ACQUIRED PSYCHIATRIC DISORDER

Summary

The Veteran, an Army Veteran who served from March 1981 to March 1984, appeals for an increased rating for his acquired psychiatric disorder and residuals of TBI. The Board of Veterans' Appeals (Board) reviewed the case, noting the Veteran's service history and awards. The Veteran sought a 70 percent rating for his psychiatric condition. The Board considered VA treatment records from 2006 to 2013, which documented chronic suicidal ideation, irritability, anger, depression, and difficulty adapting to stress. A March 2017 VA examination noted depressed mood, sleep impairment, difficulty concentrating, and questionable reliability due to inconsistencies. A November 2017 VA treatment record indicated chronic suicidal ideation. A private medical opinion from Dr. R.P. in August 2025 found deficiencies in most areas, including suicidal ideation and difficulty adapting to stress. The Board found the VA treatment records demonstrated ongoing symptoms consistent with a 70 percent rating, particularly noting the chronic suicidal ideation, irritability, and difficulty adapting to stress. Resolving reasonable doubt in the Veteran's favor, the Board granted the 70 percent rating for the acquired psychiatric disorder, finding it warranted based on the documented occupational and social impairment.

Rationale

VA treatment records demonstrate ongoing and chronic suicidal ideation, irritability with reports of violence, depression, lack of appetite, anger, and difficulty adapting to stressful circumstances.; Bankhead v. Shulkin, 29 Vet. App. 10, 18-19 (2017) supports a higher rating based on suicidal ideation.; Resolving reasonable doubt in the Veteran's favor, the Board finds the acquired psychiatric disorder and residuals of TBI manifest in occupational and social impairment with deficiencies in most areas.

Full Decision Text

Citation Nr: A26026126
Decision Date: 03/24/26	Archive Date: 03/24/26

DOCKET NO. 240228-419203
DATE: March 24, 2026

ORDER

Entitlement to a 70 percent rating for acquired psychiatric disorder and residuals of traumatic brain injury (TBI) is granted.

FINDING OF FACT

Resolving reasonable doubt in the Veteran's favor, the Veteran's acquired psychiatric disorder and residuals of TBI have manifested in occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. 

CONCLUSION OF LAW

The criteria for a 70 percent rating for acquired psychiatric disorder and residuals of TBI have been met.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.125, 4.130, Diagnostic Code 9413.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served honorably on active duty in the United States Army from March 1981 to March 1984.  His awards and decorations include the Army Service Ribbon and Overseas Service Ribbon, among others.  

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2024 rating decision of an agency of original jurisdiction (AOJ) of the United States Department of Veterans Affairs (VA).  

Procedural History

The January 2024 rating decision granted service connection for an acquired psychiatric disorder, assigning an initial noncompensable, or 0 percent rating, effective August 3, 2007.  However, a subsequent October 2024 rating decision granted service connection for residuals of TBI, assigning a 40 percent rating under Diagnostic Code 8045, effective September 1, 2025.  That same rating decision then combined the award of service connection for TBI and acquired psychiatric disorder effective August 3, 2007, assigning a 40 percent rating from that date.  

Next, a May 2025 rating decision assigned a 70 percent rating, effective October 29, 2024, under Diagnostic Code 9413.  Though the Board does not have jurisdiction over the evaluation of TBI residuals under Diagnostic Code 8045, given that the rating decision on appeal only adjudicated the Veteran's psychiatric symptoms (as the claim for TBI had not yet been granted), the Board has reframed the matter on appeal to account for the Veteran's subsequent award of service connection for TBI and combined award.  

In addition, to the extent that TDIU has been raised as part and parcel of the Veteran's service-connected acquired psychiatric disorder and residuals of TBI, the TDIU issue is addressed in a separate appeal under docket number 09-03646A, which will be adjudicated in a separate Board decision.  This is to the Veteran's benefit as that legacy appeal would allow for the earliest possible effective date assignment for a potential award of TDIU, i.e., from September 1, 2005.     

In the February 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket.  In August 2025, the Veteran requested that the hearing be canceled, addressed the matters on appeal, and submitted a memorandum in lieu of a hearing.  Thus, the Board finds that the hearing request has been withdrawn.  Moreover, the Board is granting the benefit sought by the Veteran in full.  

Evidence Windows

Therefore, the Board may only consider the evidence of record at the time of the January 2024 AOJ decision on appeal, as well as any evidence submitted by the Veteran [or representative] within 90 days following receipt of the withdrawal of the hearing request.  38 C.F.R. § 20.302(b).  If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision.  38 C.F.R. §§ 20.300, 20.302(b), 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
 of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision.  38 C.F.R. §§ 20.300, 20.302(b), 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. Cook v. McDonough, 36 Vet. App. 175 (2023).

Entitlement to a 70 percent rating for acquired psychiatric disorder and residuals of TBI is granted.

Legal and Rating Principles

Disability ratings are determined by the application of the facts presented to VA's Schedule for Rating Disabilities (Rating Schedule) at 38 C.F.R. Part 4.  The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations.  38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1.

As noted above, following the rating decision on appeal, the AOJ combined the Veteran's service-connected acquired psychiatric disorder with the newly granted claim for service connection for residuals of TBI.  The acquired psychiatric disorder and residuals of TBI were then evaluated as 40 percent disabling from August 3, 2007, under Diagnostic Codes 9413-8045, and rated as 70 percent from October 29, 2024, under Diagnostic Code 9413.  However, in this appeal, the Board only has jurisdiction over the acquired psychiatric disorder and will not evaluate the residuals of TBI under Code 8045.  Again, that matter is pending under another docket, and will be adjudicated in a separate Board decision.  Moreover, the Board notes the Veteran specifically requested a 70 percent rating, and not a 100 percent rating for his combined condition.  See August 13, 2025, correspondence.  Thus, the Board's assignment of a 70 percent rating is considered a full grant of the benefit sought on appeal.  

