PTSD DUE TO COMBAT

Summary

The Veteran, a veteran who served from January 2002 to January 2005 and April 2006 to March 2008, appeals the July 2021 rating decision concerning his service-connected post-traumatic stress disorder (PTSD). The Veteran contended he was entitled to a rating higher than the 50 percent he was already receiving for PTSD. The Board reviewed the evidence, including the Veteran's testimony from a May 2023 hearing, VA treatment notes, and a July 2021 VA examination. The VA examiner noted symptoms of anxiety, suspiciousness, weekly panic attacks, sleep impairment, motivation/mood disturbances, and difficulty maintaining work/social relationships. The Veteran testified to anger issues, passive suicidal ideation, memory problems, and occasional hygiene difficulties. The Board found that the Veteran's symptoms, including irritability, passive suicidal ideation, and difficulty adapting to stress, rose to the level of occupational and social impairment with deficiencies in most areas, consistent with the criteria for a 70 percent rating. However, the Board determined the evidence did not support a 100 percent rating, as there was no gross impairment in thought processes, persistent delusions/hallucinations, grossly inappropriate behavior, or persistent danger to self or others. Resolving all reasonable doubt in the Veteran's favor, the Board granted a 70 percent rating for PTSD, denying a higher rating.

Rationale

Symptoms consistent with 70% rating criteria; Inability to establish/maintain effective relationships; Irritability, angry outbursts, passive suicidal ideation; Difficulty adapting to stressful circumstances; Evidence does not support 100% rating

Full Decision Text

Citation Nr: A26040185
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 210805-177044
DATE: April 29, 2026

ORDER

Entitlement to a 70 percent rating for post traumatic stress disorder (PTSD) is granted.

FINDING OF FACT

Over the course of the entire appeal period, the Veteran's PTSD most closely approximated occupational and social impairment with deficiencies in most areas. 

CONCLUSION OF LAW

The criteria for a 70 percent rating for PTSD have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 4.14.14, 4.130, Diagnostic Code (DC) 9411. 

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served honorably from January 2002 to January 2005 and from April 2006 to March 2008.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2021 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).

In an August 2021 VA Form 10182 Notice of Disagreement (NOD), the Veteran requested a hearing before the Board and an opportunity to submit evidence at the hearing and within 90 days following the hearing. 38 C.F.R. § 20.202. 

In May 2023, the Veteran testified at a hearing before the undersigned Veterans Law Judge; a transcript of the hearing is of record.

1. Entitlement to a 70 percent rating for PTSD is granted.

The Veteran contends that he is entitled to a rating in excess of 50 percent for his PTSD.

The Veteran's service-connected PTSD is rated under DC 9411, which utilizes the General Rating Formula for Mental Disorders. 38 C.F.R. § 4.130. Under that Formula, a 50 percent rating is assigned when 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 rating is warranted for 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 the inability to establish and maintain effective relationships. Id.

A 100 percent rating is assigned for 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. Id.

Evaluation under 38 C.F.R. § 4.130 is "symptom-driven," meaning that "symptomatology should be the fact-finder's primary focus when deciding entitlement to a given disability rating" under that regulation. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-17 (Fed. Cir. 2013). The symptoms listed are not exhaustive, but rather "serve as examples of the type and degree of symptoms, or their effects, that would justify a particular rating." Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). In the context of determining whether a higher disability evaluation is warranted, the analysis requires considering "not only the presence of certain symptoms[,] but also that those symptoms have caused occupational and social impairment in most of the referenced areas" - i.e., "the regulation... requires an ultimate factual conclusion as to the Veteran's level of impairment in 'most areas.'" Vazquez-Claudio, 713 F.3d at 117-18 ; 38 C.F.R. § 4.130.

Further, when evaluating a mental disorder, the Board must consider the "frequency, severity, and
 that would justify a particular rating." Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). In the context of determining whether a higher disability evaluation is warranted, the analysis requires considering "not only the presence of certain symptoms[,] but also that those symptoms have caused occupational and social impairment in most of the referenced areas" - i.e., "the regulation... requires an ultimate factual conclusion as to the Veteran's level of impairment in 'most areas.'" Vazquez-Claudio, 713 F.3d at 117-18 ; 38 C.F.R. § 4.130.

Further, when evaluating a mental disorder, the Board must consider the "frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran's capacity for adjustment during periods of remission," and must also "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 (a).

The Veteran was afforded a VA examination in July 2021. The examiner noted "occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation." The Veteran reported use of medication, and engagement in anger management classes. The examiner noted symptoms of anxiety, suspiciousness, panic attacks that occur weekly or less often, sleep impairment, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships.

VA treatment notes confirm the Veteran attended anger management classes. See e.g. April 2021 VA Treatment Note. Additionally, the Veteran noted various symptoms of being tired, having low energy, trouble sleeping, nervousness, anxious, continuous worry, trouble relaxing, easily annoyed or irritable, fearful, and easily startled.

In his May 2023 hearing, the Veteran testified to having anger issues and passive suicidal ideation especially when he's angry. He noted issues with short term memory and frequently zoning out, which put him in dangerous situations like while driving. He noted isolating himself from people, including at work. He also relayed that he occasionally had problems maintaining his personal hygiene to include brushing his teeth and showering. 

Resolving all reasonable doubt in his favor, the Board finds that the Veteran's psychiatric symptoms rise to the level of severity contemplated by the rating criteria at 70 percent throughout the period on appeal. The Board has reviewed the pertinent medical and lay evidence, including VA treatment notes, VA examination reports, and the Veteran's testimony, and finds that his service-connected PTSD presented a picture consistent with occupational and social impairment with deficiencies in most areas, as contemplated by the criteria for a 70 percent rating, throughout the entire period on appeal. Specifically, the Veteran endorsed an inability to establish and maintain effective relationships; irritability and angry outbursts, passive suicidal ideation, and difficulty in adapting to stressful circumstances (including work or a work-like setting).

On the other hand, the Board finds that the evidence of record does not support a higher disability rating of 100 percent at any time during the appeal. In the absence of evidence of 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); and disorientation to time or place, the Board finds that the criteria for the next higher rating, 100 percent, have not been demonstrated. There was no evidence of memory loss for names of close relatives, or his own name. The Veteran was not found to be disoriented. The evidence did not show persistent delusions or hallucinations. The evidence did not show gross inappropriate behavior or gross impairment in communication. His thought processes have not demonstrated gross impairment. Therefore, the Board finds that the evidence did not more nearly approximate the criteria for a rating of 100 percent at any time throughout the appeal, and a rating greater than 70 percent is not shown.

Accordingly, the Board resolves reasonable doubt in favor of the Veteran and finds that the criteria for a 70 percent rating for PTSD, but not higher, were met. A rating in excess of 70 percent for the period on appeal is denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021). 

 

 

Marcus N. Fulton

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Love, Kelsey

The Board's decision in this case is binding only with respect