ADJUSTMENT DISORDER

W. DAKNIS · 2026 · Case ID: A26040200

MIXED

Summary

The veteran, who served in the U.S. Army from September 2017 to May 2020, appeals a March 2025 rating decision that reduced her disability compensation. The veteran sought increased ratings for an adjustment disorder, previously rated at 10 percent, and a back condition, previously rated at 20 percent. The Board found that the reduction of these ratings was void ab initio because the Department of Veterans Affairs Regional Office (RO) failed to address whether there was an actual improvement in the veteran's ability to function under ordinary conditions of life and work, as required by regulations and case law for ratings in effect for more than five years. Consequently, the Board granted the restoration of the 10 percent rating for the adjustment disorder and the 20 percent rating for the back condition, both effective June 1, 2025. However, the Board also remanded the claims for increased ratings for both conditions. The March 2024 VA examination for the adjustment disorder was deemed inadequate because the examiner did not address relevant VA treatment records showing ongoing mental health symptoms, despite diagnosing an acute stress reaction. For the back condition, the March 2024 VA examination was inadequate because the examiner did not specify whether the symptoms and functional limitations were assessed with or without the ameliorating effects of medication, which is required for musculoskeletal conditions. The Board also noted that the veteran's appeal of a May 2024 rating decision was untimely.

Rationale

Reduction void ab initio due to failure to address improvement in ability to function under ordinary conditions of life and work.; March 2024 VA examination inadequate; examiner did not address relevant VA treatment records showing ongoing mental health symptoms.; Remanded for new examination to determine severity and symptoms.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250717-565905

Full Decision Text

Citation Nr: A26040200
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 250717-565905
DATE: April 29, 2026

ORDER

Restoration of a 10 percent disability rating for adjustment disorder with mixed anxiety and depressed mood (adjustment disorder), effective June 1, 2025, is granted.

Restoration of a 20 percent disability rating for lumbosacral strain (back condition), effective June 1, 2025, is granted.

REMANDED

Entitlement to a disability rating greater than 10 percent for an adjustment disorder is remanded.

Entitlement to a disability rating greater than 20 percent for a back condition is remanded.

FINDINGS OF FACT

1. The rating reduction for the Veteran's adjustment disorder was not based on sustained improvement under ordinary conditions of life and work.

2. The rating reduction for the Veteran's back condition was not based on sustained improvement under ordinary conditions of life and work.

CONCLUSIONS OF LAW

1. The criteria for restoration of a 10 percent rating for an adjustment disorder effective June 1, 2025, have been met, and the reduction is void ab initio. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.105(e), 3.159, 3.344, 4.1, 4.2, 4.10, 4.130, Diagnostic Code 9440.

2. The criteria for restoration of a 20 percent rating for a back condition effective June 1, 2025, have been met, and the reduction is void ab initio. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.105(e), 3.159, 3.344, 4.1, 4.2, 4.10, 4.71a, Diagnostic Code 5237.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from September 2017 to May 2020.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2025 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO), also known as the Agency of Original Jurisdiction (AOJ). In the July 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 March 2025 AOJ decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

However, because the Board is remanding the claims of increased ratings for an adjustment disorder and back condition, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

The Board notes that the Veteran also sought to appeal issues from the May 2024 rating decision. See July 2025 VA Form 10182. However, the appeal of the May 2024 rating decision was not timely, as the July 2025 VA Form 10182 was received by VA more than one year after the May 10, 2024 notification letter for the May 2024 rating decision.

VA regulations unequivocally provide that, except in limited circumstances, a notice of disagreement (NOD, VA Form 10182) must be submitted to the AOJ within one year of the rating decision being appealed. A notice of disagreement must identify the specific decision and issue(s) therein with which the claimant disagrees. 38 C.F.R. § 20.202, 20.203. VA regulations also provide recourse in circumstances when a filing extension is required. An extension may be granted for good cause if the request is offered in writing and submitted to the Board. See 38 C.F.R. § 20.203(c). Examples of good cause can include serious illness or injury of the appellant or their representative, or an inability to access mail services. 84 Fed. Reg. 138, 153.

