PTSD DUE TO COMBAT

S.C. KREMBS · 2026 · Case ID: A26037258

DENIED

Summary

The veteran, who served from July 1984 to January 2005, appeals the denial of service connection for right branch retinal vein occlusion (OD) and bilateral mild cataracts, and seeks an increased rating for his service-connected PTSD. The Board found that the veteran's PTSD, rated at 70%, did not meet the criteria for a 100% rating, as the evidence did not show total occupational and social impairment. The veteran's symptoms, while significant, did not reach the level of gross impairment in thought processes, persistent hallucinations, or inability to perform basic daily activities. The Board considered the veteran's testimony regarding his daily activities, which included home maintenance and self-education, and noted his appropriate grooming and orientation. For the eye conditions, the Board acknowledged the veteran's contentions linking them to in-service stress, fatigue, and eye strain noted at separation. However, the Board assigned high probative value to a September 2024 VA examination which found no direct or presumptive service connection for either condition. The Board found the evidence persuasively weighed against service connection for the eye conditions, rendering the benefit of the doubt doctrine inapplicable. Service connection for the eye conditions was denied, and the increased rating for PTSD was denied.

Rationale

Veteran's disability does not meet criteria for 100% rating; Observed to be appropriately groomed and oriented; No memory loss, illogical speech, or impaired impulse control noted

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250725-570638

Full Decision Text

Citation Nr: A26037258
Decision Date: 04/21/26 Archive Date: 04/21/26

DOCKET NO. 250725-570638
DATE: April 21, 2026

ORDER

Entitlement to a disability rating in excess of 70 percent for posttraumatic stress disorder (PTSD) is denied.

Service connection for right branch retinal vein occlusion (OD) and bilateral mild cataracts is denied.

FINDINGS OF FACT

1. The PTSD disability was productive of occupational and social impairment with deficiencies in most areas. At no time during the claim period was it productive of total occupational and social impairment.

2. The Veteran is currently diagnosed with right branch retinal vein occlusion, (OD) and bilateral mild cataracts which did not have their onset during service.

CONCLUSIONS OF LAW

1. The criteria for entitlement to a disability rating in excess of 70 percent for PTSD are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.7, 4.10, 4.21, 4.130, Diagnostic Code 9411.

2. The criteria for direct or secondary service connection for branch retinal vein occlusion, right (OD) and bilateral mild cataracts are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from July 1984 to January 2005.

The rating decisions on appeal were issued in September 2024 and March 2025 and constitute an initial decisions; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

By way of history, the Veteran filed a new June 2015 claim seeking service connection for "vision problems." In August 2015 the Veteran filed a new claim seeking service connection for "visual depth perception" and PTSD, depression and insomnia. In March 2016 the agency of original jurisdiction (AOJ) issued a rating decision denying service connection for "vision problems (also claimed as visual depth perception)," and deferring a decision on service connection for PTSD. In May 2016 the AOJ issued a rating decision granting service connection for PTSD at a 70 percent disability rating effective June 17, 2015. The Veteran did not appeal this decision nor submit new evidence within the allotted time period. Thus the May 2016 rating decision became final.

In November 2017, the Veteran filed a new claim seeking service connection for "retinal vascular occlusion." In January 2018 the AOJ issued a rating decision concluding that new and material evidence had not been received and denying service connection again. The Veteran did not appeal this decision nor submit new evidence within the allotted time period. Thus the November 2017 rating decision became final.

In May 2023 the Veteran filed a supplemental claim seeking service connection for vision problems and a visual depth perception condition. In October 2023 the Veteran filed a new claim seeking service connection for "Retinal Vein Occlusion (w/Floaters)." In October and November 2023, the AOJ deferred a decision on the matter. Then in February 2024, the AOJ found new and relevant evidence was received but denied the service connection claims again. In March 2024 the Veteran sought higher level review.

On May 29, 2024 the Veteran filed a new claim seeking an increased rating in excess of 70 percent for his service connected PTSD.

In June 2024 an informal conference was held and a duty to assist error was identified. The error was the failure to obtain a VA medical opinion based on a theory of direct service connection for the Veteran's contended eye disabilities. In July 2024 the AOJ issued a rating decision informing the Veteran that a duty to assist error had been identified and that his claims would be further developed.

In September 2024 the AOJ issued a rating decision denying that a rating in excess of 70 percent for PTSD was warranted.

In March 2025 the AOJ issued a rating decision finding that new and relevant evidence was received but denying service connection for right branch retinal vein occlusion, (OD) and bilateral mild cataracts.

In the July 25, 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket.

Therefore, the Board may only consider the evidence of record at the time of September 2024 and
the Veteran that a duty to assist error had been identified and that his claims would be further developed.

