. On examination, the Veteran was noted to have depressed mood, paranoia, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, including work or a worklike setting, inability to establish and maintain effective relationships, anxiety, and suspiciousness. The examiner went on to note that these symptoms are severe enough to hinder the Veteran's ability to adequately perform tasks due to paranoia and disturbances in motivation. Additionally, the examiner noted the Veteran to have difficulties with efficient and consistent cognitive functioning largely due to his depression. 

These findings are echoed in the Veteran's medical records. In an October 2018 Neuropsychological Evaluation, the Veteran was noted to have difficulty with day-to-day attention and memory functioning. Specifically, the Veteran described difficulty remembering schedule commitments, names, and addresses he is delivering to in his work as a driver. The Veteran also found it challenging to remember to take his medications. Further, an April 2019 Psychiatry Care Note stated that the Veteran has frequent arguments with his wife. 

Collectively, this evidence shows that the Veteran has the occupational and social deficiencies in areas such as family relations, judgment, or thinking severe enough to establish a 70 percent rating.  Additionally, the Board has also considered the arguments presented by the Veteran's representative specifically seeking entitlement to a 70 percent rating, and no higher, for depression with cognitive disorder. See May 2022 Appellant's Brief. Therefore, upon review of the medical and lay evidence, the Board has determined that the Veteran's psychiatric disability is manifested by symptoms consistent with a 70 percent evaluation. 

In summary, the evidence shows the Veteran has occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood consistent with a 70 percent rating. Therefore, a 70 percent rating is warranted for the entire period on appeal.

 

 

SONJA S. AN

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Jorge Barroso, Associate 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.