MENTAL DISORDERS

Summary

The Veteran, who served from September 1969 to July 1970, appeals a May 2025 rating decision. The appeal focuses on securing a 100 percent disability rating for a service-connected psychiatric condition from April 12, 2022, and an earlier effective date for special monthly compensation (SMC) based on housebound status. The Veteran also sought Total Disability based on Individual Unemployability (TDIU) and Dependents' Educational Assistance (DEA). The Board granted a 100 percent rating for the psychiatric condition, finding that the Veteran's symptoms, including anxiety, chronic sleep impairment, depressed mood, and significant occupational and social impairment, met the criteria for total disability. The Board noted that while VA examinations estimated lesser impairment, the Veteran's testimony and a private psychiatric report estimating total impairment created relative equipoise. Resolving reasonable doubt in the Veteran's favor, the 100 percent rating was granted. Consequently, the TDIU claim was dismissed as moot. The Board also granted an earlier effective date for SMC housebound benefits, aligning with the 100 percent rating, and granted basic eligibility for DEA benefits from April 12, 2022, based on the permanent and total disability rating. The appeal is granted.

Rationale

Holistic analysis of all associated symptoms considered.; Evidence in relative equipoise; reasonable doubt resolved in Veteran's favor.; Veteran's testimony and private psychiatric report estimated total impairment.

Full Decision Text

Citation Nr: A26019980
Decision Date: 03/05/26	Archive Date: 03/05/26

DOCKET NO. 250710-554948
DATE: March 5, 2026

ORDER

Entitlement to a 100 percent evaluation for service-connected psychiatric condition from April 12, 2022, is granted.

Entitlement to a total disability rating based on individual unemployability is dismissed.

An effective date of August 10, 2022, but no earlier, for entitlement to special monthly compensation based on statutory housebound criteria is granted.

Basic eligibility to Dependents' Educational Assistance based on permanent and total disability status from April 12, 2022, is granted.

FINDINGS OF FACT

1. The period on review for rating the service-connected psychiatric condition commenced with the increased rating claim dated April 12, 2022, the rating for which has been continuously pursued; the other issues were raised/inferred during the appeal of the psychiatric rating. 

2. From April 12, 2022, the Veteran's service-connected psychiatric condition was productive of symptoms of anxiety, chronic sleep impairment, depressed mood, difficulty in adapting to a work like setting, difficulty in adapting to stressful circumstances, difficulty in adapting to work, difficulty in establishing and maintaining effective work in social relationships, disturbances of motivation and mood, flattened affect, forgetting directions, forgetting names, forgetting recent events, mild memory loss, occupational and social impairment with deficiencies in most areas such as work school family relations judgment thinking or mood, panic attacks at least weekly, suicidal ideation, and suspiciousness, best approximated as productive of total social and occupational impairment. 

3. As the Veteran is now in receipt of a total disability rating for the period on appeal, entitlement to a TDIU is moot.

4. As of August 10, 2022, but no earlier, the Veteran is in receipt of a total disability rating based on one disability plus another disability rated 60 percent or higher.

5. As the Veteran is now in receipt of a permanent and total disability rating as of April 12, 2022, and was deemed to have met the basic eligibility to Dependents' Educational Assistance otherwise below, the effective date is awarded as of April 12, 2022.

CONCLUSIONS OF LAW

1. The criteria for entitlement to a 100 percent evaluation for service-connected psychiatric condition from April 12, 2022, have been met.

2. The criteria to dismiss the claim of entitlement to a total disability rating based on individual unemployability as moot have been met. 38 C.F.R. §§ 3.340, 3.341, 4.16.

3. The criteria for an effective date of August 10, 2022, but no earlier, for entitlement to special monthly compensation based on statutory housebound criteria have been met. 38 U.S.C. § 1114(s).

4. The criteria for basic eligibility to Dependents' Educational Assistance based on permanent and total disability status from April 12, 2022, have been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.400.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from September 1969 to July 1970. 

The Veteran has been service connected for disability since January 2006.  His current combined evaluation for compensation is 100 percent from December 2024, with basic eligibility under Chapter 35 from that same date.

The appeal comes to the Board of Veterans' Appeals (Board) from a May 2025 rating decision. In the July 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on October 29, 2025. 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 or representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. §
 at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Increased Ratings

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.

The Veteran's entire history is to be considered when making disability evaluations.  See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995).  Staged ratings are appropriate for any rating claim when the factual findings show distinct time periods during the appeal period where the service-connected disability exhibits symptoms that would warrant different ratings.  Hart v. Mansfield, 21 Vet. App. 505 (2007).  Staged ratings are appropriate for any initial rating claim when the factual findings show distinct time periods during the appeal period where the service-connected disability exhibits symptoms that would warrant different ratings.  Fenderson v. West, 12 Vet. App. 119, 126 (1999).

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 for that rating.  Otherwise, the lower rating will be assigned.  38 C.F.R. § 4.7.  Any reasonable doubt regarding a degree of disability will be resolved in favor of the veteran.  38 C.F.R. § 4.3.

When considering whether lay evidence is to be given weight, the Board must determine, on a case-by-case basis, whether a veteran's particular disability is the type of disability for which lay evidence may be appropriate.  Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). 

