SCHIZOPHRENIA

Summary

The Veteran, who served from January 1968 to January 1970, appeals a September 2024 rating decision. The appeal concerns entitlement to a 100 percent disability rating for service-connected schizophrenia and an earlier effective date for Dependents' Educational Assistance (DEA). The Board previously granted service connection for schizophrenia and right ear hearing loss in July 2024. The Veteran's attorney submitted a statement in April 2025 indicating the Veteran wished to cancel his hearing, limiting the Board's review to evidence of record as of the September 2024 decision or submitted within 90 days thereafter. The Veteran also raised entitlement to TDIU, but the Board found it lacked jurisdiction as it was not adjudicated in the appealed decision. Regarding schizophrenia, the Board reviewed a February 2024 private psychological evaluation which found the Veteran totally disabled due to gross impairment in thought processes, persistent delusions, disorganized speech, poor interpersonal functioning, and high impulsivity, concluding he was "unquestionably 100% disabled." This opinion was supported by VA treatment records showing visual hallucinations and chronic delusions. The Board found the Veteran's symptoms warranted a 100 percent rating for schizophrenia prior to August 12, 2024, resolving any doubt in his favor. The Board also granted entitlement to a September 6, 2023, effective date for DEA benefits, as this is derivative of the 100 percent disability rating. However, the claim for an increased rating for bilateral hearing loss was remanded due to a pre-decisional duty to assist error, as the Veteran had asserted worsening symptoms, but no recent VA examination or objective audiometric findings were present to support the 10 percent rating assigned.

Rationale

Private psychological evaluation found Veteran "unquestionably 100% disabled" due to gross impairment in thought processes, delusions, disorganized speech, poor interpersonal functioning, and high impulsivity.; Private examiner's findings supported by VA treatment records showing visual hallucinations and chronic delusions.; Benefit of the doubt resolved in Veteran's favor, finding total occupational and social impairment.

Full Decision Text

Citation Nr: A26033480
Decision Date: 04/10/26	Archive Date: 04/10/26

DOCKET NO. 241212-497524
DATE: April 10, 2026

ORDER

Entitlement to a disability rating of 100 percent effective September 6, 2023, for service-connected schizophrenia is granted.

Entitlement to an effective date of September 6, 2023, for the award of basic eligibility to Dependents' Educational Assistance (DEA) is granted.

REMANDED 

Entitlement to a disability rating in excess of 10 percent for bilateral hearing loss is remanded. 

FINDINGS OF FACT

1. From September 6, 2023, the Veteran's schizophrenia symptoms have been shown to be productive of total occupational and social impairment.

2. The criteria for basic eligibility for Dependents' Educational Assistance under Title 38, United States Code, Chapter 35, were met as of September 6, 2023.

CONCLUSIONS OF LAW

1. Effective September 6, 2023, the criteria for a 100 percent disability rating for schizophrenia have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.130, Diagnostic Code (DC) 9201.

2. The criteria for an earlier effective date of September 6, 2023, for basic eligibility to DEA benefits have been met. 38 U.S.C. §§ 3500, 3501, 3510; 38 C.F.R. § 3.807.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from January 1968 to January 1970.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2024 rating decision. In the December 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. In April 2025, the Veteran's attorney submitted a statement indicating that the Veteran wished to cancel his hearing. As such, the Board may only consider the evidence of record as of the September 2024 rating decision, as well as any evidence submitted by the Veteran or his representative within 90 days of the April 8, 2025, date of the letter from the Veteran's attorney requesting to cancel the Board hearing. See 38 C.F.R. § 20.302.

The Veteran in his December 2024 VA Form 10182 asserted that the issue of entitlement to a total disability rating based on individual unemployability (TDIU) was reasonably raised by the record but was not adjudicated in the September 2024 rating decision. However, in a recent precedential opinion the United States Court of Appeals for the Federal Circuit held that under the Appeals Modernization Act, "a veteran's claims can no longer be implicitly denied." Hamill v. Collins, 2026 U.S. App. LEXIS 3466 (Fed. Cir. 2026). As such, the Board does not have jurisdiction over the Veteran's claimed issue of entitlement to a TDIU because this issue was never adjudicated in the September 2024 rating decision on appeal. 

Finally, the December 2024 VA Form 10182 identified July 11, 2024, as the date of decision for two issues being appealed: the evaluation for service-connected bilateral hearing loss and the evaluation for schizophrenia. This date roughly corresponds to the July 10, 2024, decision by the Board which granted the Veteran entitlement to service connection for both schizophrenia and right ear hearing loss. However, there is no adjudicatory action located in the Veteran's record dated July 11, 2024. Because the issues of entitlement to increased evaluations for bilateral hearing loss and schizophrenia were never adjudicated in the July 2024 Board decision - initial evaluations for both service-connected disabilities were assigned in the September 2024 rating decision on appeal - the Board concludes that the December 2024 VA Form 10182 does not qualify as a motion for reconsideration of the July 2024 Board decision. See 38 C.F.R. § 20.1002.

