PTSD DUE TO COMBAT

Summary

The Veteran, who served from November 1984 to June 1992, appeals the denial of an increased disability rating for PTSD. The Board previously denied an increased rating for PTSD beyond 30 percent, but this decision was vacated and remanded by the Court of Appeals for Veterans Claims due to inadequate reasoning regarding the Veteran's suicidal ideation. The RO later increased the PTSD rating to 50 percent effective October 23, 2024. The Board reviewed the evidence, including VA examinations from August 2022 and February 2023, private treatment records, and lay statements. The Veteran's symptoms, such as depressed mood, anxiety, suicidal ideation, difficulty adapting to stress, and irritability, were analyzed against the VA's rating schedule for mental disorders. While the Veteran reported suicidal ideation, the Board found it did not rise to the level of 100 percent criteria, as he denied intent or plan and had supportive family and church involvement. The Board concluded that the Veteran's symptoms most closely approximated a 70 percent rating, citing occupational and social impairment with deficiencies in most areas. The Board found the VA examinations adequate and the evidence supported a 70 percent rating, but no higher, from June 30, 2022.

Rationale

Symptoms approximated 70% criteria; Suicidal ideation noted but not at 100% level; Adequate VA examinations and lay statements considered

Full Decision Text

Citation Nr: A26040877
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 230517-348813
DATE: April 30, 2026

ORDER

A disability rating of 70 percent, but no higher, for posttraumatic stress disorder (PTSD) is granted.  

FINDING OF FACT

The evidence of record establishes that the signs and symptoms of the Veteran's PTSD most nearly approximates occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgement, thinking or mood, but does not more closely approximate total occupational and social impairment.

CONCLUSION OF LAW

The criteria for a disability rating of 70 percent for the Veteran's PTSD have been met.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code (DC) 9411.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active-duty military service from November 1984 to June 1992.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2023 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). 

In the May 2023 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected to appeal the issue listed above and requested a direct review of the evidence considered by the RO. Therefore, the Board may only consider the evidence of record at the time of the May 2023 decision on appeal. 38?C.F.R. § 20.303.

In a January 2025 decision, the Board dismissed the Veteran's claims for earlier effective dates for the award of service connection for radiculopathy of the left lower extremity and PTSD.  The Board awarded an increased disability rating of 20 percent, and no higher, for the Veteran's low back disability from June 30, 2022, and denied a rating in excess of 40 percent for such from February 29, 2024.  The Board also denied a rating in excess of 10 percent for radiculopathy of the left lower extremity and a disability rating in excess of 30 percent for PTSD.  The Veteran appealed this determination to the U.S. Court of Appeals for Veterans Claims (Court).  In an October 2025 Order, the Court granted an August 2025 Joint Motion for Partial Remand (Joint Motion or JMPR), which had the effect of vacating the Board's denial of an increased rating for his PTSD.  The dismissal of the appeals for earlier effective dates for the award of service connection for radiculopathy of the left lower extremity and PTSD were left undisturbed.  The denial of the increased ratings claims for the Veteran's low back disability and radiculopathy of the left lower extremity as well as the award of an increased rating for his low back disability were also left undisturbed.

The Board notes that in a May 2025 rating decision, the RO increased the Veteran's disability rating for his PTSD to 50 percent disabling, effective October 23, 2024.

The Joint Motion

In the August 2025 JMPR, the parties indicated that vacatur and remand of the Board's decision to deny a disability rating in excess of 30 percent for the Veteran's service-connected PTSD was necessary because the Board did not provide an adequate statement of reasons and bases for its decision. Specifically, the parties agreed that "the Board did not adequately address the level of impairment caused by Appellant's suicidal ideation."  The parties noted that "the Court has held that the presence of suicidal ideation may cause occupational and social impairment with deficiencies in most areas sufficient to warrant a 70% rating.  Bankhead v. Shulkin, 29 Vet. App. 10, 20 (2017)."  It was noted that "while the Board acknowledged the Appellant's report of suicidal ideation, it failed to explain why Appellant's suicidal ideation did not cause occupational and social impairment with deficiencies in most areas sufficient to warrant a 70% rating."  As such, the issue was remanded in order "for the Board to adequately address the level of impairment caused by Appellant's suicidal ideation."

