UNSPECIFIED TRAUMA AND STRESSOR-RELATED DISORDER

S. BUSH · 2026 · Case ID: A26038772

DENIED

Summary

The Veteran, who served in the United States Air Force from March 2018 to July 2020, appeals the denial of increased ratings for his unspecified trauma and stressor-related disorder and right ankle disability, as well as the denial of service connection for bilateral hearing loss. For the unspecified trauma and stressor-related disorder, the Veteran sought an increased rating beyond the current 30 percent. The Board reviewed the General Rating Formula for Mental Disorders, noting that a 30 percent rating applies for occupational and social impairment with occasional decreases in work efficiency due to symptoms like depressed mood, anxiety, and chronic sleep impairment. A higher rating requires more severe symptoms, which the Board found were not met. The VA examiner's September 2024 report, which noted mild symptoms and intact cognition, supported the 30 percent rating. The Board found the evidence weighed against a higher rating. For the right ankle disability, currently rated at 10 percent for moderate limited motion, the Veteran sought a higher rating. The Board reviewed the criteria for ankle disabilities, which are rated based on the extent of motion limitation. The November 2024 VA examination showed limitations consistent with a 10 percent rating, not the marked limitation required for a higher rating. The Board found the evidence persuasively weighed against a higher rating. For bilateral hearing loss, the Veteran claimed service connection due to noise exposure. However, the February 2021 VA audiology examination showed no hearing loss meeting VA's definition of disability, with normal pure tone thresholds and a 100 percent speech discrimination score. As no current disability was established, service connection was denied. The Board denied the claims for increased ratings and service connection.

Rationale

Symptoms most closely approximate 30 percent rating criteria; No evidence of symptoms for higher rating; VA examiner's findings support 30 percent rating

Service Branch

AIR FORCE

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

9413

Docket No.

250423-536199

Full Decision Text

Citation Nr: A26038772
Decision Date: 04/27/26 Archive Date: 04/27/26

DOCKET NO. 250423-536199
DATE: April 27, 2026

ORDER

Entitlement to an initial rating in excess of 30 percent for unspecified trauma and stressor-related disorder is denied.

Entitlement to a rating in excess of 10 percent for a right ankle disability is denied.

Entitlement to service connection for bilateral hearing loss is denied.

FINDINGS OF FACT

1. Throughout the period on appeal, the Veteran's unspecified trauma and stressor-related disorder has most closely approximated occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks due the severity, frequency, and duration of symptoms such as anxiety, depressed mood, and chronic sleep impairment.

2. Throughout the period on appeal, the Veteran's right ankle disability has manifested by painful movement, productive of no more than moderate limitation of ankle motion with no more than 10 degrees dorsiflexion and 30 degrees plantar flexion.

3. The Veteran does not have current bilateral hearing loss to an extent recognized as a disability for VA purposes.

CONCLUSIONS OF LAW

1. The criteria for entitlement to an initial rating in excess of 30 percent for unspecified trauma and stressor-related disorder are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.130, Diagnostic Code (DC) 9310.

2. The criteria for entitlement to a rating in excess of 10 percent for a right ankle disability are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.71a, DC 5271.

3. The criteria for entitlement to service connection for bilateral hearing loss are not met. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.303, 3.305, 3.385.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Air Force from March 2018 to July 2020.

This matter comes before the Board of Veterans' Appeals (Board) from an April 2025 higher level review rating decision issued by an Agency of Original Jurisdiction (AOJ) of the Department of Veterans Affairs (VA).

In the April 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the November 2024 (bilateral hearing loss and unspecified trauma and stressor-related disorder) and December 2024 (right ankle) rating decisions, which were subsequently subject to higher level review. 38 C.F.R. § 20.301.

The Board notes that the November 2024 and April 2025 rating decisions determined that new and relevant evidence had not been received to readjudicate the claim of bilateral hearing loss; however, the AOJ proceeded to adjudicate the claim on the merits. The Board construes the denial on the merits as an implicit finding that new and relevant evidence was submitted. The Board is bound by the favorable finding and will therefore address the merits of the claim. 38 C.F.R. § 3.104(c).

1. Entitlement to an initial rating in excess of 30 percent for unspecified trauma and stressor-related disorder is denied.

The Veteran asserts that his service-connected unspecified trauma and stressor-related disorder has been more severe than the currently assigned rating of 30 percent and that he is entitled to an increased rating. The current appeal period before the Board begins August 26, 2024, the effective date of service connection.

Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The basis of disability ratings is the ability of the body as a whole, or of the psyche, or of a system or organ of the body, to function under the ordinary conditions of daily life, including employment. 38 C.F.R. § 4.10.

When there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability more closely approximates the criteria required for that particular rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7
on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The basis of disability ratings is the ability of the body as a whole, or of the psyche, or of a system or organ of the body, to function under the ordinary conditions of daily life, including employment. 38 C.F.R. § 4.10.

