MAJOR DEPRESSIVE DISORDER

MICHAEL MARTIN · 2026 · Case ID: A26040751

DENIED

Summary

The Veteran, who served from July 1965 to June 1969, appeals the February 2025 rating decision that continued his 30 percent rating for major depressive disorder with anxious distress. The Board reviewed the evidence of record at the time of the prior decision, including VA treatment records from Richmond VAMC, private treatment records from Lifestance Health and Memorial Regional Medical Center, and two VA examinations conducted in January 2022 and November 2024. The Veteran also submitted lay statements in June 2021 and November 2023. The primary issue is whether the Veteran's symptoms warrant an increased rating beyond 30 percent. The Board found that the Veteran's symptoms, including depressed mood, anxiety, panic attacks occurring weekly or less often, and chronic sleep impairment, most closely approximated the criteria for a 30 percent rating. This conclusion was supported by both the January 2022 and November 2024 VA examinations, which found occupational and social impairment with occasional decreases in work efficiency and intermittent inability to perform tasks, but generally satisfactory functioning. While the Board acknowledged the lay evidence mentioning impaired impulse control, it found this single symptom insufficient to warrant a higher rating, as the overall impairment did not meet the criteria for 50 percent or higher. The Board denied the claim for an increased rating beyond 30 percent.

Rationale

Symptoms most closely approximated 30% criteria; VA examinations supported 30% rating; Single symptom of impaired impulse control insufficient for higher rating

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

9434

Docket No.

260218-625868

Full Decision Text

Citation Nr: A26040751
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 260218-625868
DATE: April 30, 2026

ORDER

A rating in excess of 30 percent for major depressive disorder with anxious distress is denied.

FINDING OF FACT

The Veteran's major depressive disorder with anxious distress has been manifested by symptoms indicative of 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 conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), and chronic sleep impairment.

CONCLUSION OF LAW

The criteria for a rating in excess of 30 percent for major depressive disorder with anxious distress have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9434.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from July 1965 to June 1969.

On appeal is a February 2025 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) that continued the 30 percent rating assigned for the Veteran's service-connected major depressive disorder with anxious distress.

In February 2026 the Veteran filed VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) and 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) 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.

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.

The matter is now before the Board of Veterans' Appeals (Board) for further adjudication.

Increased Rating

Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities. 38 C.F.R. Part 4. The Schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of or incident to service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

In considering the severity of a disability, it is essential to trace the medical history of the Veteran. 38 C.F.R. §§ 4.1, 4.2, 4.41. Consideration of the whole recorded history is necessary so that a rating may accurately compensate the elements of disability present. 38 C.F.R. § 4.2; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Although the regulations do not give past medical reports precedence over current findings, the Board is to consider the Veteran's medical history in determining the applicability of a higher rating for the entire period in which the appeal has been pending. Powell v. West, 13 Vet. App. 31 (1999).

Entitlement to a rating in excess of 30 percent for major depressive disorder with anxious distress.

The Veteran's major depressive disorder with anxious distress is rated pursuant to the criteria of Diagnostic Code 9434 under the General Rating Formula for Mental Disorders.

Under this General Rating Formula, a 30 percent rating is warranted for 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 conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).

A 50 percent rating is warranted when there is occupational and social impairment, but with reduced reliability and productivity due to such
anxious distress.

The Veteran's major depressive disorder with anxious distress is rated pursuant to the criteria of Diagnostic Code 9434 under the General Rating Formula for Mental Disorders.

A 50 percent rating is warranted when there is occupational and social impairment, but with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, 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 task); 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 ideations; 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 the veteran's personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work like setting); inability to establish and maintain effective relationships.

A 100 percent rating is warranted 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 inability to perform the 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.

Here, the Veteran seeks a rating in excess of 30 percent for the Veteran's major depressive disorder with anxious distress.

After review of the medical and lay evidence in this case, the Board finds that the currently assigned 30 percent rating is warranted for the Veteran's major depressive disorder with anxious distress.

VA treatment records from the Richmond VAMC are associated with the Veteran's claim file. These records contain the Veteran's VA examination for mental health disorders that are discussed in detail below.

Private treatment records from Lifestance Health are associated with the Veteran's claims file. In summary, these records reflect diagnosis and treatment for mental health issues. For example, an October 2020 record reflects the Veteran had an intake interview for treatment of depression. The examiner noted the Veteran takes medication; that he did not have thoughts or feelings of self-harm or harm to others; and that he denied hospitalizations and suicidal behaviors, but admitted to rare suicidal thoughts. The Veteran noted he has a wife and engaged in infidelity on his part; that he has no kids; and that he was a drummer. A Mental Status Exam was conducted and the following was noted: the Veteran was well dressed and groomed; appears stated age; alert; speech was normal rate, volume, tone, and prosody; thought process was linear and logical; associations were normal; there was no evidence of delusion, preoccupation, obsession, suicidal ideation. or homicidal ideation; no perceptual disturbances; judgment was intact; insight was intact; fully oriented including to person. place, situation, and time; recent memory intact; remote memory intact; attention span/concentration intact; impulse control intact; language intact; aware of current events; mood was euthymic; affect congruent; psychomotor activity normal; and attitude was cooperative. Therapist will provide support in acceptance and managing depression.

