Case A26038867

KRISTIN HADDOCK · 2026 · Case ID: A26038867

GRANTED

Summary

The veteran, who served from October 2017 to October 2022, appeals the denial of an increased disability rating for his posttraumatic stress disorder (PTSD). The veteran initially claimed PTSD, anxiety, depression, and adjustment disorder on May 4, 2023, and was denied service connection in February 2024. Following a Higher-Level Review request, service connection for PTSD was granted with a 50 percent rating effective October 2, 2022. The veteran subsequently filed an intent to file on April 15, 2024, and later a VA Form 21-526EZ on August 29, 2024, requesting an increased rating for PTSD. A January 2025 rating decision denied an increase above 50 percent. The Board reviewed the claim for an earlier effective date for the 70 percent rating. The Board found that evidence from August 2, 2023, indicated the veteran's PTSD symptoms caused significant social and occupational impairment, making a 70 percent rating factually ascertainable by that date. The Board granted an earlier effective date of August 2, 2023, for the 70 percent rating for PTSD.

Rationale

Evidence from August 2, 2023, showed social and occupational impairment due to PTSD symptoms.; Symptoms included difficulty adapting to stressful circumstances, persistent negative emotional state, and clinically significant distress.; The Board found that the Veteran's PTSD symptoms more closely approximated a 70 percent disability rating on August 2, 2023.

Special Benefit

EARLIER EFFECTIVE DATE

Docket No.

250506-542278

Full Decision Text

Citation Nr: A26038867
Decision Date: 04/27/26 Archive Date: 04/27/26

DOCKET NO. 250506-542278
DATE: April 27, 2026

ORDER

Entitlement to an earlier effective date of August 2, 2023, but no earlier, for the award of a 70 percent disability rating for posttraumatic stress disorder (PTSD) is granted.

FINDING OF FACT

1. The Veteran filed an increased rating claim within one year of submitting his intent to file on April 15, 2024.

2. It was factually ascertainable that the symptoms of his service-connected PTSD were productive of social and occupational impairment with deficiencies in most areas on August 2, 2023.

CONCLUSION OF LAW

The criteria for an effective date of August 2, 2023, but no earlier, for the grant of a 70 percent disability rating for PTSD have been met. 38 U.S.C. §§ 5107, 5110 (2018); 38 C.F.R. §§ 3.114, 3.155, 3.400 (2025).

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active naval service from October 2017 to October 2022.

This case comes before the Board of Veterans' Appeals (Board) on appeal of an April 2025 Higher-Level Review (HLR) rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). Originally, the Veteran was denied a rating in excess of 50 percent for his PTSD in a February 2025 rating decision. In April 2025, the Veteran submitted a VA Form 20-0996, Decision Review Request: HLR, requesting a review of the February 2025 rating decision. The April 2025 HLR rating decision on appeal was issued in response to that request.

In the May 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 February 2025 agency of original jurisdiction (AOJ) rating decision, which was subsequently subject to HLR. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the February 2025 rating decision, that was subsequently subject to HLR, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 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.

Earlier Effective Date - PTSD

The Veteran asserts that he should be afforded an effective date of July 25, 2023, for the assignment of a 70 percent disability rating for his PTSD. Specifically, the Veteran, through his representative, asserts that VA arbitrarily assigned the Veteran's 70 percent disability rating from the date of the July 2024 intent to file associate with the claim for a noninitial increase. The Veteran, through his representative also assert that there was evidence prior to July 25, 2024, that the Veteran's PTSD more closely warranted a 70 percent rating.

Except as otherwise provided, the effective date of an evaluation and award of compensation based on a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is later. See 38 U.S.C. § 5110; 38 C.F.R. § 3.400(o)(1). However, an earlier effective date may be assigned if, based on all the evidence of record, it is factually ascertainable that an increase in disability occurred within one year prior to the date a complete claim or intent to file a claim was received. 38 U.S.C. § 5110(b)(3); 38 C.F.R. § 3.400(o)(2); Gaston v. Shinseki, 605 F.3d 979, 982-83 (Fed. Cir. 2010).

VA amended its adjudication regulations on March 24, 2015, to require that all claims governed by VA's adjudication regulations be filed on standard forms prescribed by the Secretary, regardless of the type of claim
earlier effective date may be assigned if, based on all the evidence of record, it is factually ascertainable that an increase in disability occurred within one year prior to the date a complete claim or intent to file a claim was received. 38 U.S.C. § 5110(b)(3); 38 C.F.R. § 3.400(o)(2); Gaston v. Shinseki, 605 F.3d 979, 982-83 (Fed. Cir. 2010).

Claimants may indicate their desire for benefits by submitting an intent to file to VA. 38 C.F.R. § 3.155(b). If VA receives a complete application form, as defined by 38 C.F.R. § 3.160(a), within one year of receipt of the intent to file, the complete claim is considered filed as of the date of receipt of the intent to file. Id.