In September 2024 the AOJ issued a rating decision denying that a rating in excess of 70 percent for PTSD was warranted.

In the July 25, 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket.

Therefore, the Board may only consider the evidence of record at the time of September 2024 and March 2025 AOJ decisions on appeal, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decisions on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 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.

As a final introductory note, the Board revised the dates of the Veteran's rating decisions on appeal which were listed on the July 2025 notice of disagreement in order to correct the date as to PTSD and to ensure the notice of disagreement was timely as to right branch retinal vein occlusion, (OD) and bilateral mild cataracts. The Veteran also listed as on appeal a March 2016 rating decision which denied service connection for irritable bowel syndrome (IBS). The Board did not find a rating decision regarding IBS that is timely as to the July 2025 notice of disagreement. As such, the Board has not evaluated IBS in the instant decision.

Increased Ratings

VA's percentage ratings are based on the average impairment of earning capacity as a result of service-connected disability. 38 U.S.C. §1155; 38 C.F.R. § 4.1. If two disability evaluations are potentially applicable, 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. All reasonable doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3.

This decision will focus on the evidence pertinent to the rating criteria and disability severity during the relevant period on appeal, but the Board has considered the entire record to have a full picture of the disability. See 38C.F.R. §§ 4.1, 4.2, 4.41; Gonzales v. West, 218 F. 3d 1378 (Fed. Cir. 2000).

The Board will generally review evidence from the date of the new claim and during the one year "look back period" preceding the submission of the claim. See 38 U.S.C. § 5110(b); 38 C.F.R. § 3.400(o)(2); Gaston v. Shinseki, 605 F.3d 979, 982 (Fed. Cir. 2010). The appeal period before the Board for PTSD is May 29, 2024, the date VA received the new claim for an increased rating, plus the one year look back period. The Board, in consideration of 38 C.F.R. § 3.400(o)(2) and Gaston v. Shinseki, 605 F.3d 979 (Fed. Cir. 2010), has considered the evidence in the one year prior to the date of receipt of the increased rating claim, and finds that it does not support a finding that the Veteran's PTSD increased in severity during that one year period.

1. Entitlement to a disability rating in excess of 70 percent for PTSD

The Veteran has a 70 percent disability rating for PTSD, pursuant to 38 C.F.R. § 4.130, Diagnostic Code 9411. The
rating, plus the one year look back period. The Board, in consideration of 38 C.F.R. § 3.400(o)(2) and Gaston v. Shinseki, 605 F.3d 979 (Fed. Cir. 2010), has considered the evidence in the one year prior to the date of receipt of the increased rating claim, and finds that it does not support a finding that the Veteran's PTSD increased in severity during that one year period.

1. Entitlement to a disability rating in excess of 70 percent for PTSD

The Veteran has a 70 percent disability rating for PTSD, pursuant to 38 C.F.R. § 4.130, Diagnostic Code 9411. The Veteran has continuously pursued an increased disability rating for PTSD since the submission of a VA 21-526EZ Fully Developed Claim (Compensation) on May 29, 2024, and the period on appeal runs from that date. The Board will also consider whether it was factually ascertainable that an increased in disability occurred during the one year "look back" period preceding the submission of the claim. See 38 U.S.C. § 5110(b); 38 C.F.R. § 3.400(o)(2); Gaston v. Shinseki, 605 F.3d 979, 982 (Fed. Cir. 2010).

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 (2018). 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).

Under the General Formula, a 70 percent rating is warranted when there is 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 work-like setting); and inability to establish and maintain effective relationships.

A 100 percent rating is warranted when there is 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 ability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of closest relatives, own occupation, or own name.

The Board finds that the Veteran's disability does not nearly approximate the criteria for a 100 percent rating at any time during the appeal period. In this regard, he was consistently observed to be appropriately groomed and oriented as to place and person with intact judgment and thought process. The Veteran did not express any memory problems, and the record is devoid of any evidence that he has memory loss for names of close relatives, his own occupation, or own name during this appeal period. Additionally, his speech was noted to be clear and without problems. Further, as noted, during this appeal period, the Veteran denied thoughts of suicide or past attempts of suicide, as well as hallucinations and delusions. See, e.g., VA Medical Records June 2024 to August 2025; July 2024 VA Examination Report.

During the July 2024 VA examination, the Veteran denied receiving any mental health treatment since his 2016 VA medical examination.

He reported his mood as "pretty good for [the] most part but ... depressive thoughts about twenty to thirty minutes per day [and] ... [that] he is able to take pleasure in things." Id. He reported the same negative relationships with his family members as before but has one friend with whom he talks to on the phone once a week for about an hour. Id. This friend has become like a family member to him. Id.