The Veteran has not submitted a good cause reason for an extension to appeal the May 2024 rating decision, and the Board has not granted an extension. Therefore, the Board must unfortunately find that the Veteran did not timely appeal the May 2024 rating decision. Therefore,
20.202, 20.203. VA regulations also provide recourse in circumstances when a filing extension is required. An extension may be granted for good cause if the request is offered in writing and submitted to the Board. See 38 C.F.R. § 20.203(c). Examples of good cause can include serious illness or injury of the appellant or their representative, or an inability to access mail services. 84 Fed. Reg. 138, 153.

1. Propriety of rating reduction for an adjustment disorder from 10 to 0 percent, effective June 1, 2025.

2. Propriety of rating reduction for a back condition from 20 to 10 percent, effective June 1, 2025.

Legal Criteria

Regulations provide that where the reduction in evaluation of a service-connected disability is considered warranted and the lower evaluation would result in a reduction or discontinuance of compensation payments currently being made, rating action will be taken. The veteran will be notified of the proposed reduction and that the veteran has 60 days to present evidence showing why the reduction should not be implemented and may request a hearing. 38 C.F.R. § 3.105(e). The reduction will be made effective the last day of the month in which a 60-day period from the date of notice to the payee expires.

Furthermore, in a rating reduction, not only must it be determined that an improvement in a disability has actually occurred, but also that the improvement actually reflects an improvement in a veteran's ability to function under the ordinary conditions of life and work. Brown v. Brown, 5 Vet. App. 413, 420-21 (1993).

The provisions of 38 C.F.R. §§ 4.1, 4.2, and 4.10 require that a reduction in rating be based upon review of the entire history of a veteran's disability. VA must then ascertain whether the evidence reflects an actual change in the disability and whether the examination reports reflecting such change are based on thorough examinations. Faust v. West, 13 Vet. App. 342 (2000). VA is not limited, however, to medical indicators of improvement. Rather, VA may rely on non-medical indicators of improvement to show that a veteran is capable of more than marginal employment. Id. The examination reports on which the reduction is based must be adequate. See Tucker v. Derwinski, 2 Vet. App. 201 (1992) (holding that the failure of the examiner in that case to review the claims file rendered the reduction decision void ab initio).

In addressing whether improvement is shown, the comparison point generally is the last examination on which the rating at issue was assigned or continued. See Hohol v. Derwinski, 2 Vet. App. 169 (1992). Where, however, the rating was continued in order to see if improvement was in fact shown, the comparison point could include prior examinations as well. Collier v. Derwinski, 2 Vet. App. 247 (1992).

Specific requirements must be met in order for VA to reduce certain ratings assigned for service-connected disabilities. See 38 C.F.R. § 3.344; see also Dofflemyer v. Derwinski, 2 Vet. App. 277 (1992). The requirements for reduction of ratings in effect for five years or more are set forth at 38 C.F.R. § 3.344(a) and (b), which prescribe that only evidence of sustained material improvement under the ordinary conditions of life, as shown by full and complete examinations, can justify a reduction; these provisions prohibit a reduction on the basis of a single examination. See Brown, 5 Vet. App. at 417-18. Where doubt remains, the rating agency will continue the rating in effect, and consider scheduling reexamination 18, 24, or 30 months later. 38 C.F.R. § 3.344(b). Where a rating reduction was made without observance of law, the reduction must be vacated, and the prior rating restored. Schafrath, 1 Vet. App. at 595 (1991).

Analysis - Procedural Requirements

By way of history, the Veteran has been service connected for an adjustment disorder at a 10 percent rating and a back condition at a 20 percent rating since May 4, 2020. See January 2026 rating decision
. App. at 417-18. Where doubt remains, the rating agency will continue the rating in effect, and consider scheduling reexamination 18, 24, or 30 months later. 38 C.F.R. § 3.344(b). Where a rating reduction was made without observance of law, the reduction must be vacated, and the prior rating restored. Schafrath, 1 Vet. App. at 595 (1991).