Under the Appeals Modernization Act (AMA), an appellant can preserve an effective date by continuously pursuing a claim. This is accomplished by filing an appropriate administrating review option to an AMA decision as specified in 38 C.F.R. § 3.2500(c) within one year of the issuance of the decision (or within the specified in § 3.2500(f), as applicable to simultaneously contested claims, provided that any appeal to the U.S. Court of Appeals for Veterans Claims must be accepted as timely by that court. 38 C.F.R. § 3.2500(h)(1).

If a claim is continuously pursued it will be considered filed as of the date of the first claim in the continuously pursued chain, not the date the most recent request for review was received. 38 C.F.R. §§ 3.400, 3.2500(c). The available review options to establish continuous pursuit depend on the type of decision that was issued. If the AOJ decision is an initial or supplemental claim, an appellant may submit a (i) supplemental claim, (ii) HLR, or (iii) VA Form 10182, Board appeal, to continuously pursue the appeal. If the decision is an AOJ decision on a HLR request, an appellant may submit a (i) supplemental claim or (ii) appeal to the Board to continuously pursue the appeal.

Under the AMA, a claimant can request an increased rating based on a change or worsening of a service-connected disability by filing a VA Form 21-526EZ, which is known as an initial, or original, increased rating claim. 38 C.F.R. § 3.1(p)(1); see 38 C.F.R. § 3.160(b). However, a VA Form 21-526EZ does not maintain continuous pursuit of the prior claim. See 38 C.F.R. § 3.2500(h)(1). If instead a claimant would like to continuously pursue a rating assigned in a prior decision, within a year of issuance of that decision they should file a request for HLR (on a VA Form 21-0996), a supplemental claim (on a VA Form 21-0995), or Board appeal (on a VA Form 10182). 38 C.F.R. § 3.2500(a).

During an August 2023 VA examination, the Veteran reported that his girlfriend was concerned about his moods and nightmares. He also reported that he had trouble concentrating, that he had a bad semester in school due to flashbacks and distractions, and that he had trouble attending class due to an inability to sleep at night. At that time, it was also noted that the Veteran had moderate depressive symptoms that he reported made it extremely difficult for him to function. The VA examiner assessed that the PTSD criteria exhibited by the Veteran included the following: recurrent intrusive and distressing memories of traumatic events, persistent negative emotional state, irritable behavior and angry outbursts, sleep disturbance, problems with concentration, and disturbance that caused clinically significant distress or impairment in social, occupational, or other important areas of functioning. The VA examiner also assessed that the Veteran's symptoms included depressed mood, anxiety, panic attacks that occurred weekly or less often, and difficulty adapting to stressful circumstances, to include work or a work like setting.

The Veteran originally filed a claim for a mental health condition to include PTSD, anxiety, depression, and adjustment disorder on May 4, 2023.

A November 2023 treatment note documented that the Veteran had a lack of trust in others.

A
the following: recurrent intrusive and distressing memories of traumatic events, persistent negative emotional state, irritable behavior and angry outbursts, sleep disturbance, problems with concentration, and disturbance that caused clinically significant distress or impairment in social, occupational, or other important areas of functioning. The VA examiner also assessed that the Veteran's symptoms included depressed mood, anxiety, panic attacks that occurred weekly or less often, and difficulty adapting to stressful circumstances, to include work or a work like setting.

The Veteran originally filed a claim for a mental health condition to include PTSD, anxiety, depression, and adjustment disorder on May 4, 2023.

A November 2023 treatment note documented that the Veteran had a lack of trust in others.

A January 2024 treatment note documented the Veteran's report that he was easily triggered leading to irritability and anger and that he was hypervigilant. At that time, it was also noted that the Veteran became tearful when he spoke about his traumatic experiences.

A February 2024 treatment note revealed that the Veteran had to leave stores and crowded places due to being triggered and that he could not stay in school because his PTSD symptoms were highly distressing.

In a rating decision, dated February 22, 2024, the Veteran was denied entitlement to service connection for PTSD.

On February 26, 2024, the VA received the Veteran's VA Form 20-0996: Supplemental Claim, in regard to the denial of service connection for his claimed PTSD, anxiety, depression, and adjustment disorder in the February 2024 rating decision.

Another February treatment note revealed the Veteran's report of depressed mood, daily intrusive memories, occasional panic attacks, and nightmares. That treatment note also documented the Veteran's report that he had called the crisis line two weeks prior to that time because he felt hopeless and distressed.

In a February 2024 letter, a private clinical psychologist, Dr. C.A., assessed that the Veteran coped with his mental health diagnosis in healthy ways but remained quite isolated and struggled with related symptoms that were at times debilitating.

In a rating decision dated April 11, 2024, the AOJ found that there was a clear and unmistakable error in the February 2024 rating decision. At that time, the Veteran was granted service connection for PTSD and assigned a 50 percent disability rating effective October 2, 2022.