In the January 2025 decision, the Board acknowledged that the Veteran had raised the issue of entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities but found that this was not raised as part and parcel of his claims of increased ratings for his radiculopathy of the left lower extremity, low
 that "while the Board acknowledged the Appellant's report of suicidal ideation, it failed to explain why Appellant's suicidal ideation did not cause occupational and social impairment with deficiencies in most areas sufficient to warrant a 70% rating."  As such, the issue was remanded in order "for the Board to adequately address the level of impairment caused by Appellant's suicidal ideation."

In the January 2025 decision, the Board acknowledged that the Veteran had raised the issue of entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities but found that this was not raised as part and parcel of his claims of increased ratings for his radiculopathy of the left lower extremity, low back disability, or PTSD prior to the May 2023 rating decision on appeal.  The Board notes that, as reflected in the August 2025 JMPR, the parties did not object to the Board's general recitation of the facts or procedural history of this case.  Rather, the JMPR focused on the Board's failure to address the level of impairment caused by the Veteran's suicidal ideation in regard to his claim for an increased rating for his service-connected PTSD.

Accordingly, in the interest of judicial economy, the Board will focus the current analysis on addressing the deficiencies identified in the August 2025 JMPR and incorporates all other facts and analysis of the January 2025 Board decision by reference. See generally Carter v. Shinseki, 26 Vet. App. 534, 542-43 (2014), vacated on other grounds sub nom Carter v. McDonald, 794 F.3d 1342 (Fed. Cir.  2015).  

The Board is aware of the Court's instructions in Fletcher v. Derwinski, 1 Vet. App. 394 (1991), to the effect that a remand by the Court is not "merely for the purposes of rewriting the opinion so that it will superficially comply with the 'reasons or bases' requirement of 38 U.S.C. § 7104(d)(1). A remand is meant to entail a critical examination of the justification for the decision." The Board's analysis of the Veteran's claim has been undertaken with that obligation in mind.

1. Entitlement to a disability rating in excess of 30 percent prior to October 23, 2024, and in excess of 50 percent therefrom for service-connected PTSD 

The Veteran contends that his PTSD is more severe than what is represented by the current staged ratings.

Under the General Formula for Mental Disorders (General Formula), the Board must conduct a "holistic analysis" that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130.  The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages.  Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013). 

The issue in this appeal is whether the Veteran's associated symptoms caused the level of impairment required for a disability in excess of 30 percent prior to October 23, 2024, and in excess of 50 percent therefrom.  The Board concludes that the Veteran's symptoms more closely approximated the symptoms associated with a 70 percent rating, but no higher, and resulted in a level of impairment that most closely approximates the level of impairment associated with a 70 percent rating. 

A 30 percent rating is assigned when symptoms such 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), cause 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).

A 50 percent rating is assigned when symptoms such 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; or difficulty in establishing and maintaining effective work and social relationships cause occupational and social impairment with reduced reliability and productivity.

A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermitt
 periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and normal conversation).

A 50 percent rating is assigned when symptoms such 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; or difficulty in establishing and maintaining effective work and social relationships cause occupational and social impairment with reduced reliability and productivity.

A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; 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); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.

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 inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation or own name.

VA and private treatment records, the August 2022 and February 2023 VA examinations, and lay statements of record show that the Veteran's PTSD was manifested by symptoms associated with a 30 percent rating (depressed mood, anxiety, suspiciousness, and chronic sleep impairment), symptoms associated with a 70 percent rating (suicidal ideation and difficulty adapting to stressful circumstances), and symptoms associated with a 100 percent rating (memory loss for names of close relatives).  

The Veteran also had symptoms that are not listed with a specific rating, such as hypervigilance, sleep disturbance, anhedonia, irritability, and being easily startled.  However, his symptoms of sleep disturbance and anhedonia are similar to chronic sleep impairment and depressed mood, which is contemplated by a 30 percent rating.  His symptoms of hypervigilance, irritability and being easily startled are similar to disturbances of motivation and mood, which is contemplated by a 50 percent rating.  These symptoms do not more closely approximate the level of impairment contemplated by a 100 percent rating.