The Veteran's service-connected psychiatric disorder is currently rated at 30 percent disabling under diagnostic code 9413 (unspecified anxiety disorder), effective August 26, 2024. All psychiatric disorders are rated under the General Rating Formula for Mental Disorders.

Under the General Rating Formula for Mental Disorders, a 30 percent evaluation is warranted if the evidence establishes there is 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 normal conversation) due to such symptoms as depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, or mild memory loss (such as forgetting names, directions, or recent events). 38 C.F.R. § 4.130, DC 9310. No other Diagnostic Code may be considered to rate the Veteran's disability. See Copeland v. McDonald, 27 Vet. App. 333, 337 (2015) (when a condition is specifically listed in the rating schedule, it may not be rated by analogy and should be rated under the diagnostic code that specifically pertains to it).

A 50 percent evaluation is warranted if the evidence establishes there is 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. Id.

A 70 percent evaluation is warranted if the evidence establishes 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 a worklike setting); and/or inability to establish and maintain effective relationships. Id.

A 100 percent rating (total occupational and social impairment) is warranted due to symptoms such 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.

When determining the appropriate disability evaluation to assign, the Board's primary consideration is the 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). 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, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). Thus, the Board need not find the presence of all, most, or even some, of the enumerated symptoms to award a specific rating. Id. 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 the Veteran's impairment must be "due to" those symptoms; a Veteran may only qualify for a given disability rating by demonstrating the particular symptoms associated
after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). Thus, the Board need not find the presence of all, most, or even some, of the enumerated symptoms to award a specific rating. Id. 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 the Veteran's impairment must be "due to" those symptoms; a Veteran may only qualify for a given disability rating by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. Vazquez-Claudio, 713 F.3d at 118.

When it is not possible to separate the effects of a service-connected disability and a non-service-connected disability, reasonable doubt must be resolved in the appellant's favor and the symptoms in question must be attributed to the service-connected disability. Mittleider v. West, 11 Vet. App. 181 (1998).

The Veteran was afforded a VA examination in September 2024 in connection with his acquired psychiatric disorder claim. The examiner concluded that the Veteran's acquired psychiatric disorder was manifested by symptoms resulting in occupational and social impairment due to mild or transient symptoms which decrease work efficiency, which corresponds with a 10 percent rating. The examiner noted symptoms of depressed mood, anxiety, and chronic sleep impairment. The Veteran reported a positive family life with adequate social support. The Veteran also reported that, post service, he had completed an IT certification and worked doing sales for two companies. On mental status examination, the Veteran was engaged, his cognition was intact with no observable delusions or hallucinations. He denied current suicidal or homicidal ideation. His speech was normal and mood and affect congruent to conversation. He was oriented to person, place, time, and situation. See September 2024 C&P Exam.

Here, the evidence of record shows that the overall severity level of the Veteran's unspecified trauma and stressor-related disorder most closely approximates the rating criteria at 30 percent. Each of the Veteran's symptoms are specifically contemplated by the 30 percent rating, and the Veteran has not evidenced a single symptom listed in the criteria for a higher rating, or any other symptom of similar frequency, severity, or duration. Therefore, the Board finds that the evidence of record weighs persuasively against a finding that the Veteran's symptoms resulted in the level of impairment required for a rating of 50 percent or higher at any time during the appeal period.

2. Entitlement to a rating in excess of 10 percent for a right ankle disability is denied.

The Veteran asserts that his service-connected right ankle disability is more severe than the currently assigned rating of 10 percent and that he is entitled to a higher rating.

When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also to be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("it is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a criteria.").

Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011).

The Veteran's right ankle disability is rated at 10 percent disabling under 38 C.F.R. § 4
781, 785 (Fed. Cir. 2016) ("it is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a criteria.").

The Veteran's right ankle disability is rated at 10 percent disabling under 38 C.F.R. § 4.71a, Diagnostic Code 5271, for limitation of motion of the ankle, effective August 1, 2020. The current appeal period before the Board begins July 12, 2024, the date of the Veteran's supplemental claim application. See July 2024 VA Form 21-0995.

Under DC 5271, a 10 percent rating is warranted for moderate limited motion of the ankle. A maximum 20 percent rating is warranted for marked limited motion of the ankle. Marked limitation of ankle motion is defined as less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion; moderate limitation of motion is defined as less than 15 degrees dorsiflexion or less than 30 degrees plantar flexion. 38 C.F.R. § 4.71a, DC 5271 (2021).