When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a veteran prevailing in either event, or whether the persuasive weight of the evidence is against a claim, in which case, the claim is denied.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102, Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

1. Entitlement to a 100 percent evaluation for service-connected psychiatric condition from April 12, 2022, is granted. 

The Veteran seeks an earlier effective date for the award of a 100 percent rating for his service-connected psychiatric disability. The period on appeal commences with the claim filed on April 12, 2022; since then, he has continuously pursued the rating for this disability for this time period by filing timely supplemental claims and the present appeal. 38 C.F.R. § 3.2500(c).  

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). 

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). 

A 100 percent 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; or memory loss for names of close relatives, own occupation or own name.

The rating decision on appeal found the Veteran's service-connected psychiatric condition was currently productive of symptoms of anxiety, chronic sleep impairment, depressed mood, difficulty in adapting to a work like setting, difficulty in adapting to stressful circumstances, difficulty in adapting to work, difficulty in establishing and maintaining effective work in social relationships, disturbances of motivation and mood, flattened affect, forgetting directions, forgetting names, forgetting recent events, mild memory loss, occupational and social impairment with deficiencies in most areas such as work school family relations judgment thinking or mood, panic attacks at least weekly, suicidal ideation, and suspiciousness, best approximated as productive of total social and occupational impairment. The Board adopts these findings as adequately supported, and next addresses what period these findings should be applied.

The Board considered the Veteran's testimony at the October 2025 Board hearing, in which he testified to extremely sparse social interaction and no occupational activity, and considered the March 2025 private psychiatric report and estimation of occupational capacity of C. R., Ph.D., which estimated total impairment during the appellate period. Although there are VA examinations of record that estimate the Veteran's impairment to a lesser degree than testified to and estimated by the private clinician, the Board finds the evidence in relative equipoise and resolves reasonable doubt in the Veteran's favor. The appeal is granted.

2. Entitlement to a total disability rating based on individual unemployability is dismissed as moot. 

A TDIU was inferred during the pendency of the increased rating claim, and thus the same rating period is subject to award, if warranted.  

A TDIU may be assigned when the schedular rating for service-connected disabilities is less than 100 percent when service-connected disability is productive of unemployability. 38 C.F.R. §§ 3.340, 3.341, 4.16.

In light of the award of a 100 percent rating for the entirety of the period on appeal, the issue of entitlement to a TDIU is now moot and is accordingly dismissed. 

3. An effective date of August 10, 2022, but no earlier, for entitlement to special monthly compensation based on statutory housebound criteria is granted. 

SMC based on statutory housebound was inferred during the pendency of the increased rating claim, and thus the same rating period is subject to award, if warranted.  

SMC at the housebound rate is warranted if, in addition to having a single permanent disability rated 100 percent disabling under the VA's Schedule for Rating Disabilities, the Veteran: (1) has additional disability or disabilities independently ratable at 60 percent or more, separate and distinct from the permanent disability rated as 100 percent disabling and involving different anatomical segments or bodily systems, or, (2) is permanently housebound by reason of disability or disabilities. 38 U.S.C. § 1114(s).

With the award of the earlier effective date for the 100 percent rating, the Board may now award an earlier effective date for the statutory housebound SMC rating, if warranted. As service connection and the 60 percent secondary rating is effective for the Veteran's chronic kidney disease with hypertension as of August 10, 2022, the Veteran may receive such for the effective date for statutory housebound SMC. As he was not in receipt of qualifying ratings prior to this date, an even earlier effective date is not warranted, however.  

4. Basic eligibility to Dependents' Educational Assistance based on permanent and total disability status from April 12, 2022, is granted. 

DEA was inferred during the pendency of the increased rating claim, and thus the same rating period is subject to award, if warranted.  

For purposes of DEA benefits under 38 U.S.C. Chapter 35,
 warranted. As service connection and the 60 percent secondary rating is effective for the Veteran's chronic kidney disease with hypertension as of August 10, 2022, the Veteran may receive such for the effective date for statutory housebound SMC. As he was not in receipt of qualifying ratings prior to this date, an even earlier effective date is not warranted, however.  

4. Basic eligibility to Dependents' Educational Assistance based on permanent and total disability status from April 12, 2022, is granted. 

DEA was inferred during the pendency of the increased rating claim, and thus the same rating period is subject to award, if warranted.  

For purposes of DEA benefits under 38 U.S.C. Chapter 35, the law relevant to the Veteran's current claim provides that basic eligibility exists where the Veteran was discharged from service under conditions other than dishonorable and has a total disability permanent in nature as a result of a service-connected disability. 38 U.S.C. § 3501(a)(1); 38 C.F.R. §§ 3.807(a), 21.3021. With certain exceptions that are not applicable to the instant claim, the effective date for the grant of such award shall, to the extent feasible, correspond to effective dates for awards of disability compensation. 38 U.S.C. § 5113(a).

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Here, the assigned effective date for basic eligibility for DEA benefits corresponds with the award of a 100 percent rating below. In light of the award of an earlier effective date for the 100 percent rating herein, a corresponding earlier effective date for DEA benefits is also awarded. 

 

 

Martin T. Mitchell

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	King, Timothy (BVA)

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.