ANXIETY DISORDER

Summary

The veteran, who served in the United States Air Force from December 1987 to August 2008, appeals the agency of original jurisdiction's (AOJ) April 2021 rating decision. The veteran sought an increased rating for his service-connected anxiety disorder, which had been previously rated at 30 percent effective September 1, 2008, and then increased to 50 percent effective March 4, 2021. The veteran's appeal focused on the period covered by the April 2021 AOJ decision. The Board reviewed the evidence of record at that time, including a March 2021 VA examination and a May 2025 private mental disorders disability benefits questionnaire (DBQ). The March 2021 VA examination diagnosed anxiety disorder with mild or transient symptoms, decreasing work efficiency only during significant stress or when symptoms were controlled by medication, and noted intact judgment and capability of managing finances. The May 2025 private DBQ, completed after an in-person examination, reaffirmed the anxiety disorder diagnosis and described occupational and social impairment with deficiencies in most areas, including relationships, judgment, thinking, and mood. The Board found the private DBQ's description of impairment, particularly the preference for isolation, struggles with emotional expression, memory difficulties, and impact on relationships, warranted a 70 percent rating. The Board found the evidence did not support a rating higher than 70 percent, as the veteran did not demonstrate total occupational and social impairment, citing the continued relationship with his wife and the ability to manage finances as factors against a 100 percent rating. Service connection for anxiety disorder is granted at 70 percent for the period on appeal.

Rationale

Private DBQ described significant impairment in most areas.; Symptoms included preference for isolation, struggles with emotional expression, memory difficulties, and impact on relationships.; VA examiner noted milder symptoms, but private DBQ's detailed findings warranted higher rating.

Full Decision Text

Citation Nr: A26034289
Decision Date: 04/14/26	Archive Date: 04/14/26

DOCKET NO. 210709-170970
DATE: April 14, 2026

ORDER

Entitlement to a rating of 70 percent, but no higher, is granted for service-connected anxiety disorder for the period on appeal. 

FINDING OF FACT

Throughout the appeal period, the Veteran's anxiety disorder was productive of occupational and social impairment with deficiencies in most areas, but not total occupational and social impairment.

CONCLUSION OF LAW

Throughout the appeal period, the criteria for a 70 percent rating, but no higher, for an anxiety disorder have been met.  38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code (DC) 9400.  

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Air Force from December 1987 to August 2008.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2021 rating decision issued by a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) under the modernized appeals system known as the Appeals Modernization Act (AMA).

By way of background, in a March 2009 rating decision, the Veteran was granted entitlement to service connection for an anxiety disorder and assigned a 30 percent evaluation, effective September 1, 2008.

In March 2021, the Veteran filed VA Form 21-526EZ, Application for Disability Compensation, seeking an increased rating for his service-connected anxiety disorder.

In April 2021, the agency of original jurisdiction (AOJ) issued the rating decision on appeal, granting an increased rating of 50 percent for the service-connected anxiety disorder, effective March 4, 2021.  

In the July 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket.  On March 25, 2025, the Veteran, through his representative, withdrew the hearing request.

Therefore, the Board may only consider the evidence of record at the time of the April 2021 AOJ decision, 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, 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, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Law and Analysis 

Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4.  The rating schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of or incident to military service.  The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.  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. 38 C.F.R. § 4.7.

In considering the severity of a disability, it is essential to trace the medical history of the veteran. 38 C.F.R. §§ 4.1, 4.2, 4.41.  Consideration of the whole-recorded history is necessary so that a rating may accurately reflect the elements of disability present. 38 C.F.R. § 4.2; Peyton v. Derwinski, 1 Vet. App. 282 (1991).  While the regulations require review of
 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. 38 C.F.R. § 4.7.

In considering the severity of a disability, it is essential to trace the medical history of the veteran. 38 C.F.R. §§ 4.1, 4.2, 4.41.  Consideration of the whole-recorded history is necessary so that a rating may accurately reflect the elements of disability present. 38 C.F.R. § 4.2; Peyton v. Derwinski, 1 Vet. App. 282 (1991).  While the regulations require review of the recorded history of a disability by the adjudicator to ensure a more accurate evaluation, the regulations do not give past medical reports precedence over the current medical findings.

