ANXIETY DISORDER

T.D. JONES · 2022 · Case ID: A22011871

GRANTED

Summary

The Veteran, a Veteran who served from November 1965 to August 1967, including service in Vietnam, appeals the initial rating assigned for his service-connected anxiety disorder. The Veteran sought an increased rating, arguing his symptoms warranted a higher evaluation than the 30 percent initially granted by the agency of original jurisdiction. The Board reviewed the evidence, including a November 2020 private psychological evaluation by Dr. A.N. and a January 2022 VA examination. Dr. A.N. reported symptoms consistent with a 70 percent rating, such as difficulty adapting to stress, obsessional rituals, and impaired impulse control. The VA examiner also noted impaired impulse control and irritability. The Board found the Veteran's symptoms, including suicidal ideation, difficulty adapting to stress, obsessional rituals, and impaired impulse control, met the criteria for a 70 percent rating. However, the Board determined that total social impairment was not demonstrated, precluding a 100 percent rating, citing the Veteran's average relationship with his children, continued marriage, and social outings. Consequently, the Board granted an initial rating of 70 percent for the anxiety disorder.

Rationale

Symptoms consistent with 70% rating (suicidal ideation, difficulty adapting to stress, obsessional rituals, impaired impulse control); Total social impairment not shown (average relationship with children, married, social outings); 100% evaluation not warranted

Special Benefit

NO SPECIAL BENEFIT

Docket No.

220316-229139

Full Decision Text

Citation Nr: A22011871
Decision Date: 06/24/22 Archive Date: 06/24/22

DOCKET NO. 220316-229139
DATE: June 24, 2022

ORDER

An initial rating of 70 percent for service-connected anxiety disorder is granted.

FINDING OF FACT

The Veteran's anxiety disorder is characterized by such symptoms as unprovoked anger and irritability, strained interpersonal relationships, and occasional outbursts.

CONCLUSION OF LAW

The criteria for an initial 70 percent rating for anxiety disorder have been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.130, Diagnostic Code 9413.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service from November 1965 to August 1967, to include service in the Republic of Vietnam.

The record reflects that a rating decision was issued in February 2022 that granted service connection for anxiety disorder and assigned an initial rating of 30 percent effective December 15, 2020, the date the Veteran's service connection claim was received by VA. In March 2022, the Veteran timely appealed the initial rating assigned for his anxiety disorder by submitting VA Form 10182, Decision Review Request: Board Appeal. The Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303.

Increased Rating

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 appellant 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. Reasonable doubt regarding degree of disability is to be resolved in favor of the claimant. 38 C.F.R. § 4.3.

Under the General Rating Formula for Mental Disorders, a 30 percent evaluation is assigned when a veteran's mental disability causes occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 38 C.F.R. § 4.130, Diagnostic Code 9413.

A 50 percent evaluation is assigned when a veteran's mental disability causes 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; impaired judgment; impaired abstract thinking; disturbances of motivation and mood; or difficulty in establishing and maintaining effective work and social relationships. Id.

A 70 percent evaluation is assigned when a veteran's mental disability 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; spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances; or an inability to establish and maintain effective relationships. Id.

A 100 percent rating is assigned when a veteran's mental disability causes total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; danger of hurting self or others; intermittent inability to perform activities of living; disorientation to time or place; or, memory loss
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; spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances; or an inability to establish and maintain effective relationships. Id.

When rating a mental disorder, VA must consider the frequency, severity, and duration of the Veteran's psychiatric symptoms, the length of remissions, and the Veteran's capacity for adjustment during periods of remission. The rating agency must assign a rating 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 rating the level of disability from a mental disorder, the rating agency must consider the extent of social impairment, but cannot assign a rating solely on the basis of social impairment. 38 C.F.R. § 4.126.

Furthermore, the specified factors for each incremental rating are examples, rather than requirements, for a particular rating. The Board will not limit its analysis solely to whether the Veteran exhibited the symptoms listed in the rating criteria. Mauerhan v. Principi, 16 Vet. App. 436 (2002). Indeed, the symptoms listed under § 4.130 are not intended to serve as an exhaustive list of the symptoms that VA may consider but as examples of the type of degree of symptoms, or the effects, that would warrant a particular rating. Mauerhan, 16 Vet. App. at 442 (2002). The veteran's actual symptomatology, and resulting social and occupational impairment, will be the primary focus when assigning a disability rating for a mental disorder, and the Veteran may qualify for a particular rating by demonstrating the particular symptoms associated with that percentage, or other symptoms of similar severity, frequency, and duration. Vazquez Claudio v. Shinseki, 713 F.3d 112, 116 17 (Fed. Cir. 2013).

The Veteran asserted that he was entitled to a higher initial rating for his service-connected anxiety disorder.

In November 2020, Dr. A.N. conducted a psychological evaluation of the Veteran. He reported that he married his current wife in 1989 and remained married. He reported that they go out to eat in restaurants. The Veteran's wife reported that the Veteran had anger problems. The Veteran reported multiple events where he lost control due to his anger. He reported a history of suicidal ideation. Dr. A.N. completed a Mental Disorders Disability Benefits Questionnaire. Dr. A.N. indicated that the Veteran's anxiety symptoms included difficulty adapting to stressful circumstances, obsessional rituals that interfere with routine activities, and impaired impulse control, such as unprovoked irritability with periods of violence.

In January 2022, the Veteran was afforded a VA examination. He reported that he had an average relationship with his children but was frustrated by his grandchildren. He reported that he remained married to his wife and that they got along well. The VA examiner indicated that the Veteran's anxiety symptoms included impaired impulse control, such as unprovoked irritability with periods of violence.

The claims file establishes that the Veteran's anxiety disorder results in symptoms consistent with a 70 percent rating, such as suicidal ideation, difficulty adapting to stressful circumstances, obsessional rituals that interfere with routine activities, and impaired impulse control. However, total social impairment has not been shown, given that he has an average relationship with his children, interacted with his grandchildren, remained married to his current wife since 1989, got along well with his wife, and went out to restaurants. A 100 percent evaluation consequently is not warranted.

Accordingly, the Veteran is granted as initial rating of 70 percent for his anxiety disorder.

T.D. JONES

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T. Berryman, 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.

his current wife since 1989, got along well with his wife, and went out to restaurants. A 100 percent evaluation consequently is not warranted.

Accordingly, the Veteran is granted as initial rating of 70 percent for his anxiety disorder.

T.D. JONES

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T. Berryman, Counsel

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