Entitlement to a disability rating in excess of 10 percent prior to August 12, 2024, for service-connected schizophrenia

The issue before the Board is whether the Veteran is entitled to an increased disability rating for his schizophrenia prior to August 12, 2024. As will be discussed in more detail below, the Board concludes that, prior to August 12, 2024, the overall symptomatology and level of impairment more closely approximated the criteria for a 100 percent rating. Therefore, an increased evaluation is warranted.

Disability evaluations are determined
 Form 10182 does not qualify as a motion for reconsideration of the July 2024 Board decision. See 38 C.F.R. § 20.1002.

Entitlement to a disability rating in excess of 10 percent prior to August 12, 2024, for service-connected schizophrenia

The issue before the Board is whether the Veteran is entitled to an increased disability rating for his schizophrenia prior to August 12, 2024. As will be discussed in more detail below, the Board concludes that, prior to August 12, 2024, the overall symptomatology and level of impairment more closely approximated the criteria for a 100 percent rating. Therefore, an increased evaluation is warranted.

Disability evaluations are determined by comparing a veteran's present symptoms with criteria set forth in the VA's Schedule for Rating Disabilities (Rating Schedule), which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Separate diagnostic codes identify the various disabilities.

When a question arises as to which of two ratings applies under a particular code, the higher rating is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the veteran. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3. The evaluation of the same disability under various diagnoses, known as pyramiding, is to be avoided. 38 C.F.R. § 4.14.

Where service connection has already been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994).

When evaluating a mental disorder, VA shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran's capacity for adjustment during periods of remission. The rating agency shall assign an evaluation 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. 38 C.F.R. § 4.126.

The Veteran's schizophrenia is currently evaluated under DC 9201, in accordance with the General Rating Formula for Mental Disorders. See 38 C.F.R. § 4.130.

Under the provisions for rating psychiatric disorders, a 10 percent disability rating requires evidence of the following:

Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication.

A 30 percent disability rating requires:

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, and mild memory loss (such as forgetting names, directions, or recent events).

A 50 percent disability rating requires:

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.

A 70 percent disability rating requires:

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.

The criteria for a 100 percent rating are:

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, DC 
 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.

The criteria for a 100 percent rating are:

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, DC 9201.

When determining the appropriate disability evaluation to assign, the Board's primary consideration is a veteran's symptoms, but it must also make findings as to how those symptoms impact a veteran's occupational and social impairment. Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013); Mauerhan v. Principi, 16 Vet. App. 436 (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; see also Sellers v. Principi, 372 F.3d 1318 (Fed. Cir. 2004). 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 the veteran's impairment must be "due to" those symptoms; a veteran may only qualify for a given disability by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. Vazquez-Claudio, 713 F.3d at 118.

Turning to the facts of this case, the Board in July 2024 granted the Veteran's claim seeking entitlement to service connection for schizophrenia. In the September 2024 rating decision on appeal, the Veteran was awarded a 10 percent evaluation effective September 6, 2023, the date of his service connection claim. He was awarded a 100 percent evaluation effective August 12, 2024.  

On February 20, 2024, he underwent a private psychological evaluation in connection with his now-granted service connection claim. The examiner noted that the Veteran had numerous admissions to VA facilities for treatment of his schizophrenia, noting the Veteran's explanation that his hospitalizations "have been because the military secretly put LSD in all the spices of the food they fed the soldiers in Germany." Upon examination, the Veteran presented as excitable, disorganized and often conspiratorial. His speech was frequently illogical, often tangential and bizarre. The examiner noted that the Veteran's interpersonal functioning was very poor. He reported living with a woman he referred to as his ex-wife. He also reported having no friends. The examiner noted that the Veteran's short-term and long-term memory was grossly intact but colored with delusional material. The Veteran's insight and judgment were both deemed poor by the examiner, and his impulsivity was high.

The examiner noted that the Veteran had considerable entrenched delusions, some of which were patently bizarre and disorganized. When asked about anxiety and nervousness, the Veteran denied experiencing either and stated he is no longer worried because he has come to realize the CIA is going to give him a paycheck for his help with Ground Zero and 9/11. He then went on a tangent about how the CIA had flown him to New York due to his prior experience as part of the international underground and his x-ray powers. Throughout the interview, the examiner described the Veteran as "floridly psychotic." When asked about auditory and visual hallucinations, the Veteran adamantly denied them and became defensive and irritable. Among his other entrenched delusions, the examiner relayed the Veteran's preoccupation with the idea that Newsweek would pay him to have an interview and write an expose to the world. He reported that he has sent several letters to Newsweek requesting $300,000 for this story, but they have not responded.

The February 2024 private examiner concluded - following a review of more than three thousand pages of military and VA medical records, as well as the clinical interview - that the Veteran was "unquestionably 100% disabled and totally unemployable due to his psychiatric conditions. He evidences total occupational and social impairment due to his gross impairment and thought processes and communications due to his persistent delusions and hallucinations." Further, the examiner noted that the Veteran provided evidence of grossly inappropriate behavior that created
's preoccupation with the idea that Newsweek would pay him to have an interview and write an expose to the world. He reported that he has sent several letters to Newsweek requesting $300,000 for this story, but they have not responded.