Analysis - Procedural Requirements

By way of history, the Veteran has been service connected for an adjustment disorder at a 10 percent rating and a back condition at a 20 percent rating since May 4, 2020. See January 2026 rating decision codesheet. The Veteran applied for increased ratings for those conditions on January 25, 2024. See January 2024 Application for Disability Compensation and Related Compensation Benefits. Then, the Veteran attended the March 2024 VA examinations for her adjustment disorder and back condition. As a result of those examinations, the AOJ proposed to reduce the adjustment disorder rating to 0 percent and the back condition rating to 10 percent. See May 2024 rating decision. Due to errors in an October 2024 VA letter, the AOJ sent out another letter dated December 20, 2024, in which the Veteran was notified of the proposed reductions. The Veteran was advised that the combined evaluation for all her service-connected disabilities would be reduced from 60 to 50 percent. She was afforded the opportunity to have a pre-determination hearing and was given at least 60 days to present additional evidence. The Veteran did not ask for a pre-determination hearing. Final action to reduce the evaluation for an adjustment disorder and back condition was taken in the March 2025 rating decision and was effective June 1, 2025.

Consequently, the Board finds that the AOJ did not violate any of the procedures required under 38 C.F.R. § 3.105, as the Veteran was notified of her rights, given an opportunity for a hearing and time to respond, and the rating reduction was made effective no sooner than permitted.

Analysis - Substantive Requirements

Therefore, having decided that the process required to reduce the Veteran's adjustment disorder and back condition ratings was correctly followed by the AOJ, the next question is whether the reduction of the disability ratings was proper.

As noted above, the 10 percent rating for an adjustment disorder and 20 percent rating for a back condition were in effect for more than five years at the time of the rating reduction. Accordingly, the provisions of 38 C.F.R. § 3.344 (a) and (b) apply, which require that only evidence of sustained material improvement under the ordinary conditions of life, as shown by full and complete examinations, can justify reduction.

Upon review of the evidence of record, the Board finds that the rating reduction is void ab initio because the AOJ did not address whether there was "an actual improvement in the Veteran's ability to function under the ordinary conditions of life and work." Brown, 5 Vet. App. at 421. The AOJ did not even include the word "improve" in its decision, essentially treating the issue as an increased rating claim. Therefore, since there was no discussion of whether there was actual improvement in the Veteran's ability to function under the ordinary conditions of life and work as required by 38 C.F.R. § 3.344 and the Brown decision, the reduction is void ab initio. Accordingly, restoration of the 10 percent disability rating for an adjustment disorder and the 20 percent disability rating for a back condition, effective June 1, 2025, is granted.

REASONS FOR REMAND

Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claim so that she is afforded every possible consideration. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159.

1. Entitlement to a disability rating greater than 10 percent for adjustment disorder.

Although the Board has restored the 10 percent disability rating for an adjustment disorder, the Veteran contended that the rating should be greater than 10 percent. See January 2024 Application for Disability Compensation and Related Compensation Benefits.

As part of the Veteran's increased rating claim, she was afforded the March 2024 VA examination. The examiner explained that the Veteran no longer had mental health symptoms that were clinically significant enough to warrant a DSM-V psychiatric disorder diagnosis. The examiner explained that the Veteran had an acute stress reaction rather than a chronic psychiatric disorder. As a result, the examiner did not opine on the Veteran's level of occupational and social impairment, nor complete the symptoms section of
disability rating greater than 10 percent for adjustment disorder.

