PTSD DUE TO COMBAT

Summary

The veteran, who served in the U.S. Navy from June 1988 to January 1998, appeals the denial of an increased rating for posttraumatic stress disorder (PTSD) for the period prior to June 18, 2020. The initial rating decision granted service connection for PTSD with a 50 percent rating from October 3, 2017, and a 70 percent rating from June 18, 2020. The appeal sought to have the 70 percent rating made effective earlier, for the period prior to June 18, 2020. The Board reviewed the VA examination conducted in June 2019, which found the veteran's PTSD resulted in occasional decreases in work efficiency and intermittent inability to perform occupational tasks due to anxiety and mood disturbances, consistent with a 50 percent rating. While the veteran described more severe symptoms in 2002 and a later June 2020 examination supported a 70 percent rating, the Board found the June 2019 examination findings adequately reflected the veteran's functional level at that time. The Board noted the request for an addendum to the June 2019 exam was for etiology, not severity, and the veteran's own statements during the June 2019 exam did not support the higher rating for the earlier period. Therefore, the Board denied the increased rating for the period prior to June 18, 2020.

Rationale

June 2019 VA exam found symptoms consistent with 50% rating; Veteran's statements did not support 70% rating for the earlier period; No current suicidal ideation, violence, or near-constant panic attacks

Full Decision Text

Citation Nr: A26040935
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 260121-626681
DATE: April 30, 2026

ORDER

Prior to June 18, 2020, an initial rating higher than 50 percent for posttraumatic stress disorder (PTSD) with alcohol use disorder is denied.

FINDING OF FACT

Prior to June 18, 2020, the severity, frequency, and duration of the Veteran's PTSD symptoms did not result in occupational and social impairment with deficiencies in most areas.

CONCLUSION OF LAW

Prior to June 18, 2020, the criteria for an initial rating higher than 50 percent for PTSD with alcohol use disorder 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 (DC) 9411.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service in the U.S. Navy from June 1988 to January 1998.

The rating decision on appeal was issued in March 2024 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.  In August 2024, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of the initial decision.  In February 2025, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior decision.

In her January 2026 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 2024 AOJ decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301.  If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review 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. 

Increased Rating

The March 2024 initial rating decision granted service connection for PTSD and assigned a 50 percent rating from October 3, 2017.  A 70 percent rating was assigned from June 18, 2020.  In the January 2026 Notice of Disagreement, the Veteran's attorney limited the appeal to seeking a 70 percent rating for the period prior to June 18, 2020.

The Veteran's PTSD is rated under 38 C.F.R. § 4.130, DC 9411, which is part of the General Formula for Mental Disorders (General Formula).  Under that 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). 

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
 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). 

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 worklike 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.

In the January 2026 NOD, the Veteran's attorney argued that the 70 percent rating assigned from June 18, 2020, should be effective for the entire initial rating period.  He noted that the first VA examination afforded to the Veteran was conducted in June 2019, almost two years after the beginning of the rating period, and that this examination recorded some findings which support a higher 70 percent rating.  He also noted that an addendum opinion was requested, which led to a new VA examination on June 18, 2020, which served as the basis for the 70 percent rating assigned from that date.

The June 2019 VA examiner concluded that the Veteran's PTSD resulted only in occasional decreases in work efficiency and an intermittent inability to perform occupational tasks.  This was due to symptoms of anxiety, panic attacks weekly or less often, and mood disturbances.  These findings are all contemplated by the assigned 50 percent rating.  

In the "remarks" section at the end of the examination report, the examiner noted that the Veteran denied problems with depression but stated that she goes "manic," which included fast speech, spending money, and getting agitated.  She referenced episodes from 2002 when she was overspending and experiencing suicidal ideation.  However, with respect to current symptoms, she denied any current suicidal or homicidal ideation.  She stated her energy level could vary but was normal for months at a time.  She endorsed anger and irritability but stated that she "vented" to her husband and he listened.  She denied any altercations.  She acknowledged panic attacks but stated that these had reduced in frequency since she started taking medication in 2018.

In sum, while the Veteran described episodes of more severe symptoms in 2002, her current level of functioning at the time of the June 2019 VA examination was adequately contemplated by the assigned 50 percent rating.  There were no current periods of violence, suicidal ideation, or near-constant panic attacks consistent with the higher 70 percent rating.

The Board acknowledges the statements from the Veteran's attorney that the June 2019 VA examination required an addendum.  However, that request for an addendum related to addressing the etiology of the Veteran's PTSD and not any inadequacy with assessing its current severity.  Moreover, while the June 2020 examination recorded more severe symptoms warranting a 70 percent rating, that alone does not establish the presence of such symptoms in June 2019, particularly given the Veteran's own statements made during the first examination regarding the state of her PTSD.

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For these reasons, an initial rating higher than 50 percent prior to June 18, 2020, is not warranted.

 

 

JOHN Z. JONES

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Patel, Shamil

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.