The February 2024 private examiner concluded - following a review of more than three thousand pages of military and VA medical records, as well as the clinical interview - that the Veteran was "unquestionably 100% disabled and totally unemployable due to his psychiatric conditions. He evidences total occupational and social impairment due to his gross impairment and thought processes and communications due to his persistent delusions and hallucinations." Further, the examiner noted that the Veteran provided evidence of grossly inappropriate behavior that created an ongoing risk to himself and others. As an example, the examiner noted the Veteran has tried to secure guns to protect himself against his delusions. The examiner further stated the Veteran was unable to maintain himself in the community and was recommended for guardianship due to his inability to manage activities of daily living or care for himself to at least a minimal standard. The examiner also concluded that the Veteran had no ability to establish or maintain effective relationships, and he was unable to adapt to even ordinary daily stressors. 

A review of the Veteran's available VA treatment records indicate he was receiving private mental health care. But in October 2023, he contacted VA indicating that he was no longer seeing anyone and wished to resume his mental health care with VA. A December 2023 VA outpatient note indicates the Veteran underwent a mental status examination where he was noted to be expressing delusions that "seem less pronounced" from that of a previous visit. He reiterated his story about being taken to "Ground Zero". The examiner also noted that it was unknown whether the Veteran's reports of being in the clandestine service in the military were delusional or had a basis in reality.

An April 2024 VA outpatient note indicated that visual hallucinations were evident upon mental status exam. The examiner also noted that the Veteran had chronic delusions and mild paranoia, but he did not express any at the time of the exam. 

Following a review of the evidence of record and affording the Veteran the benefit of the doubt, the Board finds that for the period prior to August 12, 2024, the Veteran's schizophrenia warrants a 100 percent disability rating. The evidence establishes that the Veteran suffered from total occupational and social impairment. This finding was made by the February 2024 private examiner, whose determination came following a review of the medical evidence of record and examination of the Veteran. The private examiner's findings are supported by available VA treatment records during this period which confirm the Veteran suffers from symptoms that include visual hallucinations and chronic delusions. As Veteran's schizophrenia symptoms were of such severity as to render him totally impaired, the Board grants entitlement to a 100 percent evaluation for the entirety of the period on appeal.

Entitlement to an effective date earlier than August 12, 2024, for the award of basic eligibility to DEA benefits under 38 U.S.C. Chapter 35

The effective date for basic eligibility for DEA benefits is derivative from the Veteran's grant of a 100 percent disability rating assigned for service-connected schizophrenia, as basic eligibility for DEA benefits exists if a veteran has a permanent, total service-connected disability. 38 U.S.C. §§ 3500, 3501, 3510; 38 C.F.R. § 3.807. As such, the Board finds that the appropriate effective date for the award of basic eligibility for DEA benefits in this case is September 6, 2023. Accordingly, entitlement to an earlier effective date for basic eligibility to Dependents' Educational Assistance benefits is granted.

REASONS FOR REMAND 

Entitlement to a disability rating in excess of 10 percent for bilateral hearing loss is remanded.

The Board finds that there was a pre-decisional duty to assist error committed in not scheduling the Veteran for a VA examination to assess the current severity of his hearing loss prior to assigning a 10 percent evaluation for his service-connected bilateral hearing loss disability. At the time of the September 2024 rating decision on appeal, the record reveals that the Veteran had made assertions that the severity of his hearing loss disability was worse than that contemplated by his disability rating. See September 2023 VA Form 526EZ. Nevertheless, there is no record of the Veteran undergoing a VA examination to assess the current severity of his hearing loss. In fact, the Board could not find any objective audiometric findings in the Veteran's claims folder or the available medical evidence that would support the 10 percent evaluation assigned for his hearing loss disability effective September 6, 2023. A review of the record shows that the Veteran last underwent a VA examination to assess his hearing loss in December 2017, many years before the filing of his September 2023 claim seeking
 decision on appeal, the record reveals that the Veteran had made assertions that the severity of his hearing loss disability was worse than that contemplated by his disability rating. See September 2023 VA Form 526EZ. Nevertheless, there is no record of the Veteran undergoing a VA examination to assess the current severity of his hearing loss. In fact, the Board could not find any objective audiometric findings in the Veteran's claims folder or the available medical evidence that would support the 10 percent evaluation assigned for his hearing loss disability effective September 6, 2023. A review of the record shows that the Veteran last underwent a VA examination to assess his hearing loss in December 2017, many years before the filing of his September 2023 claim seeking an increased rating for left ear hearing loss or at the time of his filing of a September 6, 2023, supplemental claim seeking entitlement to service connection for right ear hearing loss - which was ultimately granted in a July 2024 Board decision.

Thus, remand is needed to correct the pre-decisional duty to assist error and afford the Veteran an appropriate VA examination to assess the current severity of his bilateral hearing loss disability.

The matters are REMANDED for the following action: 

Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected bilateral hearing loss. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's hearing loss under the applicable rating criteria.

 

 

David Gratz

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J. Komperda, 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.