All psychiatric disabilities are evaluated under a General Rating Formula for Mental Disorders (General Rating Formula).  38 C.F.R. § 4.130.

A 50 percent rating is warranted 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; and difficulty in establishing and maintaining effective work and social relationships.

A 70 percent rating is warranted 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 situations (including work or a worklike setting); and inability to establish and maintain effective relationships.

A 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 mental and personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.

When determining the appropriate disability rating to assign, the Board's primary consideration is the Veteran's symptoms, but it must also make findings as to how those symptoms impact the Veteran's occupational and social impairment.  Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013); Mauerhan v. Principi, 16 Vet. App. 426, 442 (2002).  Because the use of the term "such as" in the rating criteria demonstrates that the symptoms after that phrase
 living (including maintenance of mental and personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.

When determining the appropriate disability rating to assign, the Board's primary consideration is the Veteran's symptoms, but it must also make findings as to how those symptoms impact the Veteran's occupational and social impairment.  Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013); Mauerhan v. Principi, 16 Vet. App. 426, 442 (2002).  Because the use of the term "such as" in the rating criteria demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, the Board need not find the presence of all, most, or even some of the enumerated symptoms to award a specific rating.  Mauerhan, 16 Vet. App. at 442.  Nevertheless, all ratings in the General Rating Formula are also associated with objectively observable symptomatology, and the plain language of the regulation makes it clear that a Veteran may only qualify for a given disability by demonstrating the symptoms associated with that percentage, or others of similar severity, frequency, and duration.  Vazquez-Claudio, 713 F.3d at 118.

Evidence and Analysis

The Veteran seeks a 70 percent rating for his acquired psychiatric disorder and residuals of TBI.  See August 13, 2025, correspondence.  

VA treatment records dated in 2006 show that the Veteran experienced depression, panic attacks, irritability, anxiety, and anger.  A June 2006 VA treatment record noted that the Veteran was irritable and had outbursts of anger.  An August 2006 VA treatment record reflects anger issues and history of violence.  A September 2006 VA treatment record noted that the Veteran always had violent urges.  A May 2007 VA treatment record reflects a report of severe mood swings and difficulty focusing.  A January 2008 VA treatment record shows ongoing thoughts about not wanting to live.  An April 2008 VA treatment record reveals that the Veteran had passive suicidal ideation for over 30 years.  A May 2009 VA treatment record shows a report of emotions going up and down, anger, and mind racing.  He had depression, isolation, trouble concentrating, and lack of appetite.  He had passive suicidal ideation.  He thought of dying all the time but had a daughter so he could not harm himself.  A July 2009 VA treatment record reflects symptoms of flashbacks, irritability, avoidance, inability to recall, and hallucinations of hearing voices of friends who have died.  VA treatment records dated in December 2013 reveal reports of depression, not wanting to be around anyone, anger, and nightmares.

A March 2017 VA examination report shows symptoms of depressed mood and chronic sleep impairment.  The examiner noted that the Veteran was so medicated that it was difficult for him to keep his head up.  He reported difficulty with concentration.  On examination, the Veteran generally presented as lethargic, and his report was questionable as there were many inconsistencies noted. 

VA treatment records dated in November 2017 show symptoms of depressed mood, irritability, anxiety, impaired concentration, problems with memory, decreased appetite, passive suicidal ideation, and had previously noted auditory hallucinations of friends who have died.  A November 2017 VA treatment record noted chronic suicidal ideation.  

In an August 2025 private medical opinion, Dr. R.P., noted review of the claims folder.  Dr. R.P. found that the Veteran's acquired psychiatric disorder produced deficiencies in most areas such as suicidal ideation with psychiatric hospitalization in 2009, and evidence of difficulty adapting to stressful circumstances.  

In this case, the Board recognizes that the evidence is quite limited concerning the Veteran's psychiatric symptoms since August 2007, and there is only one VA examination report of record.  However, the VA treatment records demonstrate ongoing and chronic suicidal ideation over the course of years, irritability with reports of violence, depression, lack of appetite, anger, and difficulty adapting to stressful circumstances demonstrated by walking off jobs.  Bankhead v. Shulkin, 29 Vet. App. 10, 18-19 (2017) (holding that because suicidal ideation only appears in the 70 percent evaluation criteria, the presence of SI alone may warrant the higher rating).  Resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran's acquired psychiatric disorder and residuals of TBI manifest in occupational and social impairment with deficiencies in most areas such as work, school, family relations, judgment, thinking, or mood.  Therefore, the Board finds that a 70 percent rating for acquired psychiatric disorder and residuals
 with reports of violence, depression, lack of appetite, anger, and difficulty adapting to stressful circumstances demonstrated by walking off jobs.  Bankhead v. Shulkin, 29 Vet. App. 10, 18-19 (2017) (holding that because suicidal ideation only appears in the 70 percent evaluation criteria, the presence of SI alone may warrant the higher rating).  Resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran's acquired psychiatric disorder and residuals of TBI manifest in occupational and social impairment with deficiencies in most areas such as work, school, family relations, judgment, thinking, or mood.  Therefore, the Board finds that a 70 percent rating for acquired psychiatric disorder and residuals of TBI is warranted and the appeal is granted.    

 

 

Colleen M. Glaser-Allen

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Seay, Jessica M.

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.