The Veteran reported that he retired from the military in 2005 and has not worked ever since due to the 2008 economic downturn and then due to Covid. See July 2024 VA Examination
, the Veteran denied receiving any mental health treatment since his 2016 VA medical examination.

The Veteran reported that he retired from the military in 2005 and has not worked ever since due to the 2008 economic downturn and then due to Covid. See July 2024 VA Examination Report; August 2015 Correspondence. The Veteran reported the he bought a house in 2017 and that he earned a master's degree in business in 2013, and that his sources of income were Airforce retirement pay and compensation from VA for his service connected disabilities. See July 2024 VA Examination Report.

The Veteran described that his typical day was spent maintaining his house, figuring out what he can do, such as plumbing issues, doors to fix, as well as reading and trying to educate himself on what his next steps could be (i.e., electrical, woodworking). Id. He states he wants to establish himself and market himself and so therefore he reads marketing textbooks. Id. He discussed an idea to make beads and sell them at veterans markets and showed the examiner bead making materials. The Veteran denied any legal, behavioral, or substance abuse history. Id.

Both the 2025 and 2016 VA examiners concluded that the PTSD manifested in occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood.

Based on the above disability picture, the Board finds that the Veteran's symptomatology does not result in total occupational and social impairment to warrant a 100 percent rating for his PTSD at any time during the appeal period.

Service Connection

Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38?U.S.C. §?1110; 38?C.F.R. §?3.303.

Service connection is also warranted for disability proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Such secondary service connection is warranted for any increase in severity of a nonservice-connected disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(b).

2. Right branch retinal vein occlusion (OD) and bilateral mild cataracts

The Veteran makes the following contentions as to how currently diagnosed eye disabilities are service connected.

In November 2016, the Veteran filed correspondence with the following contentions:

A recent eye examination revealed that I have a retinal vascular occlusion. I am informed my condition is rare and requires a consistent schedule of monitoring and evaluation. During my time in military service, my history of examinations revealed diminished conditions in my vision. Prior to retirement, I was informed I developed a depth perception condition. These issues were passed off as aging. Since retirement, I had several blood spot issues in my eyes, but that was always passed off as 'normal' if the blood spot went away. It was by happenstance that my appointment was with a physician with great attention to detail. For that I am grateful. Now, I am under routine evaluations.

In the October 2023 new claim, the Veteran made the following contentions:

"While in service, during an eye exam, 2002/3, I was informed that I would have issues with my vision in the future. I associated it with stress, and fatigue after 9/11 dealing with the lack of personnel, working long hours and moving loads of equipment ready for deployment."

The Board is bound by the AOJ's favorable findings that (1) the Veteran is currently diagnosed with OD branch retinal vein occlusion and bilateral mild cataracts, and (2) service treatment records shows eye strain with depth perception loss during the Veteran's separation examination dated November 09, 2004. 38 CFR § 3.104(c); See March 2025 Rating Decision.

An August 2023 VA examiner rendered a negative nexus connection, finding that the OD branch retinal vein occlusion occurred ten years after separation from service. The Board has assigned low probative value to this opinion because it did not provide any nexus opinion as to the Veteran's diagnosed bilateral mild cataracts, therefore failing to apply valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted
Veteran is currently diagnosed with OD branch retinal vein occlusion and bilateral mild cataracts, and (2) service treatment records shows eye strain with depth perception loss during the Veteran's separation examination dated November 09, 2004. 38 CFR § 3.104(c); See March 2025 Rating Decision.

A January 2024 VA examiner rendered a negative secondary nexus opinion, finding that the Veteran's eye disabilities were unrelated to his service connected PTSD. The Board has assigned low probative value to this opinion because it did not also consider direct service connection. See Stefl v. Nicholson, 21 Vet. App. 120, 123-24 (2007).

An October 2024 VA examiner rendered a negative nexus connection, on both a direct and presumptive basis, for both eye disabilities. The Board assigns high probative value to this opinion because it considers accurate facts, including the Veteran's specific contentions, lay evidence, medical records, and service treatment records. See Reonal v. Brown, 5 Vet. App. 458.

The Board did not find any other probative medical nexus opinion in the evidence of record. Although the Veteran is competent to attest to his observation of his symptoms, the record does not demonstrates that he has the medical expertise necessary to relate his current eye conditions to any aspect of his service. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (2007).

In denying the claim for service connection, the Board concludes that the evidence in this case is neither evenly nor approximately balanced. Rather, it persuasively weighs against service connection. The benefit of the doubt doctrine (U.S.C. § 5107(b)) is therefore not applicable. Lynch v. McDonough, 21 F.4th 776.

The Board is grateful for the Veteran's honorable service and regrets that a more favorable outcome could not be reached.

S. C. Krembs

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Jackson, Atossa K.

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.

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