PSYCHOSES

ANN K. MINAMI · 2026 · Case ID: 26004579

MIXED

Summary

The Veteran, an Army Veteran who served from March 2003 to September 2010, appeals the denial of an increased disability rating for an acquired psychiatric disorder and the grant of TDIU. The Board reviewed the Veteran's service treatment records and multiple VA examinations from June 2017, December 2019, and November 2025. The June 2017 VA exam found occupational and social impairment with occasional decreases in work efficiency, while the December 2019 and November 2025 exams noted more significant impairments, including reduced reliability and productivity, and in the latter, suicidal ideation and psychosis. The Board found the evidence supported a 70% rating from July 1, 2017, based on a reinterpretation of the December 2019 exam findings, but denied ratings higher than 70% due to the continued presence of some social functioning and the lack of total occupational and social impairment. The Board granted TDIU effective May 12, 2017, noting the Veteran's combined disabilities, including the psychiatric condition, back, bilateral lower extremities, and tinnitus, prevented substantially gainful employment throughout the period on appeal. Service connection for the acquired psychiatric disorder was granted at 70% from July 1, 2017, and TDIU was granted.

Rationale

Evidence did not support total occupational and social impairment prior to July 1, 2017.; Veteran maintained some social relationships and had normal thought processes/judgement per VA exam.; Evidence did not support total occupational and social impairment from December 11, 2019.

Service Branch

ARMY

Special Benefit

TDIU

Docket No.

18-49 684

Full Decision Text

Citation Nr: 26004579
Decision Date: 04/15/26 Archive Date: 04/15/26

DOCKET NO. 18-49 684
DATE: April 15, 2026

ORDER

An initial disability rating in excess of 50 percent prior to July 1, 2017 for an acquired psychiatric disorder is denied.

An initial disability rating of 70 percent, but no more, from July 1, 2017 to December 11, 2019 for an acquired psychiatric disorder is granted.

An initial disability rating in excess of 70 percent from December 11, 2019 for an acquired psychiatric disorder is denied.

A total disability rating due to individual unemployability (TDIU) effective May 12, 2017 is granted.

FINDINGS OF FACT

1. Prior to July 1, 2017, the Veteran's acquired psychiatric disorder did not manifest occupational and social impairment with deficiencies in most areas or total occupational and social impairment.

2. From July 1, 2017 to December 11, 2019, the Veteran manifested occupational and social impairment with deficiencies in most areas, but the Veteran did not manifest total occupational and social impairment.

3. From December 11, 2019, the Veteran did not manifest total occupational and social impairment.

4. From May 12, 2017, the Veteran's previously service-connected disabilities prevented the Veteran from securing and maintaining substantially gainful employment, and the Veteran met the schedular criteria for TDIU from May 12, 2017.

CONCLUSIONS OF LAW

1. The criteria for an initial disability rating in excess of 50 percent prior to July 1, 2017 for an acquired psychiatric disorder have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.130, Diagnostic Code 9411.

2. The criteria for an initial disability rating of 70 percent, but no more, from July 1, 2017 to December 11, 2019 for an acquired psychiatric disorder have been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.130, Diagnostic Code 9411.

3. The criteria for an initial disability rating in excess of 70 percent from December 11, 2019 for an acquired psychiatric disorder have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.130, Diagnostic Code 9411.

4. The criteria for TDIU effective May 12, 2017 have been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.16.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served honorably in the United States Army from March 2003 to September 2010.

These matters come to the Board of Veterans' Appeals (Board) on appeal from a July 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This appeal is being adjudicated under the legacy appellate framework.

The Veteran did not desire a personal hearing before the Board.

These matters were previously before the Board, and, in September 2019, the Board remanded these matters for further development. In February 2023, the Board disposed of these matters. In March 2024, the Court of Appeals for Veterans Claims (Veterans Court) vacated the Board's opinion and remanded these matters back to the Board for further consideration. The Board ordered additional development in July 2024, September 2024, and July 2025. Additional development in substantial compliance with the Veterans Court's and the Board's remand instructions has been completed.

1. An initial disability rating in excess of 50 percent prior to July 1, 2017 for an acquired psychiatric disorder is denied.

2. An initial disability rating of 70 percent, but no more, from July 1, 2017 to December 11, 2019 for an acquired psychiatric disorder is granted.

3. An initial disability rating in excess of 70 percent from December 11, 2019 for an acquired psychiatric disorder is denied.

At issue is whether the Veteran is entitled to an increased initial disability rating for an acquired psychiatric disorder. The weight of the evidence indicates that the Veteran is entitled to a disability rating of 70 percent, but no more, from July 1, 2017 to December 11, 2019, but that the Veteran is not otherwise entitled to an increased disability rating for an acquired psychiatric disorder.

In July 2017, the Veteran was granted service connection for an acquired psychiatric disorder an assigned an initial disability rating of 30
December 11, 2019 for an acquired psychiatric disorder is granted.

3. An initial disability rating in excess of 70 percent from December 11, 2019 for an acquired psychiatric disorder is denied.