However, the Board finds that the March 2024 VA examination is inadequate. In the remarks section of the disability benefits questionnaire, the examiner stated that the Veteran had symptoms of low mood, being reclusive, nervousness, anxiety, and sleep disturbances. Moreover, the Veteran's VA treatment records during the review period show a diagnosis of anxiety disorder, as well as mental health symptoms of anxiety, restlessness, over-thinking, worry, anger, irritability, memory problems, and sleep trouble. See February 2023, March 2023, November 2023, February 2024 VA treatment records. Nevertheless, the March 2024 VA examiner did not address those relevant VA treatment records which still showed a mental health condition diagnosis and mental health symptoms within the review period. This was a pre-decisional duty to assist error, and the Board must remand for a new examination. See 38 C.F.R. § 20.802(a).

2. Entitlement to a disability rating greater than 20 percent for a back condition.

Although the Board has restored the 20 percent disability rating for a back condition, the Veteran contended that the rating should be greater than 20 percent. See January 2024 Application for Disability Compensation and Related Compensation Benefits.

As part of the Veteran's increased rating claim, she was afforded the March 2024 VA examination. The examiner explained that the Veteran took anti-inflammatory medication for her back condition. The Board must discount beneficial effects of medication for musculoskeletal increased rating claims when the relevant rating criteria do not explicitly contemplate medication use. Ingram v. Collins, 38 Vet. App. 130 (2025); Jones v. Shinseki, 26 Vet. App. 56 (2012). Since the applicable diagnostic codes for the back do not explicitly contemplate medication use, the Board must discount the beneficial effects of medication when assigning an evaluation for the Veteran's musculoskeletal disability. See 38 C.F.R. § 4.71a. However, the March 2024 VA examiner did not indicate whether the Veteran's back condition symptoms and degree of functional limitation were with or without the use of anti-inflammatory medication. As such, the examination was inadequate, and relying on the examination was a pre-decisional duty to assist error. See 38 C.F.R. § 20.802(a). Accordingly, the Board will remand for an examiner to provide an addendum opinion on what the severity of the Veteran's back condition would be without the ameliorating impact of medication.

The matters are REMANDED for the following action:

1. Schedule the Veteran for an examination by an appropriate clinician to determine the severity of the service-connected adjustment disorder with mixed anxiety and depressed mood, as well as any other diagnosed mental health conditions. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to identified mental health conditions alone.

2. Obtain an addendum opinion from an appropriate clinician to determine the severity of the Veteran's back condition with and without the use of medication. The addendum opinion should be provided by the examiner that rendered the March 2024 VA examination if available. Otherwise, obtain an opinion from another qualified clinician.

The examiner should review the March 2024 VA examination and opine as to whether the results of that examination were with the ameliorating effects of anti-inflammatory medication.

Specifically, the examiner should provide an opinion on what the Veteran's back condition symptoms would have been but for the ameliorating effects of medication. Additionally, the examiner should specifically address the ameliorating effects of medication on every aspect of the March 2024 VA Disability Benefits Questionnaire, including but not limited to (1) all functional limitations of the back, including range of motion (ROM) (active and passive motion) after observed repetitive use, after repeated use over time, during a flare-up
Otherwise, obtain an opinion from another qualified clinician.

The examiner should review the March 2024 VA examination and opine as to whether the results of that examination were with the ameliorating effects of anti-inflammatory medication.

Specifically, the examiner should provide an opinion on what the Veteran's back condition symptoms would have been but for the ameliorating effects of medication. Additionally, the examiner should specifically address the ameliorating effects of medication on every aspect of the March 2024 VA Disability Benefits Questionnaire, including but not limited to (1) all functional limitations of the back, including range of motion (ROM) (active and passive motion) after observed repetitive use, after repeated use over time, during a flare-up, and due to pain on both weightbearing and non-weightbearing positions; and (2) favorable or unfavorable ankylosis of the spine.

If the examiner opines that the medication would not have an impact, the examiner must specifically state that opinion.

A complete rationale must be given for all opinions and conclusions expressed. If it is not possible to provide a specific measurement without resorting to mere speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training).

The Veteran may also be scheduled for another VA examination if deemed necessary by the examiner to properly evaluate the back condition with and without the ameliorating impact of medication.

W. Daknis

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board D. Brodbeck

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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