On April 15, 2024, the Veteran submitted an intent to file. Subsequently, on June 30, 2024, he submitted a VA Form 20-0996, Request for HLR for claims related to left shoulder tendonitis, neck strain, degenerative disc disease of the lumbar spine, headaches, and bilateral hearing loss.

The Veteran submitted another intent to file on July 25, 2024. Later, on August 29, 2024, the VA received the Veteran's VA Form 21-526EZ, at which time he requested an increased rating for his PTSD.

On October 31, 2024, the VA received the Veteran's VA Form 21-526EZ at which time he requested service connection for depression (major depressive disorder) and generalized anxiety disorder (GAD).

In a rating decision dated January 7, 2025, issued in response to the increased rating claim filed in August 2024, the Veteran was denied a rating in excess of 50 percent for his PTSD (which was noted as being claimed as major depressive disorder and GAD).

The VA informed the Veteran of the January 2025 rating decision in a VA notification letter dated January 9, 2025.

On February 3, 2025, the VA received the Veteran's VA Form 20-0995, Supplemental Claim, at which time he requested a higher initial evaluation for PTSD. On the VA Form 20-0995, the Veteran specifically noted that the date of VA decision notice was January 9, 2025.

In a rating decision dated February 28, 2025, the Veteran was again denied entitlement to a rating in excess of 50 percent for his PTSD.

The VA informed the Veteran of the February 2025 rating decision in a VA notification letter dated March 4, 2025.

On April 7, 2025, the VA received the Veteran's VA Form 20-0996, Decision Review Request: HLR, at which time he requested a higher initial evaluation for his PTSD. On that VA Form 20-0996, the Veteran specifically noted that the date of the VA decision notification letter was March 4, 2025.

On April 9, 2025, the AOJ issued a rating decision, in response to the HLR request from April 2025, at which time the Veteran's PTSD was assigned
50 percent for his PTSD.

The VA informed the Veteran of the February 2025 rating decision in a VA notification letter dated March 4, 2025.

On April 9, 2025, the AOJ issued a rating decision, in response to the HLR request from April 2025, at which time the Veteran's PTSD was assigned a 70 percent disability rating, effective July 25, 2024.

In this case, based on the evidence above, the Board initially emphasizes that the Veteran never submitted a Supplemental Claim, HLR request, nor Board appeal (VA Form 10182), related to the April 2024 rating decision that awarded service connection for his PTSD. As such, the Board is not permitted to review evidence that dated back to the date of claim in May 2023. Additionally, albeit within one year after the April 2024 rating decision, the Veteran's August 2024 VA Form 21-526EZ, as opposed to a Supplemental Claim, broke the chain of continuous pursuit as it was considered an initial claim for an increased rating. See 38 C.F.R. § 3.2500(h)(1).

Nonetheless, as noted above, there is an exception to the effective date being the date of claim in instances where the increase in disability was factually ascertainable within one year of the date of claim. 38 C.F.R. § 3.400(o)(2). Therefore, in this case, the earliest possible effective date is April 15, 2023 (i.e., one year prior to receipt of the intent to file a claim).

Here, the Board finds that it was factually ascertainable that during the one-year "lookback" period prior to his April 15, 2024, intent to file that the Veteran's PTSD symptoms warranted a 70 percent disability rating. In this regard, the evidence as early as August 2, 2023, revealed that the Veteran's PTSD symptoms were manifested by social and occupational impairment with deficiencies in most areas. In particular, the evidence of record reveals that his symptoms included difficulty in adapting to stressful circumstances, a persistent negative emotional state, and disturbance that caused clinically significant distress. Additionally, the Board notes that prior to July 25, 2024, the evidence reveals that the Veteran's PTSD symptoms were objectively assessed to be, at times, debilitating. Further, the Board finds that the evidence prior to that time also indicated that the Veteran may have experienced suicidal ideation as he contacted the crisis line because he felt helpless and distressed. As such, when the Veteran's disability picture is considered as a whole, the Board finds that it was factually ascertainable that his PTSD symptoms more closely approximated a 70 percent disability rating on August 2, 2023.

The Board finds that the evidence of record does not contain any evidence that the Veteran filed any increased rating claim for his service-connected PTSD prior to his intent to file submitted on April 15, 2024. Additionally, there is no medical or lay evidence of record in which the Board can determine with any degree of certainty a specific date on which it was factually ascertainable that an increase in the Veteran's PTSD symptoms occurred prior to August 2, 2023, during the relevant evidentiary window.

Accordingly, the Board finds that the appropriate effective date in this case is August 2, 2023, which is the date that it became factually ascertainable that the Veteran's PTSD symptoms warranted a 70 percent disability rating. As such, the Board finds that the criteria for an effective date of August 2, 2023, but no earlier, for PTSD is warranted. 38 U.S.C. § 5107(b) (2018); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

Kristin Haddock

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board A. Randall

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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