Private treatment records from Memorial Regional Medical Center are also associated with the Veteran's claims file. In summary, these records reflect diagnosis and treatment for mental health issues. For example, a June 2021 record reflects the Veteran was "Positive for behavioral problems. Negative for depression, hallucinations and memory loss. The patient is nervous/anxious. The patient does not have insomnia." It was noted the Veteran had a diagnosis of bipolar disorder, most recent episode (or current) depressed, severe, specified as with psychotic behavior, stable/improving. It was noted the Veteran was prescribed medication (Lorazepam/ATIVAN) to take daily as needed for Anxiety. Patient states he takes 1 tab 2 x daily.

The Veteran underwent a VA examination in January 2022. Two diagnoses were noted: PTSD and major depressive
In summary, these records reflect diagnosis and treatment for mental health issues. For example, a June 2021 record reflects the Veteran was "Positive for behavioral problems. Negative for depression, hallucinations and memory loss. The patient is nervous/anxious. The patient does not have insomnia." It was noted the Veteran had a diagnosis of bipolar disorder, most recent episode (or current) depressed, severe, specified as with psychotic behavior, stable/improving. It was noted the Veteran was prescribed medication (Lorazepam/ATIVAN) to take daily as needed for Anxiety. Patient states he takes 1 tab 2 x daily.

The Veteran underwent a VA examination in January 2022. Two diagnoses were noted: PTSD and major depressive disorder with anxious distress. In terms of his relevant social/marital/family history, the Veteran reported that he has been married over 50 years and they have a good relationship. He does not have much contact with anyone else anymore (his choice). He and his wife take care of their godson (age 5) and they both enjoy that. In terms of his relevant occupational and educational history, he reported that he had a lot of trouble keeping jobs in the past because of his drug, mood, and anxiety problems. He retired from Phillip Morris in 2008. In terms of his relevant mental health history, to include prescribed medications and family mental health, the Veteran reported that he gets mental health counseling and the medications are helping a lot. He said that his moods are a lot better, his anxiety is under control, and he is not having any trouble with irritability. He said that he sleeps about four hours a night but feels that he gets enough rest. His appetite is good and he has gained 10 pounds lately. His energy level is "ok," and he does not get any panic attacks with his current medications. He said that he spends his time relaxing and watching television. He reported that he does not spend time with family or friends. He does most of the shopping and gets out of the house most days. For VA rating purposes, the following symptoms were noted: depressed mood; anxiety; panic attacks that occur weekly or less often; and chronic sleep impairment. The examiner made the following behavioral observations: The Veteran was neatly groomed/casually dressed, and was cooperative during the evaluation. He understood the purpose of the evaluation and consented to the limits of confidentiality. The Veteran's mood was neutral and affect was appropriate. On mental status exam, Veteran was alert and oriented. Immediate memory was good (4 of 4 objects) and delayed recall was fair (3 of 4 objects after five minutes). Fund of information was good. Mental control was good on days-of-the-week-backwards and while subtracting serial 3's. This Veteran's communication skills were good. Abstract thinking was good and judgment was good. Thoughts were clear and logical. Thought content was unmarkable. There were no signs of delusions or hallucinations. Suicide risk is estimated to be low at this time. The examiner opined the Veteran's mental health symptoms result in 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.

An addendum opinion from the examiner above was submitted in September 2022. The examiner stated, "I mistakenly clicked on the YES box concerning PTSD rather than the NO box. The report clearly shows that this Veteran has problems with depression and anxiety rather than PTSD. Therefore, the correct diagnosis is Major Depressive Disorder with Anxious Distress. His records support this diagnosis."