In July 2017, the Veteran was granted service connection for an acquired psychiatric disorder an assigned an initial disability rating of 30 percent effective May 12, 2017. The Veteran appealed. During the pendency of the appeal, the Veteran was assigned a disability rating of 50 percent effective May 12, 2017 and a disability rating of 70 percent effective December 12, 2019. See November 2025 Rating Decision Code Sheet.

Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the Veteran working or seeking work. 38 C.F.R. § 4.2. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7.

Disability ratings for acquired psychiatric disorders are assigned pursuant to the General Rating Formula for Mental Disorders. Under the General Rating Formula for Mental Disorders, a disability rating of 50 percent is assigned for occupational and social impairment with reduced reliability and productivity due to such symptoms 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; difficulty in establishing and maintaining effective work and social relationships. 38 C.F.R. § 4.130, General Rating Formula for Mental Disorders.

A disability rating of 70 percent is assigned for 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. Id.

A total disability rating is assigned 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. 38 C.F.R. § 4.130, General Rating Formula for Mental Disorders.

The use of the term 'such as' in the General Rating Formula for Mental Disorders in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of symptoms, or their effects, that would justify a particular rating. See Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). It is not required to find the presence of all, most, or even some, of the enumerated symptoms recited for particular ratings. Id. The use of the phrase 'such symptoms as,' followed by a list of examples, provides guidance as to the severity of the symptoms contemplated for each rating, in addition to permitting consideration of other symptoms particular to each veteran and disorder, and the effect of those symptoms on his/her social and
phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of symptoms, or their effects, that would justify a particular rating. See Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). It is not required to find the presence of all, most, or even some, of the enumerated symptoms recited for particular ratings. Id. The use of the phrase 'such symptoms as,' followed by a list of examples, provides guidance as to the severity of the symptoms contemplated for each rating, in addition to permitting consideration of other symptoms particular to each veteran and disorder, and the effect of those symptoms on his/her social and work situation. Id. In Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013), the Federal Circuit stated that "a veteran may only qualify for a given disability under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration." It was also noted that "§ 4.130 requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment in most of the referenced areas." Id.

The Veteran's treatment records indicate that the Veteran manifested psychiatric symptomology throughout the period on appeal.

The Veteran underwent a VA examination on June 30, 2017. The Veteran reported that he divorced, but that he had a two-year old daughter with an ex-girlfriend; but that he did not see his daughter often. The Veteran indicated that he had a strained relationship with his mother. The Veteran stated that he was unemployed. The VA examiner observed a number of psychiatric symptoms including: avoidance of disturbing stimuli, irritable behavior, angry outburst, hypervigilance, sleep disturbance, depressed mood, anxiety, suspiciousness, chronic sleep impairment, normal thought processes and content, and judgement sufficient to understand the outcomes of behavior. The VA examiner opined that the Veteran manifested 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 underwent another VA examination on December 12, 2019. The Veteran reported problems managing his relationships with family and friends. The Veteran indicated that he had a roommate, and that he had a good relationship with his four year old daughter. The VA examiner observed a number of psychiatric symptoms including: avoidance of disturbing stimuli, irritable behavior, angry outbursts, hyper-vigilance, depressed mood, anxiety, chronic sleep impairment, disturbances of motivation and mood, and suicidal ideation. The Veteran stated that he was unemployed. The examiner opined that the Veteran manifested occupational and social impairment with reduced reliability and productivity.

The Veteran underwent another VA examination in November 2025. The Veteran reported that he was now married. The Veteran stated that he was unemployed. The VA examiner observed a number of psychiatric symptoms: avoidance of disturbing stimuli, irritable behavior, angry outbursts, reckless or self-destructive behavior, hypervigilance, problems with concentration, anxiety suspiciousness, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, and psychosis. The VA examiner opined that the Veteran manifested occupational and social impairment with reduced reliability and productivity. The VA examiner further opined that the Veteran's symptoms negatively impact the Veteran's ability to work due to difficulty staying in one place at a time and focusing on a task.

The weight of the evidence indicates that the Veteran is not entitled to a disability rating in excess of 50 percent prior to July 1, 2017. In order to meet the criteria for a disability rating in excess of 50 percent, the Veteran needed to manifest either total occupational and social impairment or occupational impairment with deficiencies in most areas such as work, school, family relations, judgment, thinking, or mood. The Veteran indicated that he had strained relationship with his mother. This relationship, however strained, indicates that the Veteran was not totally socially impaired, and that the Veteran was able to maintain family relationships. A VA examiner opined that the Veteran had normal thought processes and content, and that the Veteran's judgement sufficient to understand the outcomes of behavior. The Veteran was not in school, but that is normal for the Veteran's age cohort. A VA examiner opined that the Veteran only manifested 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. Additionally, the record is silent for a competent medical opinion prior to July 1, 2017 indicating that the Veteran has
This relationship, however strained, indicates that the Veteran was not totally socially impaired, and that the Veteran was able to maintain family relationships. A VA examiner opined that the Veteran had normal thought processes and content, and that the Veteran's judgement sufficient to understand the outcomes of behavior. The Veteran was not in school, but that is normal for the Veteran's age cohort. A VA examiner opined that the Veteran only manifested 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. Additionally, the record is silent for a competent medical opinion prior to July 1, 2017 indicating that the Veteran has total occupational and social impairment or occupational and social impairment in most areas. The Board notes that the Veteran has manifested deficiencies in the areas of work and mood during this period of time, but the Board finds that, overall, the Veteran is not deficient in most areas. Additionally, the Veteran's ability to maintain some social relationships means that the Veteran was not totally socially impaired and logically not totally occupationally and socially impaired. As such, the Veteran is not entitled to a disability rating in excess of 50 percent prior to July 1, 2017.