Where entitlement to compensation 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).  However, where the question for consideration is the propriety of the initial rating assigned, evaluation of the evidence since the effective date of the grant of service connection is required. Fenderson v. West, 12 Vet. App. 119, 125-26 (1999).  Where VA's adjudication of the claim for increase is lengthy and factual findings show distinct time periods where the service-connected disability exhibits symptoms which would warrant different ratings, different or "staged" ratings may be assigned for such different periods of time. Hart v. Mansfield, 21 Vet. App. 505, 509-10 (2007); Fenderson, 12 Vet. App. at 126-27.

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits.  VA shall consider all information and lay and medical evidence of record in a case and when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (benefit-of-the-doubt rule not for application when evidence persuasively favors one side or the other).

The Veteran is currently assigned a 30 percent rating for an anxiety disorder prior to March 4, 2021, and a rating of 50 percent thereafter, pursuant to 38 C.F.R. § 4.130, Diagnostic Code 9400.  The Veteran seeks a rating in excess of 50 percent for his service-connected anxiety disorder for the period on appeal.  

Under Diagnostic Code 9400, a 30 percent evaluation is warranted when the psychiatric disorder results in 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, recent events).

A 50 percent evaluation is warranted when the psychiatric disorder results in 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 evaluation is warranted when the psychiatric disorder results in 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 work-like setting); and an inability to establish and maintain effective relationships.

A 100 percent evaluation is warranted when the psychiatric disorder results in 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
 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 work-like setting); and an inability to establish and maintain effective relationships.

A 100 percent evaluation is warranted when the psychiatric disorder results in 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; and memory loss for names of close relatives, own occupation, or own name.

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 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 the claimant's 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 rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration."  It was further 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."

In considering the evidence of record under the laws and regulations as set forth above, the Board finds that the Veteran is entitled to a 70 percent rating, but no higher, for the entire appeal period.

The Veteran was afforded a VA mental disorders examination in March 2021.  In the March 2021 VA examination, the Veteran was diagnosed with anxiety disorder, and the VA examiner found that it manifested in 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 medication.  The Veteran denied any history of suicidal/homicidal ideation and/or hallucinations.  The Veteran reported chronic sleep problems, worsened anxiety, erratic appetite, preferred isolation, short-term memory loss, fatigue, and lapses in attention and concentration.  The Veteran's symptoms included depressed mood, anxiety, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, and difficulties in establishing and maintaining effective work and social relationships.  Behavioral observations by the VA examiner showed the Veteran displayed logical and linear thought processes, normal speech rate and prosody, and intact judgment.  The Veteran was found capable of managing his financial affairs.  The VA examiner noted the Veteran did not endorse suicidal thoughts and did not appear to be a threat to self or others.

During the March 2021 VA examination, the Veteran reported that he had been married for 32 years and lived with his wife. He reported that he feels "on guard" in public and that he is not able to function as well socially, and keeps to himself.  He also reported that he was working full time and had no problems, and that he did not have to deal with "a lot of folks" which makes it easier for him to work. 

In May 2025, the Veteran also submitted a private mental disorders disability benefits questionnaire (DBQ) that was completed, via in-person examination, by a  licensed psychologist in February 2025.  In the DBQ, the Veteran's diagnosis of anxiety disorder was reaffirmed, and the psychologist summarized the Veteran's anxiety disorder as occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood.  The examination report noted that the Veteran preferred isolation and remains distant and withdrawn from his relationships, and he continues to take medications to alleviate his psychiatric symptoms.  The Veteran reported that he experiences intrusive thoughts and memories, disrupting his sleep, and he suffers from anxiety and hypervigilance when he is
, the Veteran also submitted a private mental disorders disability benefits questionnaire (DBQ) that was completed, via in-person examination, by a  licensed psychologist in February 2025.  In the DBQ, the Veteran's diagnosis of anxiety disorder was reaffirmed, and the psychologist summarized the Veteran's anxiety disorder as occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood.  The examination report noted that the Veteran preferred isolation and remains distant and withdrawn from his relationships, and he continues to take medications to alleviate his psychiatric symptoms.  The Veteran reported that he experiences intrusive thoughts and memories, disrupting his sleep, and he suffers from anxiety and hypervigilance when he is out in public.  Additionally, he stated that he struggles to express emotion and faces difficulties with short-term and long-term memory.  