The Board finds the August 2022 and February 2023 VA examinations are adequate for rating purposes, as the examiners interviewed the Veteran, reviewed the electronic claims file (including medical records), provided detailed behavioral observations, and reported all signs and symptoms necessary for evaluating the Veteran's PTSD under the rating criteria. The Veteran does not contend otherwise.

The Board notes that the Veteran expressed suicidal ideation, which is similar to persistent danger of self-harm, which is contemplated by the 100 percent criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 19 (2017).  However, the severity, frequency, and duration of the Veteran's suicidal ideation has not risen to the level contemplated by the 100 percent disability rating.  The Veteran regularly denied thoughts, intent, or a plan involving self-harm in existing treatment records and at the August 2022 and February 2023 VA examinations.

Following a review of the claims file, the Board finds that the severity, frequency, and duration of the Veteran's symptoms more closely approximate the symptoms contemplated by a 70 percent rating, which are less severe, less frequent, and shorter in duration than those contemplated by a 100 percent rating. See 38 C.F.R. § 4.126. 

Although the evidence of record indicates that the Veteran has had memory loss of names of close family members, which is contemplated by a 100 percent disability rating, the evidence overall does not demonstrate the level of impairment associated with a 100 percent disability rating.

As to the level of social and occupational impairment caused by the Veteran's symptoms, a June 2022 statement from the Veteran's spouse reflects that he has expressed severe depression and suicidal ideation, avoids leaving the home, and expresses shame about being in public.  At the August 2022 VA examination, the Veteran reported significant social isolation.  He further indicated that, prior to his retirement in 2018 as a first responder and fire inspector, he experienced ongoing difficulties at work, as his duties triggered memories of his military service.  At the February 2023 VA examination, the Veteran reported diminished motivation and indicated that
100 percent disability rating, the evidence overall does not demonstrate the level of impairment associated with a 100 percent disability rating.

As to the level of social and occupational impairment caused by the Veteran's symptoms, a June 2022 statement from the Veteran's spouse reflects that he has expressed severe depression and suicidal ideation, avoids leaving the home, and expresses shame about being in public.  At the August 2022 VA examination, the Veteran reported significant social isolation.  He further indicated that, prior to his retirement in 2018 as a first responder and fire inspector, he experienced ongoing difficulties at work, as his duties triggered memories of his military service.  At the February 2023 VA examination, the Veteran reported diminished motivation and indicated that his mental health symptoms adversely affect his relationship with his spouse, noting that he becomes irritable and snaps at her during periods of low mood.

Upon review of the record, the Board finds that the Veteran experienced occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking or mood beginning on June 30, 2022. The VA examinations, medical treatment records, and lay statements of record indicate that the Veteran had mental health symptoms that were moderate to severe in nature and resulted in moderate to severe functional impairment.

The Veteran's quality of life is significantly lowered by his symptoms, and his social functioning is negatively impacted. The Veteran's condition limits his ability to engage in effective interpersonal interactions, and his PTSD symptoms, including disturbances in motivation and mood, have adversely affected him both socially and occupationally.  The Veteran has reported that his PTSD symptoms were exacerbated by his prior employment as a first responder.  His social history reflects a pattern of isolation and diminished motivation to participate in public activities.  Additionally, he has endorsed irritability, including instances of snapping at his spouse during periods of mood disturbances.

The Board finds that the evidence does not demonstrate the level of impairment associated with a 100 percent rating. As noted above, the Veteran's symptoms were either contemplated by or consistent with a 70 percent rating. While the Veteran was unemployed during the appeal period, he is not totally occupationally and socially impaired.  The Veteran has reported being close to his wife and that she is a good support for him. The evidence of record also indicates that the Veteran is involved in his church.  See February 2023 VA examination. 

The evidence also demonstrates that the Veteran was alert and oriented with appropriate thought processes and communication.  The August 2022 and February 2023 VA examinations indicated that the Veteran was alert and oriented.  He was attentive and did not endorse memory problems.  His thought processes were noted to be "organized, logical, coherent, and sequential with no evidence of loose associations."  The examiner noted that the Veteran's "capacity to make sound, reasoned, and responsible decisions appears to be intact."

Accordingly, the Board finds that the requirements for a disability rating of 70 percent, but no higher, have been met from June 30, 2022, the date of his claim.

 

 

M. Donohue

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S. Morrad, Counsel

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.