The Veteran is entitled to a disability rating of 70 percent from July 1, 2017. A November 2025 rating decision, based in no small part on the results of the November 2025 VA examination, reinterpreted the results of the December 12, 2019 VA examination to indicate that the Veteran was manifesting occupational and social impairments with deficiencies in most areas and, based on the finding that the December 12, 2019 VA examination memorialized such an impairment, assigned a disability rating of 70 percent effective December 12, 2019. The Board is bound by this favorable finding. 38 C.F.R. § 3.107. It is unclear from the record exactly when the Veteran's acquired psychiatric disorder increased from 50 percent to 70 percent. Interpreting all facts in the Veteran's behavior, the Veteran must be assigned an effective date of July 1, 2017. This is the date after the June 30, 2017 VA examination indicating that the Veteran was not entitled to a disability rating in excess of 50 percent and the earliest possible date that the Veteran's increased disability rating could have begun to manifest. As such, a disability rating of 70 percent effective July 1, 2017 is granted.

The weight of the evidence indicates that the Veteran is not entitled to a disability rating in excess of 70 percent from July 1, 2017. In order to meet the criteria for a disability rating in excess of 70 percent, the Veteran needed to manifest total occupational and social impairment. VA examinations after July 1, 2017 indicate that the Veteran maintained family relationships with his daughter and later with his new wife who he met courted, married, and maintained a marriage with to this day. Additionally, neither VA examiner opined that the Veteran was totally occupationally and socially impaired, and the record is otherwise silent for such an opinion from a competent medical provider. As such, the weight of the evidence does not establish that the Veteran was totally occupationally and socially impaired from July 1, 2017.

The Board notes that this matter was previously disposed of, but the Veterans Court vacated the Board's disposition and remanded the matter back to the Board for further consideration. The Board has engaged in further development responsive to the Veterans Court's instructions including providing the Veteran with an additional VA examination.

Here, the weight of the probative evidence of record indicates that the Veteran is entitled to a disability rating of 70 percent, but no more, from July 1, 2017 to December 11, 2019, but that the Veteran is not otherwise entitled to an increased disability rating for an acquired psychiatric disorder. Therefore, the evidence in this case is evenly balanced enough so as to allow application of the benefit-of-the-doubt rule as required by law and VA regulations. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. As such, a disability rating of 70 percent, but no more, from July 1, 2017 to December 11, 2019 for an acquired psychiatric disorder is granted.

4. TDIU effective May 12, 2017 is granted.

At issue is whether the Veteran is entitled to TDIU. The weight of the evidence indicates that the Veteran is entitled to TDIU throughout the period on appeal.

The Veteran meets the schedular criteria throughout the period on appeal, because the Veteran has been
benefit-of-the-doubt rule as required by law and VA regulations. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. As such, a disability rating of 70 percent, but no more, from July 1, 2017 to December 11, 2019 for an acquired psychiatric disorder is granted.

4. TDIU effective May 12, 2017 is granted.

At issue is whether the Veteran is entitled to TDIU. The weight of the evidence indicates that the Veteran is entitled to TDIU throughout the period on appeal.

The Veteran meets the schedular criteria throughout the period on appeal, because the Veteran has been assigned an individual disability that is at least 40 percent disabling and a combined disability rating of 70 percent throughout the period on appeal. 38 C.F.R. § 4.16.

The Veteran has been granted service connection for an acquired psychiatric disorder throughout the period on appeal which consistently caused either occupational impairment with deficiencies in most areas or reduced reliability and productivity. See November 2025 Rating Decision Code Sheet. In addition to the Veteran's decreased mental acuity, the Veteran has orthopedic and neurological disabilities of the back and bilateral lower extremities. Id. Finally, the Veteran has been granted service connection for tinnitus; which necessarily hampers communication. Id. The Veteran has been unemployed throughout the period on appeal. See supra. All told, the Veteran's disabilities prevent the Veteran from engaging in any work that requires a high level of mental acuity and concentration, substantial levels of physical exertion, and clear communication during a period of time when the Veteran has been continuously unemployed. The Board is satisfied that the Veteran cannot secure and maintain substantially gainful employment.

Therefore, the Veteran meets the schedular criteria for TDIU and has been unable to secure and maintain substantially gainful employment throughout the period on appeal. This is sufficient to grant TDIU. 38 C.F.R. § 4.16.

Here, the weight of the probative evidence of record indicates that the Veteran is entitled TDIU throughout the period on appeal. TDIU effective May 12, 2017 is granted.

Ann K. Minami

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board David R. Seaton, 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.

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