The Veteran underwent another VA examination in November 2024. The examiner diagnosed the Veteran with major depressive disorder with anxious distress. In terms of his relevant social/marital/family history, the Veteran reported living with his wife, married since 1966. He explained that he is still helping to take care of his Godson who is living with them on weekends and holidays. He described his relationship with his wife as, "good, very good," and endorsed having social support ("yeah, I believe so"). When asked how his relationships are impacted by his depression, the Veteran explained, "some people don't want to be bothered with me because of my attitude." When prompted about what he does when upset, the Veteran explained, "I take a pill." He also endorsed yelling at his Godson at times ("my wife reminds me I shouldn't be doing that; I don't do that very often, I'm used to his ways"). Later in the interview, the Veteran noted, "sometimes there's a void between us [him and his wife], slightly irritable, she understand me better than sometimes I understand myself." He explained, "she gets a little depressed my attitude, the way I sleep all day, all night, it bothers her." In
asked how his relationships are impacted by his depression, the Veteran explained, "some people don't want to be bothered with me because of my attitude." When prompted about what he does when upset, the Veteran explained, "I take a pill." He also endorsed yelling at his Godson at times ("my wife reminds me I shouldn't be doing that; I don't do that very often, I'm used to his ways"). Later in the interview, the Veteran noted, "sometimes there's a void between us [him and his wife], slightly irritable, she understand me better than sometimes I understand myself." He explained, "she gets a little depressed my attitude, the way I sleep all day, all night, it bothers her." In terms of his relevant occupational and educational history, the Veteran reported having been retired since 1986. When asked to describe his typical day, the Veteran reported "rest," denying hobbies. For VA rating purposes, the Veteran's symptoms were: depressed mood; anxiety; and chronic sleep impairment. The examiner's behavioral observations were as follows: The Veteran arrived for the appointment, using a cane to ambulate. He was pleasant and cooperative throughout the clinical interview. On mental status exam, the Veteran was alert and oriented. Orientation was intact for person, time, place, and situation. Immediate memory was good; delayed memory was poor, 0 of 4 objects recalled after five minute delay (2 of 4 objects recalled upon receiving category prompts). Fund of information was good. Mental control was good when asked to spell "world" backwards and while subtracting serial 3's from 20. There was no abnormality of gait, posture or deportment. Speech functions were appropriate for rate, volume, prosody, and fluency. This Veteran's communication skills were good, with appropriate eye contact. Speech revealed normal rate and flow. He described his mood as, "somber." Abstract thinking, judgment, and insight appeared to be good. Thought content was clear and logical with no evidence of delusions or hallucinations. Suicide risk is estimated to be low acute and low chronic at this time. The examiner opined the Veteran's mental health symptoms result in 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.

Lay evidence is also associated with the Veteran's claim file. In a June 2021 lay statement, the Veteran's spouse stated, "We married a year after he entered the military. After he returned from the military, he started having problems with sleeping and hearing things. He was very easily agitated and very hard to get along with. Every little thing would set him into a rage. He lost several jobs because of his behavior. He began to physically and emotionally abuse me, something he never did to me before he entered the military. He has anxiety attacks and often gets very depressed with psychotic behavior."

In a November 2023 lay statement, the Veteran stated, "My anxiety, and depression effects the relationships that I have in my life. Back when I had a job, my anxiety, and depression caused problems with my co-workers. I was told to be medicated, and to see a therapist. I isolate myself, and don't have a desire to go out and do anything, which effects my marriage. I have a short fuse with my wife as I don't have much tolerance or patience. I avoid going in town as much as possible. I go maybe once a week. When I am out, I get irritable, and I don't like to be around the busy crowded areas. I have paranoia. I am constantly alert and waiting for something bad to happen. I don't trust others, and I don't make friends. I have camera at home, and I constantly look at them. Several times during the day, and at night I will check locks and windows to make sure they are secure. I also check the outside frequently. I have nightmares 3 to 4 times a week. My mind is constantly going. I feel like I have no peace within me. My tinnitus effects my state of mind often. It makes me anxious, and irritable. I feel like I hear voices sometimes, which I am now medicated for. I struggle with my self worth. I hate feeling this way, and I just want to be happy and normal again."

Given the nature, frequency and severity of the Veteran's psychiatric symptoms as shown by the cumulative evidentiary record, the Board finds that the Veteran's level of functioning has not more nearly approximated occupational and social impairment occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (
state of mind often. It makes me anxious, and irritable. I feel like I hear voices sometimes, which I am now medicated for. I struggle with my self worth. I hate feeling this way, and I just want to be happy and normal again."

Given the nature, frequency and severity of the Veteran's psychiatric symptoms as shown by the cumulative evidentiary record, the Board finds that the Veteran's level of functioning has not more nearly approximated occupational and social impairment occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, 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 task); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. Rather, the Veteran's psychiatric symptoms and overall level of impairment have most closely approximated the criteria for a 30 percent rating under the General Rating Formula during the entire appellate period.

This is supported by the January 2022 VA examination in which the examiner opined, after an in-person interview and examination of the Veteran, and review of his records, that the Veteran's overall functioning resulted in 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 conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). The Board notes this is the same opinion of the November 2024 VA examiner who also conducted an in-person interview and examination of the Veteran.

The Board acknowledges that the lay evidence in this case indicated the Veteran's symptoms include "impaired impulse control (such as unprovoked irritability)." While this symptom is part of the criteria for a 70 percent rating, reference to a single symptom included in the 70 percent rating is insufficient to warrant an increased rating in this case. The 70 percent rating is warranted for when there is occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. After review of the record and interview of the Veteran, the January 2022 VA examiner and the November 2024 VA examiner both determined that the Veteran's mental health symptoms were not productive of social or occupational impairment worse than that contemplated by the 30 percent rating.

The Board finds as fact that during the period on review for this appeal the Veteran's PTSD symptoms result in 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 conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). Thus, the severity, frequency, and duration of the Veteran's reported symptoms have not risen to the level contemplated by the 50 percent, 70 percent or 100 percent disability rating.

The claim for a rating in excess of 30 percent for the Veteran's service-connected major depressive disorder with anxious distress is denied.

Martin T. Mitchell

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Bess, T.

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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