ACQUIRED PSYCHIATRIC DISORDER

Summary

The veteran, who served honorably in the U.S. Army from October 2015 to May 2016 and June 2018 to May 2019, appeals the denial of an increased disability rating for an acquired psychiatric disorder. The primary issue is whether the veteran's symptoms warrant a rating higher than the 30% initially granted by the RO effective February 4, 2021. The Board reviewed three VA examinations conducted in January 2022, October 2023, and August 2024. The January 2022 exam noted symptoms like anxiety, memory loss, difficulty adapting to stress, and impaired impulse control, leading the examiner to opine reduced reliability and productivity. The October 2023 exam identified anxiety, irritability, difficulty concentrating, and weekly panic attacks, with the examiner opining occasional decreases in work efficiency and intermittent inability to perform tasks. The August 2024 exam noted anxiety, sleep impairment, and mild memory loss, with the examiner again opining occasional decreases in work efficiency and intermittent inability to perform tasks. The Board found the evidence, particularly the first examiner's opinion and the symptoms identified in subsequent exams, supported a finding of occupational and social impairment with reduced reliability and productivity, warranting a 50% rating. The veteran was denied a higher rating because they remained gainfully employed and did not demonstrate total occupational or social impairment or deficiencies in most areas, despite some mood impairment and workplace anxiety. The Board applied the benefit-of-the-doubt rule, granting the 50% rating.

Rationale

Weight of evidence supports 50% rating.; Symptoms identified (anxiety, memory loss, difficulty adapting, impaired impulse control) align with criteria for 50% rating.; Veteran's employment and family relationships, though sometimes strained, prevent higher rating.

Full Decision Text

Citation Nr: A26030636
Decision Date: 04/03/26	Archive Date: 04/03/26

DOCKET NO. 250801-570818
DATE: April 3, 2026

ORDER

An initial disability rating of 50 percent, but no more, for an acquired psychiatric disorder effective February 4, 2021 is granted.

FINDING OF FACT

The Veteran's acquired psychiatric disorder manifested occupational and social impairment with reduced reliability and productivity throughout the period on appeal, but the Veteran's acquired psychiatric disorder did not manifest total occupational or social impairment or occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood throughout the period on appeal.

CONCLUSION OF LAW

The criteria for an initial disability rating of 50 percent, but no more, for an acquired psychiatric disorder effective February 4, 2021 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 served honorably in the United States Army from October 2015 to May 2016 and from June 2018 to May 2019.

These matters come to the Board of Veterans' Appeals (Board) on appeal from a March 2025 Higher-Level Review of an October 2024 rating decision of a Department of Veterans Appeals (VA) Regional Office (RO).  This appeal is being adjudicated under the modern appellate framework.  In the August 2025 notice of disagreement (NOD) which commenced this appeal, the Veteran opted into the Direct Review Docket.  

As the Veteran has selected the Direct Review Docket, the Board may only consider the evidence of record before the agency of original jurisdiction (AOJ) at the time of its decision on the issue(s) on appeal.  See 38 C.F.R. §§ 20.300(a), 301.  The Board will not consider evidence received after the AOJ decision unless the claimant files a timely request for a Board hearing or an opportunity to submit additional evidence on the NOD (VA Form 10182). 38 C.F.R. § 20.301. The Veteran has not filed such a request. If additional evidence was submitted after the AOJ decision, the Board will not consider it. If the Veteran would like VA to consider any evidence that was added to the claims file 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.  See also Cook v. McDonough, 36 Vet. App. 175 (2023).

An initial disability rating of 50 percent, but no more, for an acquired psychiatric disorder effective February 4, 2021 is granted.

At issue is whether the Veteran is entitled to an increased disability rating for an acquired psychiatric disability.  The weight of the evidence indicates that the Veteran is entitled to an initial disability rating of 50 percent, but no more, for an acquired psychiatric disorder throughout the period on appeal.

In October 2023, the RO granted service connection for an acquired psychiatric disorder and assigned an initial disability rating of 30 percent effective February 4, 2021.  The Veteran challenged the initial disability rating and continuously pursued the claim until appealing the matter to the Board.

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
  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 30 percent is assigned for 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, 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.  Id.

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.  38 C.F.R. § 4.130, General Rating Formula for Mental Disorders.

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.  Id.

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 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 in January 2022.  The Veteran indicated that he was still married to his first wife and that he had two children and one on the way.  The Veteran indicated that he was gainfully employed in the field of insurance.  The examiner noted a number of psychiatric symptoms including: depressed mood, anxiety
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 in January 2022.  The Veteran indicated that he was still married to his first wife and that he had two children and one on the way.  The Veteran indicated that he was gainfully employed in the field of insurance.  The examiner noted a number of psychiatric symptoms including: depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, flattened affect, disturbances of motivation or mood, difficulty adapting to stressful circumstances including work or a worklike setting, and impaired impulse control with periods of violence.  The examiner did not identify any problems with judgement or impaired thinking.  The examiner opined that the Veteran manifested occupational and social impairment with reduced reliability and productivity.