Upon examination, the Veteran's symptoms included depressed mood, anxiety, suspiciousness, panic attacks that occur weekly or less often, near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively, chronic sleep impairment, mild memory loss, impairment of short and long term memory, flattened effect, circumstantial, circumlocutory or stereotyped speech, intermittently illogical, obscure, or irrelevant speech, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, and obsessional rituals which interfere with routine activities.  The Veteran was found capable of managing his financial affairs.  The examiner noted the Veteran did not endorse suicidal thoughts and did not appear to be a threat to self or others.

The Veteran also reported that his condition has significantly impacted his relationships.  He indicated that he struggles to connect with his spouse and that his relationships with friends and family have suffered.  He prefers isolation and relies on medication to manage his struggles.

The Veteran also reported that he resigned from his job due to his worsening mental health.  He indicated that it would be difficult to get out of bed but that he had performed his duties effectively with minimal interaction.

Upon review of the evidence, with specific emphasis on the sustained level of impairment described in the February 2025 mental disorders DBQ, the Board finds that the Veteran's anxiety disorder warrants a rating of 70 percent.  As noted above, a 70 percent evaluation is warranted when the psychiatric disorder results in 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 work-like setting); and an inability to establish and maintain effective relationships.  Accordingly, the Veteran is entitled to a rating of 70 percent for his anxiety disorder for the period on appeal.  

Nevertheless, the Board finds that an evaluation in excess of 70 percent is not warranted for any time period on appeal.  The Veteran has not demonstrated a level of impairment consistent with the 100 percent criteria, nor have his symptoms caused both total occupational and social impairment, to include in areas referenced by the 100 percent criteria. Mauerhan, supra, Vazquez-Claudio, supra.  The Board emphasizes that a 100 percent disability evaluation requires both total social and occupational impairment. See Melson v. Derwinski, 1 Vet. App. 334 (1991) (use of the conjunctive "and" in a statutory provision meant that all of the conditions listed in the provision must be met); cf. Johnson v. Brown, 7 Vet. App. 95 (1994) (only one disjunctive "or" requirement must be met in order for an increased evaluation to be assigned).  Indeed, although the Veteran may have significant occupational impairment, he has still been able to maintain a relationship with his wife.  Thus, it cannot be said that the Veteran had total social impairment.  Moreover, to the extent that symptoms associated with the 100 percent rating criteria may be shown or argued, the Board emphasizes that the disability has not been shown to be productive of both total social and occupational impairment.

In addition, the March 2021 VA examiner opined that the Veteran's anxiety disorder manifested in 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 medication.  The May 2025 VA examiner also found that the Veteran's anxiety disorder manifested in occupational and social impairment with deficiencies in most areas, such as work, school, family relations,
.  Thus, it cannot be said that the Veteran had total social impairment.  Moreover, to the extent that symptoms associated with the 100 percent rating criteria may be shown or argued, the Board emphasizes that the disability has not been shown to be productive of both total social and occupational impairment.

In addition, the March 2021 VA examiner opined that the Veteran's anxiety disorder manifested in 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 medication.  The May 2025 VA examiner also found that the Veteran's anxiety disorder manifested in occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, and/or mood.  Neither examiner indicated that the Veteran had total occupational and social impairment.  Such findings are commensurate with 10 and 70 percent evaluations, respectively.

Based on the foregoing, the Board finds that the evidence supports the assignment of a 70 percent evaluation for the entire appeal period, and the claim is granted to this extent.  The Board also finds that the evidence persuasively weighs against a higher evaluation in excess of that now assigned for any time period on appeal.

Neither the Veteran nor his representative has raised any other issues in this appeal, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 368 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).

 

 

J. SAIKH

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Ahmed, Zarar

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.