The Veteran was afforded a VA examination in connection with his right ankle in November 2024. See November 2024 C&P Exam. His plantar flexion was 30 degrees, with pain, and dorsiflexion was 10 degrees, with pain. The examiner noted pain on weight-bearing, active and passive motion, but noted that the pain did not result in or cause functional loss. The examiner did not find evidence of crepitus, localized tenderness or pain on palpation, muscle atrophy, ankylosis, instability, shin splints, or any other pertinent physical findings or symptoms. The Veteran did not report flare-ups of the right ankle during this examination. The Veteran did not report taking any medications for pain.

After review of the evidence of record, the Board finds that a higher 20 percent rating under DC 5271 is not warranted for the right ankle, as there is no evidence of limitation of motion or functional loss that would equate to marked limitation of motion of the ankle. See 38 C.F.R. § 4.71a, DC 5271. While the Veteran has reported painful motion of the ankle, and difficulty with running, walking, or standing for long periods, motion was reduced to no more than 30 degrees plantar flexion and 10 degrees dorsiflexion, which demonstrates nearly half the normal range of motion for the ankle. The Board finds that the Veteran's functional limitations and reported symptoms and their severity are more closely approximated as moderate (i.e., 10 percent rating criteria). The Veteran's right ankle has not demonstrated less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion at any time during the appeal period. Accordingly, a disability rating in excess of 10 percent for the right ankle is not warranted.

The Board has also considered all potentially applicable provisions of the rating schedule, whether or not they have been raised by the Veteran or the record, as required by Schafrath v. Derwinski, 1 Vet. App. 589 (1991). However, there have been no objective finding of ankylosis of the Veteran's right ankle, subastragalar or tarsal joint, malunion of the os calcis or astragalus, or astragalectomy that would provide a higher rating; therefore, Diagnostic Codes 5270, 5272, 5273, and 5274 are not for application. Similarly, the Board does not find any additional foot or ankle symptoms consistent with a finding of severe residuals of a foot injury or loss of use of the foot as required for higher ratings under Diagnostic Code 5284. See 38 C.F.R. § 4.71a, Diagnostic Codes 5270, 5272-5274, 5284. Similarly, use of DC 7804 would not avail the Veteran, as there is no evidence of painful scarring associated with his right ankle condition during the appeal period. See, e.g., November 2024 C&P Exam.

In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's appeal for a rating in excess of 10 percent for a right ankle disability. As the evidence of record persuasively weighs
finding of severe residuals of a foot injury or loss of use of the foot as required for higher ratings under Diagnostic Code 5284. See 38 C.F.R. § 4.71a, Diagnostic Codes 5270, 5272-5274, 5284. Similarly, use of DC 7804 would not avail the Veteran, as there is no evidence of painful scarring associated with his right ankle condition during the appeal period. See, e.g., November 2024 C&P Exam.

In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's appeal for a rating in excess of 10 percent for a right ankle disability. As the evidence of record persuasively weighs against a rating in excess of 10 percent, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

3. Entitlement to service connection for bilateral hearing loss is denied.

The Veteran asserts that his bilateral hearing loss is due to his in-service exposure to hazardous noise.

Service connection may be established for a disability resulting from injury or disease incurred during or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. In the absence of proof of a current disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (Fed. Cir. 1992).

For VA purposes, impaired hearing is considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory threshold for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385.

The claim of service connection for bilateral hearing loss must be denied because there is no competent evidence of any current bilateral hearing loss as defined by VA at any time during the appeal period.

The Veteran presented for a VA audiology examination in February 2021. The examiner conducted controlled speech discrimination testing (Maryland CNC) and pure tone audiometry testing. Puretone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 5 5 5 0 0

LEFT 10 0 5 0 5

No puretone results were 26 decibels or greater. Moreover, the Veteran achieved a 100 percent speech discrimination score in both ears.

The Veteran has not undergone any other reported hearing examinations during the appeal period and there is no medical or lay evidence of any other treatment of his bilateral hearing loss during the claim period. While he is certainly competent to report the symptoms and history of his claimed bilateral hearing loss, the determination of whether a Veteran's bilateral hearing loss constitutes a hearing disability for VA purposes is determined by a mechanical application of the definition found in 38 C.F.R. § 3.385 to audiometric (pure tone threshold and Maryland CNC) testing results.

In sum, as the competent evidence of record indicates that the Veteran does not have current bilateral hearing loss pursuant to 38 C.F.R. § 3.385 at any time just prior to or since his claim was received in July 2024, the first element of service connection, or current diagnosis, is not established, and the claim fails on this basis alone. See Brammer v. Derwinski, 3 Vet. App. 223 (1992) (The presence of a current disability is fundamental to any successful claim of service connection, and in the absence of a current disability, a claim must be denied).

Accordingly, the claim of entitlement to service connection for bilateral hearing loss must be denied.

S. BUSH

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Cooper, Jacob A.

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.

service connection, and in the absence of a current disability, a claim must be denied).

Accordingly, the claim of entitlement to service connection for bilateral hearing loss must be denied.

S. BUSH

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Cooper, Jacob A.

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