The Veteran underwent another VA examination in October 2023.  The Veteran indicated that he continued to live with his wife and children, and that he had "good" and "pretty good" relationships with his wife and children respectively.  The Veteran reported that his social activities included church, singing, playing guitar, and going out with friends and family.  The Veteran stated that his support group also included his parents, his siblings, his wife, and his children.  The Veteran reported that he is still employed as an insurance agency, but that he gets anxious at work.  The Veteran also noted that he was taking college classes.  The examiner noted a number of psychiatric symptoms including: anxiety, suspiciousness, chronic sleep impairment, avoidance of anxiety provoking situations, irritability, difficulty concentrating, difficulty falling and staying asleep, hypervigilance, feeling keyed up and on edge, excessive worry, difficulty concentrating, muscle tension, and weekly panic attacks.  The examiner indicated that the Veteran had good insight and judgement, and that the Veteran had logical and goal-oriented speech.  The 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 in August 2024.  The Veteran indicated that he did not have a good relationship with his wife, because communication and intimacy had decreased.  The Veteran claimed to still have a good relationship with his children.  The Veteran reported that he spends spare time at church, and that he had maintained a relationship with his family.  The Veteran was still gainfully employed in the insurance industry, but that Veteran claimed that he was often tardy due to difficulty sleeping.  The Veteran was one class away from getting a new degrees.  The examiner noted a number of symptoms including: anxiety, chronic sleep impairment, and mild memory loss.  The examiner did not identify any problems with judgement or impaired thinking.  The 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 weight of the evidence indicates that the Veteran is entitled to a disability rating of 50 percent throughout the period on appeal.  In order to meet the criteria for a disability rating of 50 percent, the Veteran needed to manifest occupational and social impairment with reduced reliability and productivity.  The first VA examiner opined that the Veteran manifested occupational and social impairment with reduced reliability and productivity.  Additionally, the VA examiner identified a number of symptoms associated with reduced reliability and productivity including: anxiety, memory loss, difficulty adapting to stressful circumstances including work or a worklike setting, and impaired impulse control with periods of violence   While the remaining VA examiners failed to make such an opinion, the remaining VA examiners identified symptoms which would have reduced the Veteran's reliability and productivity including: anxiety specifically associated with the workplace, regular tardiness, avoidance of anxiety provoking situations (like work), irritability, difficulty concentrating, difficulty falling and staying asleep, feeling keyed up and on edge, excessive worry, difficulty concentrating, and weekly panic attacks.  As such, the weight of the evidence indicates that the Veteran manifested occupational and social impairment with reduced reliability and productivity and is entitled to a disability rating of 50 percent throughout the period on appeal.

The Veteran is not entitled to a disability rating in excess of 50 percent.  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 and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking,
 avoidance of anxiety provoking situations (like work), irritability, difficulty concentrating, difficulty falling and staying asleep, feeling keyed up and on edge, excessive worry, difficulty concentrating, and weekly panic attacks.  As such, the weight of the evidence indicates that the Veteran manifested occupational and social impairment with reduced reliability and productivity and is entitled to a disability rating of 50 percent throughout the period on appeal.

The Veteran is not entitled to a disability rating in excess of 50 percent.  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 and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.  The Veteran reported being gainfully employed as well as maintaining relationships, albeit sometimes strained relationships, with his wife, children, and family throughout the period on appeal.  As such, the Veteran has some degree of occupational and social competence and is not totally occupational and socially impaired.  Additionally, the Veteran has not manifested occupational and social impairment with deficiencies in most areas including such as work, school, family relations, judgment, thinking, or mood.  In addition to maintaining gainful employment and family relations, the Veteran was able to successfully participate in school, and the record is silent for problems with judgment or impaired thinking.  The Veteran has clearly manifested mood impairment throughout the period on appeal.  Nevertheless, the Veteran's impaired mood does not outweigh the Veteran's clear competence in the areas of work, school, family relations, judgment, and thinking.  Additionally, the Board notes that the record is silent for a VA examination or any other competent medical opinion indicating that the Veteran manifested total occupational and social impairment or occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.  As such, the criteria for a disability rating in excess of 50 percent have not been met.

Here, the weight of the probative evidence of record demonstrates that the Veteran is entitled to a disability rating of 50 percent, but no more, throughout the period on appeal.  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.A. § 5107(b); 38 C.F.R. § 3.102.  As such, an initial disability rating of 50 percent, but no more, for an acquired psychiatric disability is granted.

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?

The Board has considered whether or not the issue of a total disability rating due to individual unemployability (TDIU) has been raised by the record on appeal.  Rice v. Shinseki, 22 Vet. App. 447 (2009).  The Board finds that it has not, because the Veteran has been gainfully employed throughout the period on appeal.

 

 

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.